On July 30, U.S. Senators John Boozman (R-AR), Peter Welch (D-VT), Roger Marshall, MD (R-KS), Angus King (I-ME), Thom Tillis (R-NC), and Jeanne Shaheen (D-NH) introduced the Provider Reimbursement Stability Act to modernize Medicare’s Physician Fee Schedule (MPFS) by creating better predictability in physician payment. A version of this legislation was previously introduced in the House of Representatives and was passed favorably through the Ways and Means Committee unanimously.

As noted by AAOS Advocacy Council Chair Joel Mayerson, MD, FAAOS: “Orthopaedic surgeons are dedicated to caring for Medicare beneficiaries and helping them maintain mobility, independence, and quality of life. The Provider Reimbursement Stability Act represents a meaningful step toward a more stable and sustainable Medicare payment system that supports both patients and the physicians who care for them.”

The Provider Reimbursement Stability Act would:

• increase the budget neutrality threshold from $20 million to $57.64 million and index it to the Medicare Economic Index (MEI) every five years to address rising practice costs;
• revise spending estimates and budget neutrality adjustments based on utilization rates derived from claims data;
• provide updates to direct costs used to calculate practice expense relative value units (RVUs), including clinical wage rates and medical supplies and equipment, not less often than every five years; and
• limit year-to-year positive or negative variances in the conversion factor to no greater than 2.5%.

“We commend the Senate for recognizing the growing challenges facing physician practices, including rising costs and years of reimbursement instability. Ensuring fair and predictable payment is not just about supporting physicians; it is about protecting access to high-quality musculoskeletal care for millions of older Americans,” Dr. Mayerson added.