The proposal from the Centers for Medicare & Medicaid Services would fundamentally restructure how providers are reimbursed for multiple services during a single visit. Under the new model, Medicare would cover the highest-valued procedure at full price while slashing reimbursement for all subsequent services by 50%. For specialists like Dr. Eugene Brown III, president of the American Academy of Otolaryngology–Head and Neck Surgery, the change is a direct barrier to life-saving efficiency. Brown cited a recent case where he diagnosed a patient’s cancer during a single appointment by performing an on-site CT scan and biopsy, a process that would become financially unsustainable under the proposed cuts.

Data from a survey of over 1,400 otolaryngologists underscores the potential fallout: 67% of respondents indicated the policy would force them to reduce their Medicare patient load, while 14% warned they would exit the program entirely. Beyond financial strain on private practices, particularly in rural regions, 84% of clinicians predict the rule will lead to longer wait times and restricted referral networks. Rahul K. Shah, CEO of the AAO-HNS, contends the policy creates a hurdle where there should be a streamlined path to diagnosis. The coalition is currently demanding that CMS release the underlying data for the rule and conduct a comprehensive impact study before the policy takes effect.