Physicians Urge Congress to Fix Medicare Payment Gap Threatening Independent Clinics
Washington, Wednesday, 10 June 2026.
Twelve national medical societies are urging Congress to reform Medicare. Outdated policies currently pay hospitals 124% more than independent clinics for identical procedures, threatening community healthcare access.
The Economics of Medicare Reimbursement Disparities
Introduced in the 119th Congress, the Promoting Fairness for Medicare Providers Act (H.R. 7863) is a bipartisan legislative effort spearheaded by Representatives Gus Bilirakis (R-FL), Raul Ruiz, M.D. (D-CA), Greg Murphy, M.D. (R-NC), and Danny K. Davis (D-IL) [1]. The legislation targets a growing financial schism in the United States healthcare sector caused by the Medicare Physician Fee Schedule (PFS) [1]. Currently, the PFS practice expense methodology relies on survey data from 2008, effectively cutting actual practice expense costs by up to 58% before any reimbursement is calculated [1]. By 2025, this outdated methodology resulted in Medicare reimbursements falling below the direct cost of care for more than 300 common office-based CPT (Current Procedural Terminology [GPT]) codes [1].
Proposed Structural Fixes for Independent Practices
To rectify this economic imbalance, a coalition of 12 national physician specialty societies—representing fields ranging from interventional cardiology to vascular surgery—formally announced their joint support for H.R. 7863 between June 8 and June 9, 2026 [1]. The bill proposes a structural overhaul by removing high-cost medical supplies from the flawed PFS methodology [1]. Furthermore, it establishes a new “Office-Based Facility” payment category specifically for surgical procedures that incur supply costs exceeding $500 [1]. Under this new classification, independent practices would be reimbursed at 90% of Ambulatory Surgery Center (ASC) rates [1].
A Growing Wave of Physician Policy Advocacy
The push for H.R. 7863 reflects a broader, ongoing trend of medical professionals actively engaging in legislative advocacy to shape healthcare economics and policy. For example, on June 9, 2026, the Emergency Medicine Residents’ Association (EMRA) utilized its social media platform to organize a panel discussion scheduled for today, June 10, 2026 [alert! ‘EMRA panel execution status is unconfirmed as the event is scheduled to occur today’] [2]. The discussion was specifically designed to educate medical trainees on navigating Medicaid cuts, promoting health equity, and taking actionable steps through legislation [2].