Sponsors (70)
Changes Medicare physician payment law to require PE input updates, correct budget-neutrality adjustments based on estimated utilization, replace a hard-coded dollar figure with a year-specific reference, and cap annual conversion-factor changes at 2.5% starting 2027.
Official title: To amend title XVIII of the Social Security Act to ensure stability for provider payments under the Medicare program.
Introduced March 30, 2026 by Gregory Francis Murphy · Last progress March 30, 2026
This bill makes Medicare physician payments more accurate, transparent, and predictable—helping providers and patient access—but it likely increases program costs, adds administrative complexity, and constrains CMS flexibility in ways that could delay needed larger adjustments or shift costs elsewhere.
Medicare beneficiaries and providers: The bill improves accuracy and correction of physician payments (correcting prior assumption-driven adjustments and aligning fee schedules), reducing unexpected payment swings and helping sustain provider participation and patient access.
Physicians and practices: Payment updates tied to current wages, supply, and equipment prices reduce the mismatch between reimbursement and operating costs, improving practice financial viability and budgeting.
Providers, beneficiaries, and CMS: The bill creates more predictable payment timing and limits (e.g., a defined correction process, a scheduled update cadence and an annual adjustment constraint), which reduces year-to-year volatility in payments and aids planning.
Taxpayers and the Medicare Trust Fund: Corrections and higher payments to reflect rising input costs or to correct prior underestimates could increase Medicare spending and place added pressure on the trust fund and federal budgets.
Medicare beneficiaries and providers: The annual adjustment cap (±2.5%) and related limits could prevent or delay larger, necessary budget-neutrality corrections or reforms, leaving payments misaligned with current costs when bigger changes are needed.
CMS, federal employees, and providers: Creating year-specific items, new correction processes, and more frequent revisions/stakeholder consultations increases administrative complexity, implementation burden, and transitional uncertainty for regulators and providers.
Based on analysis of 5 sections of legislative text.
Makes targeted changes to how Medicare pays physicians by (1) requiring periodic updates to the price inputs used to set practice expense relative value units (PE RVUs); (2) creating a process to correct prior budget-neutrality adjustments that were based on estimated utilization starting in 2027; (3) replacing a hard-coded budget-neutrality dollar figure with a year-specific cross-reference; and (4) capping year-to-year changes in the Medicare conversion factor to no more than 2.5 percent (starting 2027), while preserving the underlying budget-neutrality framework. The goal is to stabilize physician payments, improve how cost inputs are updated, and require CMS to correct certain prior assumptions used in budget-neutrality calculations.