H.R. 9693

Patients First Act of 2026

Official summary

Written by the Congressional Research Service.

Patients First Act of 2026

This bill modifies payments and incentive programs under the Medicare physician fee schedule.

The bill establishes a temporary program to provide hybrid payments for certain primary care services. Under the program, payments for services relating to care management, behavioral health integration, office-based evaluation and management (including telehealth), and communications (e.g., phone calls) are made on a monthly basis to providers for each individual that is attributed to the provider's practice. The monthly amount is based on the national average amount for such services. Providers may opt into the model; in order to qualify, providers must be owned or controlled by health care practitioners and must have had the majority of their prior year's payments consist of payments for the covered services.

The bill also renames the Merit-based Incentive Payment System (MIPS) and modifies the program to include performance measures relating to care efficiency (e.g., reducing avoidable hospitalizations). (MIPS is an incentive program under Medicare that allows health professionals to receive payment adjustments based on certain performance measures.) The bill generally reduces the program's performance-based payment adjustments, including positive adjustments for providers that are not owned or controlled by health care practitioners.

Finally, the bill allows for larger annual adjustments to the Medicare physician fee schedule and bases these adjustments on inflation. It also requires certain corrections to compensate for expenditures under the fee schedule that exceed a certain amount in a given year, and it limits how much certain adjustment factors may vary each year.

Text of the bill

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I Strengthening reimbursement and patient access

Sec. 103. Work geographic floor adjustment for high inflationary years

(a) In general. Section 1848(e)(1)(E) of the Social Security Act (42 U.S.C. 1395w–4(e)(1)(E)) is amended—

(1) by striking the header and inserting Work geographic index;

(2) by striking After calculating and inserting the following:

Text this section adds to the law

(i) In general. After calculating

(3) in clause (i) (as so inserted)—

(A) by inserting (or 1.025, in the case such year is a high inflationary year (as defined in clause (iii))) after to 1.00; and

(B) by striking 2027 and inserting 2032; and

(4) by adding at the end the following new clauses:

Text this section adds to the law

(ii) Increase in high inflationary years for other localities. After calculating the work geographic index in subparagraph (A)(iii), for purposes of payment for services furnished on or after January 1, 2027, and before January 1, 2033, the Secretary shall increase the work geographic index by .02 points if such year is a high inflationary year, unless such work geographic index is subject to an increase under clause (i) for such year.

(iii) Definition. In this subparagraph, the term high inflationary year means a year if, over the 12-month period ending on the last day of the preceding year, the consumer price index for all urban consumers (U.S. city average) increased by more than 2 percent.

(iv) Publication. Medicare administrative contractors shall publish the geographically adjusted work relative value units for both the inflation adjustments under clauses (i) and (ii) and the work geographic adjustment for all services on a quarterly basis effective January 1, 2027, for each of their geographic areas.

(b) Report. Not later than 1 year after the date of the enactment of this Act, the Comptroller General of the United States shall submit to the House Energy and Commerce and Ways and Means Committees and Senate Finance Committee a study on the economic factors that are impacting physician choice, by specialty, regarding the geographic area in which such physicians choose to practice, including salaries, contract terms, cost of living, availability of capital, volume of services, and costs to conduct a practice.

II POINTS

III APM improvement

IV Physician payment improvements