ACR presses Congress on Medicare payment floor

American College of Radiology CEO Dana H. Smetherman, MD, MPH, MBA, asked Congress to stabilize Medicare physician payment during a May 20 hearing before the U.S. House Energy and Commerce Subcommittee on Health. The hearing focused on the Medicare Physician Fee Schedule, MACRA, and payment reform.

Smetherman argued that Congress should move beyond temporary payment patches and create a more predictable physician reimbursement structure. ACR said she cited Medicare Physician Fee Schedule volatility as a concern for practices planning operations, investing in technology, and maintaining access for Medicare patients.

Her written testimony said physicians do not receive a statutory annual inflationary update under the physician fee schedule, unlike many other Medicare provider types. Citing an American Medical Association analysis of Medicare Trustees data, the testimony said physician reimbursement declined 33% from 2001 to 2025 after inflation adjustment.

Radiology-specific pressure was also part of the testimony. Smetherman said workforce shortages persist while imaging demand rises, and cited a 113% increase in average turnaround time across modalities since 2014, with most of that increase occurring between 2021 and 2023.

ACR’s requested payment reforms include payment adequacy and sustainability, budget-neutrality updates to the conversion factor, and MACRA reform. The college also recommended adding a standing statutory annual inflation adjuster to Medicare’s physician fee schedule.

The testimony also linked payment reform to imaging utilization policy. Smetherman urged passage of the Radiology Outpatient Ordering Transmission Act, or ROOT Act, which would modify the Appropriate Use Criteria program for advanced diagnostic imaging orders.

Congress.gov lists the House version, H.R. 5737, as introduced by Rep. Diana Harshbarger on October 10, 2025, and referred to the Energy and Commerce and Ways and Means committees. The Senate version, S.1692, was introduced by Sen. Marsha Blackburn on May 8, 2025, and referred to the Senate Finance Committee.

The Moran Company estimated that implementing AUC program changes included in the ROOT Act would save the federal government about $2B over 10 years and Medicare beneficiaries about $1.5B over the same period, according to Smetherman’s written testimony.

ACR said the ROOT Act was also included in a recent Medicare Payment/MACRA reform discussion draft. The bill remains introduced in both chambers, according to Congress.gov.