Sponsors (13)
Official title: To amend title XVIII of the Social Security Act to delay the implementation of an efficiency adjustment to work relative value units under the Medicare physician fee schedule.
The bill postpones and constrains near-term physician payment reductions to protect patients and give providers time to adapt, but does so at the likely cost of higher Medicare spending, greater budgetary pressure, and the risk of future abrupt cuts or implementation complexity.
Medicare patients (including those with chronic conditions) and their physicians will face slower reductions in physician payment rates because the bill delays the efficiency-based payment cut until at least 2030, reducing near-term payment pressure.
Physicians and clinician practices get more time and a required consultation process with specialty representatives before any post-2030 changes, giving practices time to prepare and potentially influence implementation.
The bill limits how the across-the-board adjustment can be applied (excluding services revalued in the prior 10 years and prohibiting repeated adjustments), protecting recently reviewed services and reducing the chance of multiple back-to-back cuts for the same services.
Taxpayers and Medicare’s long-term finances could face higher costs because delaying the efficiency adjustment likely increases Medicare spending or slows planned reductions in provider payments.
Raising the qualifying and nonqualifying APM update percentages for 2026 and altering future-year rules could increase provider payments relative to the baseline, adding budgetary pressure and potential taxpayer costs.
Even with delay and consultation, if the post-2030 methodology still reduces work RVUs some physician specialties could face sudden, disruptive payment cuts when implemented, harming practice finances and access to certain services.
Based on analysis of 2 sections of legislative text.
Delays the 2025 Medicare work RVU efficiency adjustment until Jan 1, 2030, requires a 2‑year congressional report, and adjusts conversion‑factor update percentages for 2026 and later.
Introduced February 12, 2026 by Ron Estes · Last progress February 12, 2026
Delays implementation of the Medicare physician fee schedule "work RVU efficiency" adjustment and related physician time updates adopted in the November 5, 2025 final rule until January 1, 2030, requires a congressionally directed report on whether a one-time across‑the‑board work RVU adjustment is needed, and sets conditions for any later implementation (consultation with specialty groups, exclusions for recently revalued services, limits on methodology, and a one‑time cap on efficiency adjustments). It also amends the statute governing annual conversion‑factor update percentages so that 2026 uses the modified update language (higher numeric percentages), and restores the prior annual percentages for 2027 and later (0.75% for qualifying APMs and 0.25% for nonqualifying APMs).