1.0 Work GPCI Floor Extended

IMS advocacy has successfully averted a $22.5 million Medicare payment cut for Iowa physicians. As part of the year-end budget deal, which was signed into law on December 23, 2019, temporary 1.0 Physician Work (PW) GPCI floor that was set to expire on January 1, 2020, has been extended until May 23, 2020. While not the long-term extension or the permanent solution that IMS would have preferred, this temporary measure averts substantial payment cuts in the short-term and gives us more time to work on a long-term solution to this problem.


For the past several years, Iowa has benefited from the temporary 1.0 PW floor that holds harmless rural payment localities set to experience negative Medicare payment adjustments as a result of the flawed geographic practice cost index (GPCI) formula. Over the past year, IMS has worked with our Congressional Delegation to educate new members on the impact of this issue and to find a solution to this problem. This includes both extending the temporary 1.0 floor and finding a permanent solution to this rate cut, which would cost Iowa physicians an estimated $22.5 million in Medicare payments in 2020 alone.


Final negotiations, aided by the advocacy of several members of Iowa’s Congressional Delegation, yielded a compromise extension of several Medicare provisions set to expire at the start of 2020. One high-profile issue – surprising billing – was ultimately removed from the final legislation. This has led some to speculate that the Medicare provisions were only extended until May so as to create a new must-pass healthcare policy bill in a few months that could serve a legislative vehicle for an ultimate compromise on the surprise billing issue. Permanently addressing the Medicare GPCI problem continues to be a top IMS Federal Priority. Over the coming months, we will work closely with our congressional partners to find a more sustainable path forward. In the short-term, Medicare will not move forward with the scheduled GPCI rate cuts included in the CY2020 Medicare Physician Fee Schedule final rule thanks to the ongoing advocacy of your Iowa Medical Society and the support of Iowa’s Congressional Delegation.

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