President Biden signed the American Relief Act of 2025, a short-term Continuing Resolution (CR), into law on December 21, averting a shutdown of the federal government. While this short-term CR will keep the federal government funded through March 14, it, unfortunately, did not address most of the priority issues that PM&R physicians care about and have advocated for Congress to act upon.
WIN: The American Relief Act of 2025 includes a short-term extension of the current federal waivers that allow physicians to provide telehealth services to their patients. These waivers were set to expire at the end of 2024, and they will now extend until March 31, 2025, making this a partial victory for physiatrists and their patients. The Academy has prioritized making these flexibilities permanent and will work to ensure that Congress takes action to do so before the end of March 2025 (further details below).
Unfortunately, the CR did not address other PM&R policy priorities. Congress did not act to halt the scheduled 2.8% cut to Medicare physician payment rates, this cut will now go into effect on January 1. And Congress did not pass landmark prior authorization reforms into law, allowing the bipartisan Improving Seniors’ Timely Access to Care Act to expire at the end of the current Congress.
The passage of this CR follows Congress failing to advance a bipartisan spending package released on Tuesday, December 17. This earlier package included a number of key healthcare policy provisions, including a 2.5% increase to Medicare physician payment rates (which would have resulted in a net .3% decrease for 2025 in place of the scheduled 2.8% cut); a two-year extension of the telehealth flexibilities granted during the COVID-19 public health emergency; a reauthorization of the Traumatic Brain Injury (TBI) Act; and additional Medicare policy “extenders,” among other provisions.
Action Needed
As we continue working to advance PM&R policy priorities, please consider joining the hundreds of PM&R physicians who have already contacted their representatives in Congress to advocate for Medicare payment relief for physicians, permanent extension of the current telehealth flexibilities, and common-sense prior authorization reforms.
MEMBER ACTION CENTER
Medicare Payment Rates for Physicians
The Academy remains committed to pursuing fair reimbursement for physician-led care in the ever-changing healthcare environment and is particularly concerned with the annual decreases to Medicare payment rates for care provided by physicians.
As the Academy has previously shared with members, Medicare physician payment rates under the Calendar Year (CY) 2025 Medicare Physician Fee Schedule (MPFS) are slated to be reduced by approximately 2.8% for 2025 relative to 2024. With Congress failing to act by the end of 2024 to halt this scheduled cut, 2025 will mark the fifth straight year of decreases to the physician payment rates under the MPFS.
It is not clear at this time whether Congress will prioritize passing a payment fix in 2025, nor what the size of the fix will be if one is enacted. Furthermore, additional unknowns include when such legislation may be enacted, whether it would be retroactive to January 1, 2025 and how long it would take the Centers for Medicare and Medicaid Services (CMS) and its contractors to implement the fix – again, all assuming Congress prioritizes mitigating the MPFS payment rate reduction.
While Congress did eventually act to partially offset the scheduled cuts to Medicare physician payment rates for CY 2024, this action did not take place until March, was not retroactive, and did not entirely cancel the remaining cuts for the year.
Click here to learn more about the Academy’s work advocating for physician payment reform.
Extension of Telehealth Flexibilities
As a result of the COVID-19 pandemic, telehealth has quickly become a more prominent aspect of clinical practice for PM&R physicians. Patients rely more and more on telehealth to access vitally important care, and the waivers granted by the federal government allow PM&R physicians to branch out into offering care in innovative ways.
Vital telehealth flexibilities (including the elimination of geographic restrictions based on patient location, payment parity for telehealth services, and coverage of audio-only services when providing necessary telehealth services to patients, among other policies) will remain in place until the end of March 2025, but Congress needs to lock these priorities into place on a permanent basis.
Click here for an example of recent advocacy work by the Academy focused on expanding access to telehealth for patients and providers.
Prior Authorization Reform
Reducing burden on physicians continues to be a priority for AAPM&R’s advocacy efforts. PM&R physicians regularly identify overly burdensome and arbitrary prior authorization (PA) requirements as both a significant barrier to delivering care to patients and one of the primary drivers of physician burnout.
A core part of the Academy’s advocacy to reform PA has been working to advance the Improving Seniors’ Timely Access to Care Act (H.R. 8702/S. 4532), bipartisan legislation would help protect patients from unnecessary delays in care by streamlining and standardizing the prior authorization process under the Medicare Advantage program. This Academy-endorsed legislation has been cosponsored by more than 300 members of the U.S. House of Representatives and 60 members of the U.S. Senate, endorsed by over 500 stakeholder organizations, and is projected by the Congressional Budget Office to cost the federal government $0 for implementation.
It has been reported that the Improving Seniors’ Timely Access to Care Act was strongly considered for inclusion in the year-end spending package, but that Republican and Democratic congressional negotiators were unable to come to an agreement that would have advanced this common-sense legislation before the end of the 118th Congress.
Click here to learn more about the Academy’s advocacy on prior authorization reform.
AAPM&R will continue working to advance the health policy priorities that matter to PM&R physicians and will provide updates as they occur. Please contact Academy staff at healthpolicy@aapmr.org with any questions or concerns.