AMA Federation Letter on MACRA Reform VI

Dear Speaker Johnson, Majority Leader Schumer, Minority Leader McConnell, and Minority Leader Jeffries:

The undersigned national medical societies and state medical associations write to collectively urge Congress to prioritize and advance several key bills and legislative proposals that provide greater fiscal stability for physicians and reform key elements of the Medicare Access and CHIP Reauthorization Act (MACRA). The current Medicare Physician Payment System (MPPS) is increasingly unsustainable and the necessary policy reforms can no longer be delayed without severe repercussions for patient access and quality of care.

The foundational component of strengthening the current payment system is refining the Medicare Physician Fee Schedule (MPFS) to accurately reflect the fiscal and clinical realities of medical practice today. To accomplish this pressing task, we focus on four key areas of reform:

  1. Enacting an annual, permanent inflationary payment update in Medicare that is tied to the Medicare Economic Index (MEI);
  2. Budget Neutrality reforms;
  3. An overhaul of MACRA’s Merit-based Incentive Payment System (MIPS); and
  4. Modifications to Alternative Payment Models (APM).
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