On Dec. 21, 2024, President Biden signed a stopgap funding bill into law to prevent a government shutdown and keep the government operating until March 14, 2025. Although an early version of the funding agreement negotiated by leaders in both parties included several key wins for AAOS members, AAOS is extremely disappointed that this agreement fell apart and that the final, slimmed-down bill did not include relief for physicians from the 2.8 percent Medicare payment cut that went into effect on Jan. 1, 2025.

The original version of the year-end spending bill would have eliminated nearly all (2.5 percent) of the scheduled 2.8 percent cut for 2025 and extended the Advanced Alternative Payment Model bonus for 1 year at 3.53 percent.

Additional wins that were expected to be a part of the deal included:

• extending pandemic-era Medicare telehealth flexibilities for 2 years
• requiring National Provider Identifier for off-campus hospital outpatient clinics
• codifying much-needed improvements to the Medicare Advantage prior authorization process

After pushback from the incoming administration, what appeared to be an airtight agreement unraveled as rank-and-file members began to defect over a number of issues. At that point, leadership no longer had the votes to pass such wide-ranging policy changes and were instead forced to settle for a “clean” extension of current government funding.

The final bill, which debuted on the eve of the federal shutdown, was passed and signed into law. The bill included the following provisions:

• Telehealth and hospital-at-home providers will remain eligible for Medicare reimbursement until March 31, 2025.
• Scheduled cuts to Medicaid disproportionate share payments for safety-net hospitals were postponed, and special Medicare reimbursements for low-volume hospitals and Medicare-dependent hospitals are extended until April 1, 2025.
• Funding for community health centers and pandemic preparedness programs are sustained until March 31, 2025.

The House passed the bill 366-34 on Dec. 20, 2024, and the Senate followed after midnight and approved the legislation on a 85-11 vote.

Although AAOS is beyond disappointed in this outcome, the fight for all of these priorities is far from over. Several of AAOS’ champions on Capitol Hill are already committed to putting a Medicare payment fix, prior authorization reform, and other AAOS priorities at the top of their agenda for 2025. Rep. Greg Murphy, MD (R-North Carolina), posted on X to share that he has been in contact with President Trump’s incoming administration and has received assurances that a Medicare payment fix will be included in the next funding bill in March.

In an interview with Politico about the prospects for a healthcare reform package in the new Congress, Rep. Buddy Carter (R-Georgia), incoming chair of the House Energy and Commerce Subcommittee on Health, said, “We’re going to make sure it happens.”

AAOS will continue to engage with lawmakers to bring these promises to fruition in 2025 and will be in touch throughout the year to share how members can help advocate for the specialty.

Reference

1. Leonard B: Carter on health package: ‘We’re going to make sure it happens.’ Available at: https://subscriber.politicopro.com/article/2025/01/carter-on-health-package-were-going-to-make-sure-it-happens-00196659. Accessed Jan. 7, 2025.