Provider Reimbursement Stability Act of 2023 (H.R. 6371)
Provider Reimbursement Stability Act of 2023 (H.R. 6371) is a bipartisan bill introduced in the House of Representatives on November 13, 2023. The bill aims to stabilize the Medicare Physician Fee Schedule (PFS) by addressing several issues related to budget neutrality and ensuring more predictable payment updates for providers.
Key Provisions of the Bill:
Increase in the Budget Neutrality Threshold: The bill proposes raising the budget neutrality threshold from $20 million to $53 million in 2025, and it will be adjusted annually based on the Medicare Economic Index (MEI) starting in 2026. This adjustment aims to reduce the frequency and impact of cuts due to budget neutrality adjustments.
Utilization Corrections: H.R. 6371 introduces a mechanism to reconcile overestimates or underestimates in projected utilization for services. This will allow the Centers for Medicare & Medicaid Services (CMS) to make corrections based on actual utilization data, preventing large financial discrepancies and avoiding undue reductions in physician payments.
Regular Practice Cost Updates: The bill mandates that CMS update elements of direct practice costs—such as clinical wage rates, medical supply prices, and equipment prices—every five years to maintain the accuracy and relevance of payment calculations.
Guardrails for Payment Variances: The legislation seeks to cap year-to-year changes in the Medicare physician payment schedule’s conversion factor at 2.5%, providing more predictability for physicians. This limitation excludes changes from specific statutory updates like the Merit-based Incentive Payment System (MIPS) or future MEI updates.
The bill has gained support from a diverse group of sponsors, including both Republicans and Democrats, and has been forwarded by the Subcommittee to the full committee for further consideration.
Current Status:
The bill has bipartisan support, with 33 co-sponsors from both parties, and aims to provide more predictability and stability in Medicare reimbursements for physicians, addressing long-standing issues with payment volatility and practice sustainability. was introduced in the House of Representatives on November 13, 2023, by Rep. Gregory Murphy (R-NC). The bill has been referred to the House Committee on Energy and Commerce, as well as the Ways and Means Committee. It was forwarded by the Subcommittee on Health to the full committee by voice vote on November 15, 2023, and is currently awaiting further action in the full committee.
https://www.congress.gov/bill/118th-congress/house-bill/6371