The recently introduced Provider Reimbursement Stability Act, H.R. 8163, takes a major step in modernizing Medicare physician payment. The bipartisan bill modernizes key budget neutrality rules, ensuring fairness and predictability for medical practices and stability for physicians and patients. Make your voice heard: Contact your member of Congress and urge them to support commonsense Medicare payment reforms by cosponsoring this bipartisan bill. 

This bill is a step in the right direction toward creating stability for physicians and keeping doctor-owned practices sustainable for Medicare patients, while helping prevent further consolidation that drives up costs and reduces patient choice.

Introduced by Rep. Greg Murphy, M.D. (R-N.C.) and Rep. Tom Suozzi (D-NY), H.R. 8163 promotes reimbursement stability and protects physicians by: 1) updating the budget neutrality threshold, 2) mandating that CMS evaluate the actual base costs for running a medical practice at least every five years, and 3) revising how CMS addresses incorrect billing codes.

Currently, budget neutrality dictates that if spending increases in one area exceed $20 million, they must be offset by other health care costs. The $20 million budget neutrality threshold has remained the same since the early 1990s and has never been adjusted for inflation. H.R. 8163 would modernize this outdated provision, providing a long-overdue threshold increase to $54.3 million, and indexing it every five years based on the cumulative percentage increase in the Medical Economic Index (MEI).  

This bill requires CMS to regularly evaluate medical practice costs (i.e. clinical wage rates, equipment, medical supplies, etc.) to prevent large swings in payment rates. In addition, H.R. 8163 directs CMS to correct major errors in billing code estimates by reviewing actual claims data and making prospective rate adjustments, thus preventing deep, unnecessary cuts under current budget neutrality guidelines that stem from inaccurate utilization projections.