Federal Legislative Update
End-of-Year Legislative Wrap-up of 2024
Before leaving Washington, DC for the holidays, Congress passed a continuing resolution, or CR, to fund the federal government through March 2025. The CR also includes a farm bill extension, disaster aid, and several healthcare provisions.
The CR did extend current telehealth flexibilities, quality measure funding, and the work geographic index floor (GPCI) through March 2025. Additionally, the bill averts a potential across-the-board Medicare payment reduction resulting from statutorily mandated PAYGO requirements.
Although early versions of the CR included an additional increase to the Medicare Physician Fee Schedule (MPFS) conversion factor (CF), broader politics prevented this provision from inclusion in the final package signed into law.
For more information contact
Rebecca Spangler, ACR Senior Government Affairs Director.
Medicare Payment
In the CY 2025 Medicare Payment Fee Schedule (MPFS) final rule, released November 2024, included a positive budget neutrality update to the MPFS conversion factor (CF) of 0.02%. However, expiration of short-term relief added by Congress for 2024 results in a 2025 MPFS CF that is approximately -2.83% below the 2024 CF.
ACR and the physician and non-physician provider group community will continue to advocate for short-term relief at the earliest possible legislative opportunity, most likely Q1 of 2025.
The provider community will continue to work with Congress on long-term Medicare payment reform. Potential solutions include, but are not limited to, an annual inflationary update to the MPFS (based on Medical Economic Index) and tweaks to the statutorily required application of budget neutrality which we believe will help stabilize the payment system. Substantive Medicare payment reform will be a multi-year effort that will need the collaboration of the entire provider community and a willingness from Congress to make a significant investment in the program.
For more information contact Ashley Walton, ACR Government Affairs Director.
Physician Workforce
With the passage of a “clean CR”, Congress did not take action to address shortages of radiologists or other health care professionals before year-end. Just as the 118th Congress adjourned, Sens. Cortez Masto (D-NV), Cassidy (R-LA.), Cornyn (R-TX), and Bennet (D-CO.), all members of the Senate Finance Committee and a bipartisan Medicare Graduate Medical Education (GME) working group, released draft legislative text to improve the Medicare GME program. The legislation would:
• Expand Medicare-supported residency positions in areas and specialties with critical shortages, like primary care and psychiatry.
• Support rural hospitals in building residency training infrastructure.
• Improve federal data collection to better allocate GME funding and address workforce gaps
Specifically, the proposal would add 5,000 Medicare-funded residency slots to train new doctors from 2027 through 2031. A quarter of the new slots would go to training primary care doctors, and 15 percent would go to training psychiatrists. The legislation aims to target shortages in rural and underserved areas, which would get priority when the new slots are distributed.
This framework could be used as a basis for legislation in 2025 and ACR will continue to advocate to Congress for several short and long-term solutions to address the shortage of radiologists.
For more information contact Rebecca Spangler, ACR Senior Government Affairs Director.
PAMA/AUC Implementation
ACR continues to work closely with congressional staff to get its amended appropriate use criteria (AUC) legislative language passed. The Congressional Budget Office (CBO) has performed an initial analysis to confirm savings from a study by The Moran Company (TMC). In addition to the amended bill’s potential savings, ACR GR staff will continue to highlight the many other advantages of amending AUC and continue to seek inclusion in future healthcare-related legislation.
No Surprises Act
Legislation to strengthen compliance with provisions of the NSA, the No Surprises Enforcement Act (HR 9572), which would financially penalize health insurance companies that fail to pay physicians within 30 days of the conclusion of the independent dispute resolution (IDR) process, did not pass prior to the end of the year and will have to be reintroduced in the 119th Congress for consideration.
The lawsuits related to the NSA continue to play out in court. An October 30th court decision put an end to physicians’ undefeated streak in the NSA court cases. The court ruled partly against ACR members and other physicians in TMA III. The TMA III lawsuit challenges the Government’s methodology for calculating the Qualifying Payment Amount (QPA).
Maintaining the court misread the NSA’s statutory provisions regarding the calculation of the QPA methodology, particularly the “ghost rates”, the TMA filed a petition for rehearing of the Government’s TMA III appeal and seeks to have the full “banc” or group of judges rehear and overturn the three-judge panel’s partial ruling for the Government.
For more information contact Josh Cooper, ACR Vice President Congressional Affairs.
Artificial Intelligence
In December, the Bipartisan House Task Force on AI released its end-of-year report. This is intended to inform Congressional actions and priorities on AI issues in the future. The report covers all industries but of key importance, health care recommendations include:
• Ensure AI safety/transparency, particularly for AI that denies or approves care/coverage.
• Support NIH and other agencies’ research into healthcare AI.
• Create incentives to ensure appropriate risk management practices.
• Explore expanding FDA authority to add more post-market surveillance capabilities.
• Examine relevant liability laws and standards.
• Support appropriate payment mechanisms.
AI will likely remain a Congressional priority in the 119th Congress.
For more information contact Michael Peters, ACR Senior Director, Government Affairs.
