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Congress will likely mitigate pay cuts under the 2024 physician fee schedule by early March, but a long-term doc fix will probably take a few more years, Rep. Larry Bucshon (R-IN) said during the American Medical Association’s National Advocacy Conference on Tuesday (Feb. 13).

The continuing resolution Congress settled on in January didn’t address the Medicare pay cuts -- much to providers’ disappointment -- but Bucshon has remained optimistic that lawmakers will be able to include at least temporary adjustments to reimbursements in the next legislative package. Physician payment reform also has new life in the Senate as a bipartisan group of six lawmakers on Friday (Feb. 9) announced a new working group that will explore ways to ensure adequate reimbursements that incentivize quality care. The group includes Sens. Marsha Blackburn (R-TN), John Thune (R-SD), John Barrasso (R-WY), Debbie Stabenow (D-MI), Mark Warner (D-VA) and Catherine Cortez Masto (D-NV).

Bucshon, a GOP Doctors Caucus member and who isn’t seeking reelection this year, told AMA National Advocacy Conference attendees he’s not sure whether providers will see the full 3.4% cut mitigated, though, and he was less optimistic about the immediate passage of his long-term doc fix proposal, which would tie annual Medicare fee schedule updates to the Medicare Economic Index.

“I think it may take us another one or two congresses, so stay in the fight. A lot of times, big things like this will take you six years, eight years, but we're probably three, four years into this. So keep up the pressure; I think we'll find solutions,” Bucshon said.

The biggest issue with this proposal has been projecting the bill’s cost since it would vary with inflation, Bucshon said. To get around this, he said he’s been working with the Congressional Budget Office to mark up the bill based on its average annual cost.

Bucshon also talked about his other health care priorities, like improving the prior authorization process and protecting health care workers from violence in the workplace.

CMS has finalized over the past year several rules meant to streamline and improve the prior authorization process. Bucshon celebrated the Biden administration’s progress in reforming this area, but he credited Congress and physician organizations as the impetus for CMS’ regulations.

Bucshon’s having a hard time convincing the House Judiciary Committee to take up a bill he’s sponsoring, the Safety from Violence for Healthcare Employees (SAVE) Act, which would make attacking a health care provider a federal crime -- similar to repercussions for assaulting a flight attendant. But many lawmakers feel it’s a local issue.

“If you know any of your representatives are on the House Judiciary Committee, call them, because right now we're stuck on the House side because the committee of jurisdiction is the House Judiciary Committee, and at this point, they haven't taken action on it,” Bucshon told AMA conference attendees.

At a rally for the SAVE Act on Jan. 30, American College of Emergency Physicians President Aisha Terry detailed how patient care was impacted when a nurse was punched in the face, which knocked her out.

“I can tell you everything stopped. When we heard that bump -- and everyone heard it -- everything stopped,” Terry said. “The patient who was there to have his heart attack treated; the care stopped at that moment. The patient who was there for the broken femur bone did not get the attention they needed because there was disruption and distractions in the emergency department. And it happens every day.”

Proponents for the bill and other workplace violence prevention acts say the issue is now so pervasive that it’s impacting the health care workforce pipeline and chasing people away or out of the profession.