MGMA weighs in on proposed CR from Congress

The Medical Group Management Association (MGMA) is calling a proposed continuing resolution (CR) from the U.S. Congress "a mixed bag" when it comes to addressing healthcare concerns.

Congress on December 17 introduced a stopgap measure to keep the government funded through March 14. It has until December 20 to pass the measure or face a funding lapse for federal services, including those in healthcare and health sciences.

Part of the proposed CR calls for delaying Medicaid disproportionate hospital share pay cuts for 2025 until January 2027 and extending certain Medicare telehealth services through 2026.

Among other components, the CR would temporarily increase the Medicare physician fee schedule (MPFS) by 2.5% for 2025. This would offset the 2.83% pay cut that the Centers for Medicare & Medicaid Services (CMS) finalized for the new year.

Radiology groups previously expressed concern about changes to reimbursement under the MPFS. While CMS estimates a 0% change to reimbursement for radiology, nuclear medicine, and radiation oncology, an ACR analysis suggested that interventional radiology will have a 2% decrease in reimbursement.

The MGMA said it is pleased that alternative payment model (APM) incentive payments will be increased to 3.53% and the 1.0 Medicare work geographic practice cost index (GCPI) will be extended.

“These are big wins for medical groups,” said Anders Gilberg, senior vice president of government affairs for the MGMA.

However, the association expressed disappointment that Congress “failed to fully remedy” the looming 2025 Medicare payment cut to physician practices.

“Any cut, however fractional, is unacceptable,” Gilberg said.

The MGMA added that not including legislation to reform prior authorization, despite having bipartisan support, “represents a huge congressional end-of-year failure and another win for big insurance to the detriment of America's patients.”

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