S. 5672

Patients First Act of 2026

Sponsor: Roger Marshall · 0 cosponsors

Follow this bill

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

Expand all
Sec. 1. Short title; table of contents

(a) Short title. This Act may be cited as the Patients First Act of 2026.

(b) Table of contents. Sec. 1. Short title; table of contents.TITLE I—Strengthening reimbursement and patient accessSec. 101. Modifying the conversion factor updates applicable to physicians’ services under the Medicare program.Sec. 102. Hybrid payment model for primary care services.Sec. 103. Work geographic floor adjustment for high inflationary years.TITLE II—POINTSSec. 201. Implementation of the Patient Outcome Improvement National Tabulation System.Sec. 202. Payment reform.Sec. 203. Quality Reform Task Force.Sec. 204. Modification of MIPS payment adjustments.Sec. 205. Modifying requirements and approval periods for qualified clinical data registries.Sec. 206. Expanded access to claims data to facilitate research and quality improvement.Sec. 207. Modification of appropriate use criteria data collection for applicable imaging services.Sec. 208. Rules of construction.TITLE III—APM improvementSec. 301. Qualifying APM participant threshold freeze.Sec. 302. CMI model requirements.Sec. 303. Report on barriers to participation in value-based payment models.TITLE IV—Physician payment improvementsSec. 401. Updating the budget neutrality threshold.Sec. 402. Budget neutrality corrections relating to estimated utilization.Sec. 403. Timely updates to direct costs used to calculate practice expense RVUs.Sec. 404. Limitation on year-to-year conversion factor variance.

I Strengthening reimbursement and patient access

II POINTS

III APM improvement

IV Physician payment improvements