S. 5672
Patients First Act of 2026
Sponsor: Roger Marshall · 0 cosponsors
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
I Strengthening reimbursement and patient access
(a) In general. Section 1848(d) of the Social Security Act (42 U.S.C. 1395w–4(d)) is amended—
(1) in paragraph (1)(A), in the second sentence, by inserting or (21) after paragraph (20);
(2) in paragraph (20)—
(A) in the header, by striking and subsequent years; and
(B) by striking and each subsequent year; and
(3) by adding at the end the following new paragraph:
(21) Update for 2027 and subsequent years
(A) In general. For 2027 and each subsequent year, the update to the nonqualifying APM conversion factor established under paragraph (1)(A) is, subject to subparagraph (B), the Secretary's estimate of the percentage increase in the MEI (as defined in section 1842(i)(3)) for the year, less 1 percentage point, and the update to the qualifying APM conversion factor established under such paragraph is the update to the nonqualifying APM conversion factor for the year, increased by 0.5 percentage point.
(B) Floor and ceiling on nonqualifying APM conversion factor update. In the case that the update to the nonqualifying APM conversion factor for a year as calculated under subparagraph (A) is—
(i) less than 25 percent of the Secretary’s estimate of the percentage increase in the MEI (as defined in section 1842(i)(3)) for the year, such update shall be deemed to be equal to 25 percent of such estimate; or
(ii) more than 75 percent of such estimate, such update shall be deemed to be equal to 75 percent of such estimate.
(b) Reports. The Secretary of Health and Human Services shall, for 2027 and each year thereafter, submit to Congress a report on the updates to the qualifying APM conversion factor and nonqualifying APM conversion factor under section 1848(d) of the Social Security Act (42 U.S.C. 1395w–4(d)) for such year. Such report shall include an analysis of the impact of such updates on Medicare beneficiaries’ access to services under the Medicare program and on the consolidation of physician practices.
II POINTS
III APM improvement
IV Physician payment improvements