May 3, 2023
The Honorable Raul Ruiz, MD
United States House of Representatives
2342 Rayburn House Office Building
Washington, DC 20515

The Honorable Larry Bucshon, MD
United States House of Representatives
2313 Rayburn House Office Building
Washington, DC 20515

The Honorable Ami Bera, MD
United States House of Representatives
172 Cannon House Office Building
Washington, DC 20515

The Honorable Mariannette Miller-Meeks, MD
United States House of Representatives
1034 Longworth House Office Building
Washington, DC 20515

Dear Representatives Ruiz, Bucshon, Bera and Miller-Meeks:
On behalf of the undersigned physician and non-physician organizations, representing more than one
million clinicians and the patients they serve, thank you for introducing H.R. 2474, the Strengthening
Medicare for Patients and Providers Act. The legislation applies a permanent inflation-based update to
the Medicare Physician Fee Schedule (MPFS) conversion factor, which will provide much-neededstability to the Medicare payment system as our members contend with an increasingly challenging
environment providing Medicare beneficiaries with access to timely and quality care.
Congress has taken action to mitigate some of the recent MPFS cuts on a temporary basis, however,reimbursement continues to decline. According to an American Medical Association analysis ofMedicare Trustees data, when adjusted for inflation, Medicare payments to clinicians have declined by
26% from 2001-2023 1. The failure of the MPFS to keep pace with the true cost of providing care,combined with year-over-year cuts resulting from the application of budget neutrality, sequestration,
and a paucity of available alternative payment model/value-based care models, clearly demonstrates
the Medicare payment system is broken. The addition of an inflationary update will provide budgetarystability as clinicians-many of whom are small business owners-contend with a wide range of shifting
economic factors, such as increasing administrative burdens, staff salaries, office rent and purchasing ofessential technology.
Congress has a unique opportunity to adopt comprehensive, transformative reforms to the Medicare
payment system and we applaud your leadership in introducing this legislation. We look forward toworking with Congress to ensure passage of H.R. 2474 and continue conversations around further
payment reform to ensure America’s seniors continue to receive access to the high-quality care they
deserve.
Thank you,https://www.ama-assn.org/system/files/medicare-updates-inflation-chart.pdf; https://www.amaassn.org/system/files/medicare-updates-inflation-chart-cumulative.pdf
1Academy of Neurologic Physical Therapy
Academy of Nutrition and Dietetics
Academy of Orthopaedic Physical Therapy
ADVION (Formerly the National Association for the Support of Long Term Care (NASL))
Alliance for Physical Therapy Quality and Innovation
Alliance for Recovery Care
Alliance of Specialty Medicine
Alliance of Wound Care Stakeholders
Ambulatory Surgery Center Association
American Academy of Allergy, Asthma & Immunology
American Academy of Audiology
American Academy of Dermatology Association
American Academy of Facial Plastic and Reconstructive Surgery
American Academy of Family Physicians
American Academy of Hospice and Palliative Medicine
American Academy of Neurology
American Academy of Ophthalmology
American Academy of Otolaryngology-Head and Neck Surgery
American Academy of Physical Medicine and Rehabilitation
American Association of Hip & Knee Surgeons
American Association of Neurological Surgeons
American Association of Nurse Anesthesiology
American Association of Oral and Maxillofacial Surgeons
American Association of Orthopaedic Surgeons
American Chiropractic Association
American College of Allergy, Asthma and Immunology
American College of Cardiology
American College of Emergency Physicians
American College of Foot and Ankle Surgeons
American College of Gastroenterology
American College of Mohs Surgery
American College of Obstetricians and Gynecologists
American College of Osteopathic Family Physicians
American College of Osteopathic Internists
American College of Physicians
American College of Radiation Oncology
American College of Radiology
American College of Rheumatology
American College of Surgeons
American Gastroenterological Association
American Health Care Association
American Medical Association

American Medical Group Association
American Medical Rehabilitation Providers Association
American Occupational Therapy Association
American Optometric Association
American Orthopaedic Foot & Ankle Society
American Osteopathic Association
American Physical Therapy AssociationAmerican Podiatric Medical Association
American Psychiatric Association
American Psychological Association Services
American Rhinologic Society
American Society for Dermatologic Surgery Association
American Society for Gastrointestinal Endoscopy
American Society for Radiation Oncology
American Society for Surgery of the Hand Professional Organization
American Society of Anesthesiologists
American Society of Breast Surgeons
American Society of Cataract and Refractive Surgery
American Society of Colon & Rectal Surgeons
American Society of Diagnostic and Interventional Nephrology
American Society of General Surgeons
American Society of Hand Therapists
American Society of Neuroradiology
American Society of Nuclear Cardiology
American Society of Plastic Surgeons
American Society of Retina Specialists
American Society of Transplant Surgeons
American Speech-Language-Hearing Association
American Urogynecologic Society
American Urological Association
Association for Clinical Oncology
Association for Quality Imaging
Association of Black Cardiologists
Association of Diabetes Care & Education Specialists
Association of Freestanding Radiation Oncology Centers
Association of Pathology Chairs
Association of Women in Rheumatology
CardioVascular Coalition
Clinical Social Work Association
Coalition of State Rheumatology Organizations
College of American Pathologists
Congress of Neurological SurgeonsDialysis Vascular Access Coalition
Digestive Health Physicians Association
Emergency Department Practice Management Association
Heart Failure Society of America
Infectious Diseases Society of America
Infusion Providers Alliance
Large Urology Group Practice Association
Medical Group Management Association
National Association of Rehab Providers & Agencies
National Association of Spine Specialists
National Center for Assisted Living
Outpatient Endovascular and Interventional Society
Private Practice Section of the American Physical Therapy AssociationRadiology Business Management Association
Renal Physicians Association
Society for Cardiovascular Angiography and Interventions
Society for Vascular Surgery
Society of Interventional Radiology
Society of NeuroInterventional Surgery
The Society of Thoracic Surgeons
United Specialists for Patient Access
US Oncology Network
CC: The Honorable Charles Schumer, Majority Leader, United States Senate
The Honorable Mitch McConnell, Minority Leader, United States Senate
The Honorable Kevin McCarthy, Speaker, United States House of Representatives
The Honorable Hakeem Jeffries, Minority Leader, United States House of Representatives
The Honorable Ron Wyden, Chair, Senate Committee on Finance
The Honorable Mike Crapo, Ranking Member, Senate Committee on Finance
The Honorable Cathy McMorris Rodgers, Chair, House Committee on Energy and Commerce
The Honorable Frank Pallone, Ranking Member, House Committee on Energy and Commerce
The Honorable Jason Smith, Chair, House Committee on Ways and Means
The Honorable Richie Neal, Ranking Member, House Committee on Ways and Means