In recent developments, various draft legislative proposals threatening substantial Medicare payment cuts to physicians in urban and suburban regions were circulating in Congress. The California Medical Association (CMA) successfully halted the progression of these proposals, preventing their consideration in committee this week, contrary to initial expectations. However, CMA is urging Congress to conduct a thorough examination of the potential consequences of Medicare geographic payment proposals before implementing changes, emphasizing the need to avoid unintended negative impacts on physicians and patients across both urban and rural communities.

While the intention behind these proposals was to support rural physicians, CMA expresses apprehension that they could have significantly and inappropriately altered the geographic payment adjustments in the Medicare physician fee schedule. This could result in reduced payments to the majority of physicians nationwide, including those in rural areas, thereby worsening existing patient access to care challenges. CMA's analysis reveals that, instead of aiding rural physicians, these proposals might, in some instances, have no impact, and in others, have the opposite effect, leading to cuts.

In a letter addressed to the leaders of key congressional committees, CMA acknowledges the healthcare challenges faced in rural areas and advocates for comprehensive solutions to improve medical care access. However, the association emphasizes the importance of avoiding distortions in the fee schedule and ensuring accurate adjustments that account for a physician's local costs of providing care. CMA believes that alternative approaches can assist rural areas without further distorting geographic adjustments in the fee schedule and imposing cuts on physicians, especially given the current healthcare environment.

Concerns Regarding the Medicare Geographic Practice Cost Index (GPCI):

Medicare adjusts physician payments to accommodate local geographic costs of care, encompassing factors like medical malpractice insurance, office rent, staff wages, supplies, and physician wages. These adjustments address significant geographic cost variations, ensuring adequate payment for physicians and equitable access to care for Medicare seniors.

While recognizing ongoing efforts to reform the Medicare physician payment system, CMA, along with other state medical associations, expresses specific concerns about proposals tying Medicare physician rent reimbursement to rents paid by Federally Qualified Health Centers. There is worry that this could lead to reduced rent payments for all physicians nationwide. Additionally, CMA opposes changes diminishing the impact of the Physician Work GPCI (physician wages) due to rising cost-of-living expenses. CMA calls for a careful evaluation of these proposals by CMS before implementing changes, emphasizing the potential unintended negative consequences on access to care.