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WASHINGTON — There’s been a long lull in fighting between primary care and specialty doctors over how much they get paid by Medicare, but that truce might not last if Congress overhauls the system that determines physician payment.

This year, Congress began considering changes to the Medicare physician pay system for the first time since creating the current version in 2015. Committees in the House and Senate have held hearings on the matter, including the powerful Senate Finance Committee, which recently published a 30-page paper on potential changes.

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Medicare recently proposed a 2.8% cut to its main physician pay rate next year, adding urgency to the efforts. Congress has scaled back the proposed pay-rate reductions each of the past four years, but still allowed some to go forward, pressuring physicians.

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