Congressman Brett Guthrie, Chairman of the House Committee on Energy and Commerce, and Congressman Morgan Griffith, Chairman of the Subcommittee on Health, announced on May 14 a hearing titled ‘Examining the Medicare Physician Fee Schedule, MACRA, and Opportunities for Payment Reforms.’ The hearing is scheduled for May 20 at 2:00 PM ET in the Rayburn House Office Building.
Guthrie and Griffith said, “As the Committee continues working to improve care for seniors, this hearing will examine efforts under the Medicare Access and CHIP Reauthorization Act (MACRA) to reform Medicare physician payment and explore current challenges in the Medicare physician fee schedule. Despite efforts in MACRA to move past annual ‘doc fixes’ and enhance seniors’ quality of care, we have continued to see physician payment instability in the Medicare program. This uncertainty, in addition to other regulatory burdens, creates challenges for providers and, ultimately, the beneficiaries they serve. This hearing will examine these long-standing challenges and help identify solutions to stabilize physician payment and protect seniors’ access to care.”
Dr. Dana Smetherman testified on behalf of The American College of Radiology (ACR), stating that diagnostic radiologists provide care for a high number of individual Medicare beneficiaries across fifty-six distinct specialties. According to Smetherman: “From using low-dose CT lung screening to reduce lung cancer mortality to providing guideline-based breast cancer screening to promote earlier detection, the impact of imaging to improve morbidity and survival is well documented. Imaging also plays a crucial role in the diagnosis and treatment of emergency and hospital patients and accelerates emergency department diagnoses and throughput. Through early and accurate diagnosis, appropriate utilization management, diagnostic error prevention, and proactive risk mitigation, radiology substantially reduces avoidable downstream complications, unnecessary procedures, and excess utilization.”
Smetherman said that workforce shortages persist due to rising imaging demand combined with a limited supply of radiologists. She also addressed financial pressures exacerbated by what she described as a long-broken Medicare physician payment system that encourages consolidation among practices. Smetherman outlined three main components needed for Fee-For-Service Medicare payment reform: payment adequacy with an annual inflation adjuster; updates related to budget neutrality; and MACRA reform tailored for specialties like radiology.
The ACR recommends adding a statutory annual inflation adjuster to Medicare’s Physician Fee Schedule due to declining reimbursement rates when adjusted for inflation compared with other provider types who receive annual adjustments. Smetherman highlighted issues created by budget neutrality requirements that result in volatility among different specialties’ reimbursements year-to-year.
The testimony further called for reforms within MACRA so that alternative payment models are accessible for facility-based specialists such as radiologists who often do not have direct patient encounters or use traditional evaluation codes. Additional recommendations included eliminating certain penalty structures within MIPS (Merit-based Incentive Payment System), aligning reporting requirements with specialty registries already used by radiology groups such as ACR’s National Radiology Data Registry (NRDR), increasing flexibility around electronic health record requirements for non-patient-facing clinicians like radiologists or pathologists, encouraging outcome-oriented measures relevant specifically to imaging services rather than generic process metrics or cost measures designed primarily for primary-care relationships.
Further details about this hearing can be found at the organization’s press release.
