Bill would give docs 2% pay boost, with next year's rule very close to launch
Momentum is building for physician pay solutions to be incorporated into a massive congressional reconciliation bill, a fix that would affect doctors and therapists delivering care in nursing homes.
The American Medical Association at its annual meeting this week championed a Senate bill that calls for the reversal of a 2.83% pay cut that went into effect Jan. 1, 2025 and also applies a 2% raise. Introduced in May, it’s a companion to a House Bill that was introduced in January but left out of both a short-term spending plan passed in March and the House reconciliation package.
The immediate goal is to get the Senate to fold language from the Medicare Patient Access and Practice Stabilization Act of 2025 into its reconciliation package, on which lawmakers are trying to hit a July 4 voting deadline.
“The Senate bill, like its House counterpart, H. 879, takes a meaningful step toward reestablishing Medicare payment stability,” AMA CEO and Executive Vice President James L. Madara, MD, wrote in a letter to Sen. Roger Marshall, MD (R-KS).
In recent years, CMS has finalized statutorily imposed cuts that have been quickly remedied by Congress following concerns that payments have not kept up with inflation. But physicians and therapists have been billing at a reduced rate since the start of the year.
It’s so late in the year that the physician fee schedule for calendar year 2026 has already been at the White Office for Management and Budget — the last stop before proposal — for seven weeks.
“It’s unusual that Congress has not been able to get provider relief over the finish line this year,” ADVION CEO Cynthia Morton told McKnight’s Long-Term Care News Friday. “They tried but when the package fell apart late last year, then our opportunity dried up. This year, leadership has been solely focused on reconciliation, which is primarily a spending reduction exercise.”
House Republicans did not add a bill from Rep. Greg Murphy (R-NC) calling for a retroactive update but instead added a measure requiring inflationary increases at 75% of the Medicare Economic Index in 2026 and 2027.
Morton said she was grateful for that inclusion but noted that the lower reimbursement is affecting skilled nursing providers.
“By Congress not providing any help to mitigate the fee schedule reductions, plain and simple, it reduces funds for patient care,” she said.
