Sponsors (15)
The bill prioritizes short‑term payment stability and procedural protections for clinicians and recently reviewed services, at the cost of higher near‑term Medicare spending and the risk of future implementation complexity or sudden payment adjustments.
Medicare beneficiaries (especially those with chronic conditions) will face slower reductions in physician payment rates through at least 2030 because the bill delays the efficiency cut.
Physicians and clinician practices get more time and formal input because the bill requires consultation with affected specialty representatives before any post-2030 implementation.
Services recently revalued are protected and repeated across‑the‑board cuts are limited because the bill excludes services revalued in the prior 10 years and prohibits more than one adjustment.
Taxpayers and Medicare could face higher costs because delaying the efficiency adjustment until 2030 is likely to increase program spending or slow needed provider payment reductions.
Taxpayers may pay more because raising the qualifying and nonqualifying APM update percentages for 2026 (and altering future-year rules) increases baseline payments relative to current law.
Physician specialties and hospitals risk sudden future payment cuts if the post‑2030 methodology still reduces work RVUs, which could disrupt practice and hospital finances despite the consultation requirement.
Based on analysis of 2 sections of legislative text.
Delays CMS implementation of the 2025 physician work RVU efficiency and time-input updates until Jan 1, 2030, requires a congressional report, and adjusts Medicare conversion-factor update percentages for 2026 and later years.
Prevents the Department of Health and Human Services from applying the November 5, 2025 Medicare physician payment "work RVU efficiency" adjustment and related physician time updates before January 1, 2030, requires a report to key congressional committees on whether a one-time across-the-board work RVU adjustment is needed, and sets conditions for any implementation after 2030. It also revises numeric percentages used in Medicare conversion-factor update rules for 2026 and restores smaller, fixed update percentages for 2027 and later years. The bill preserves CMS authority to revalue misvalued or new/revised codes, limits the number of efficiency adjustments to one, requires consultation with affected physician specialties before post-2030 implementation, and conditions use of a productivity-vs-inflation factor on an APM conversion factor test tied to CPI-U changes.
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.
Introduced February 12, 2026 by Ron Estes · Last progress February 12, 2026