Urges Congress to Act Now
Alexandria, VA – AMGA called on Congress to utilize the remaining days of the 119th Congress to stop a series of Medicare cuts set to hit clinicians on January 1, 2027.
In a letter to House and Senate leadership, AMGA outlined several impending reductions to Medicare reimbursement that will hinder the ability of medical groups and integrated systems of care to meet their communities’ healthcare needs.
"Patients don't experience Medicare policy one rule at a time, and neither do the AMGA members that care for them,” said Jerry Penso, MD, MBA, AMGA president and CEO. “Congress should treat these cuts as the combined threat to patient care that they are."
To protect patient access to care, AMGA is calling on Congress to:
- Stop cuts to Medicare Part B reimbursement: Prevent the finalized 1.83% and 2.31% cuts to the Physician Fee Schedule (PFS) conversion factor.
- Prevent Hospital Outpatient Prospective Payment System (OPPS) cuts to 340B entities: Delay the finalized cut to payment for 340B-acquired drugs until the Centers for Medicare & Medicaid Services (CMS) has representative, multiyear data, and keep the current, more gradual 340B remedy recoupment schedule.
- Stop the 340B drug rebate model: Halt the shift from upfront discounts to post-sale rebates, as rebates would strain safety-net providers' cash flow.
- Prevent drastic Clinical Laboratory Fee Schedule (CLFS) cuts: Prevent the CY 2027 reductions and reform how CLFS rates are set so they reflect a representative sample of the laboratory market, including physician office and medical group laboratories.
- Extend the Advanced Alternative Payment Model (APM) incentive: Ensure clinicians have the resources to continue investing in value-based care.
- Continue the Medicare Geographic Practice Cost Index (GPCI) floor of 1.0: Protect payment in rural and low-cost areas beyond Dec. 31, 2026.
- Make the telehealth waivers permanent: End the cycle of short-term extensions before the waivers expire on Dec. 31, 2027.
- Prevent the 20% same-day evaluation and management (E/M) payment reduction: Maintain full payment for significant, separately identifiable E/M services reported with modifier -25.
Taken together, these actions would prevent a series of compounding cuts from taking effect on Jan. 1 and give medical groups and integrated systems of care the stability to continue caring for their patients.
The full letter is available on the AMGA website.
###
About AMGA
AMGA is a trade association leading the transformation of healthcare in America. Representing multispecialty medical groups and integrated systems of care, we advocate, educate, innovate, and empower our members to deliver the next level of high-performance health. AMGA is the national voice promoting awareness of our members’ recognized excellence in the delivery of coordinated, high-quality, high-value care. More than 175,000 physicians practice in our member organizations, delivering care to one in three Americans.