December 1, 2024
The year ahead in legislative and regulatory activity promises to be interesting. Here are some of the issues to keep your eye on:
- Physician Payment. On November 1, the Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2025 Medicare Physician Fee Schedule (PFS) final rule, which reduced payment rates by 2.83% in CY 2025 compared to the average payment rates for CY 2024. This is the fifth year in a row that the CMS fee schedule proposal lowered payments to physicians and other clinicians. “In the short term, there is a 2.9% proposed cut in the final rule, so we will be working to try and get relief from that. In the long-term, we will be looking at fixes that including Medicare economic index updates built into the budget,” Alex Bardakh, MPP, CAE, PALTmed senior director, advocacy and strategic partnerships, said.
- Medicare Patient Access and Practice Stabilization Act. On October 29, a bipartisan group of House members introduced the Medicare Patient Access and Practice Stabilization Act of 2024 (H.R. 10073), which proposes a 4.73% payment increase for physicians in 2025.
- Telehealth. “CMS had no authority to extend the COVID-era provisions that expanded telehealth beyond rural areas and included many more originating sites. These provisions will expire on December 31, 2024, unless Congress takes action,” Mr. Bardakh said. “There are bi-partisan bills in Congress that extend these provisions for two years, and another for a permanent fix that PALTmed and others are pushing to be included in the end-of-the-year legislative package,” said Mr. Bardakh.
- Staffing Mandate. Repeal of the nursing home staffing rule is possible, and Congress could use up to $22 billion in savings from fully blocking or delaying CMS’ implementation of the nursing home minimum staffing rule to pay for other health-care priorities. However, it remains unclear whether Congress has the votes for this action.
- CHANGE Act. The Ways and Means Committee passed the Concentrating on High-Value Alzheimer’s Needs to Get to an End (CHANGE) Act (H.R. 4752/S.2379) as part of a larger package earlier this year. The bill improves the Welcome to Medicare and Medicare Annual Wellness Visits by authorizing clinicians to use tools identified by the National Institute on Aging (NIA) to complete the cognitive assessment component of the visits. PALTmed is part of a coalition supporting this bill.
- The Future of the Center for Medicare and Medicaid Innovation (CMMI). The future of CCMI is uncertain, including how to align financial incentives for clinical practitioners and facility providers. PALTmed will be watching this closely, especially as practice groups, facilities, and physicians continue the move from fee-for-service to value-based care models.
With a new Congress and administration comes opportunities to educate decision-makers and their teams on geriatrics and post-acute and long-term care. Realize that they may not be familiar with all the issues and the implications of various bills and actions on our nation’s older adults and the practitioners who care for them. You need to offer your insights and expertise to help them. Sharing personal stories of how legislation affects your patients and your practice—from a constituent’s viewpoint—can have an impact. Even if you didn’t vote for the person, it is important to make connections and try to find common ground so you can build relationships.
You don’t have to be an advocacy expert, as PALTmed stays on top of the issues. Read the association’s policy articles in the weekly PALTnews e-newsletter and use the PALTmed Policy Finder, which makes it easy to search the association’s resolutions, white papers, and position statements addressing various topics. You can view the top issues of interest to PALTmed members here.