Patients First Act of 2026
Official title: To amend title XVIII of the Social Security Act to modify certain physician payments under the Medicare program.
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Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
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.
- Introduced in House Formatted Text PDF Formatted XML
- THE AMERICAN OCCUPATIONAL THERAPY ASSOCIATION, INC. (AOTA)
- MASON CONSULTING, LLC
- SIMS STRATEGIES, LLC
- SIMS STRATEGIES, LLC
- CONGRESS OF NEUROLOGICAL SURGEONS
- AMERICAN ASSOCIATION OF NEUROLOGICAL SURGEONS
Bodies those filers lobbied
- HOUSE OF REPRESENTATIVES
- SENATE
- Centers For Medicare and Medicaid Services (CMS)
- Health & Human Services, Dept of (HHS)
- Office of Management & Budget (OMB)
- Veterans Affairs, Dept of (VA)
- Food & Drug Administration (FDA)
- Homeland Security, Dept of (DHS)
Cite this page
U.S. Congress. (2026). H.R. 9693: Patients First Act of 2026. 119th Congress. Open America. https://openamerica.io/bill/119-HR-9693/
"H.R. 9693: Patients First Act of 2026." 119th Congress, 2026, Open America, https://openamerica.io/bill/119-HR-9693/.
H.R. 9693, 119th Cong. (2026), https://openamerica.io/bill/119-HR-9693/.
[H.R. 9693: Patients First Act of 2026](https://openamerica.io/bill/119-HR-9693/)