AMERICAN COLLEGE OF PHYSICIANS

ACPs 2026 Second Quarter Lobbying Disclosure Report Medicare Payments to Physicians: Met with House Doctors Caucus about Medicare payment reform, including draft language to be included in bills for a Medicare Economic Index inflationary updated to the physician fee schedule for physician practices. Supported and urged Congress to pass H.R. 8163, the Provider Reimbursement Stability Act, to enhance Medicare reimbursement stability for physicians by modernizing the Medicare Physician Fee Schedule. The Provider Reimbursement Stability Act of 2026. H.R. 8163 would raise the budget neutrality threshold from $20 million to $54.3 million and would use cumulative increases in the Medicare Economic Index (MEI) to update the threshold every 5 years. ACP supported the Medicare Physician Data-Drive Performance Payment System Act of 2026. This critical legislation seeks to modernize Medicare payments by reducing administrative burdens, improving patient care, and supporting small/rural practices through a more practical, data-driven approach. Dr. William Fox, Chair Emeritus of ACPs Board of Regents, testified before the House Energy and Commerce Committees Health Subcommittee on policy reforms to improve the Medicare Physician Fee Schedule and the Medicare Access and CHIP Reauthorization Act (MACRA) on behalf of ACP. Support Value-Based Care: Urged reintroduction and support of the Value in Health Care Act of 2024. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that expired at the end of 2024. ACP supported the Preserving Patient Access to Accountable Care Act which aligns with Colleges policy to support the transition to value-based payments through alternative payment models (APMs) that can accommodate a wide range of specialties, practice sizes, and unique patient populations. ACP supported this legislation as it would extend the incentive payments for qualifying physicians and other clinicians to participate in Medicare advanced APMs through payment year 2027 at an increased amount of 3.53 percent and would freeze the scheduled increase in qualifying thresholds. Pricing Transparency/Consolidation: Provided comments to the House Energy and Commerce Committees markup, which includes the Lower Cost, More Transparency Act, H.R. 9393, and the Improving Seniors Timely Access to Care Act, H.R. 3514. The two bills would enhance price transparency across health care entities and streamline unnecessary administrative burden, respectively. ACP also supported several policies included in bills slated for markup that would reform Medicare Advantage practices to ensure accountability and safeguard market competition. ACP strongly supports pricing transparency in health care. ACP supported the passage of the Lower Costs, More Transparency Act, which passed the House in the 118th Congress, and we continue to support its reintroduction and passage in this Congress under H.R. 9393. ACP supported provisions within the Medicare Advantage Cost Transparency Act, H.R. 9392, led by Ranking Member DeGette and Dr. Joyce, which would provide greater oversight by requiring that Medicare Advantage (MA) plans report to the Centers for Medicare & Medicaid Services (CMS) on encounter data, including the allowed amount that a plan agreed to pay for a service in total and the total out-of-pocket costs the patient pays for a service. The College has repeatedly voiced support for the Improving Seniors' Timely Access to Care Act, led by Reps. Kelly and DelBene, which would protect patients from unnecessary delays in care and reduce administrative burden on physicians by streamlining MAs prior authorization approval processes. We urge Congress to pass H.R. 3514 to ensure that our patients will get the care they need, when they need it most. FY2026 Appropriations/Agency Restructuring: For FY2027, ACP is urged appropriations committees that funding be either maintained or increased for the following proven programs: 1) Health Resources Services Administration (HRSA), $10.5 billion, including: 2) Health Workforce, National Health Service Corps (NHSC), $915.6 million in total program funding; 3) Primary Care Training and Enhancement (PCTE), $71 million; 4) Title X Family Planning Program, $390 million; 5) Agency for Healthcare Research and Quality (AHRQ), $500 million; 6) Centers for Disease Control and Prevention (CDC) Injury Prevention and Control, $11.6 billion, including: 7) Firearm Injury and Mortality Prevention Research, $35 million; 8) Chronic Disease Prevention and Health Promotion, Social Determinants of Health, $100 million; 9) National Institutes of Health (NIH), $51.3 billion, including: 10) Office of the Director, Firearms Research, $25 million; 11) Centers for Medicare and Medicaid Services (CMS) and Government Accountability Office (GAO); and 12) Report language to ensure primary care physicians are receiving Medicare physician revaluations. We urged Congress to include report language in the FY2026 Labor HHS appropriations bill to direct the GAO to conduct a study encompassing the last decade of CMS estimates of new and revised code utilizations. ACP believes CMS has overestimated utilizations, thus adversely affecting available funds in the Medicare physician fee schedule for other code usage. While the House and Senate bills included language, we prefer the stronger House version language and hope Congress will pass the FY26 Labor HHS bills. Also urged Congress to include report language in the FY2027 Labor HHS appropriations bill directing a study on extent G2211 add on codes and increases in fee schedule for primary care are being retained by hiring entities (hospitals, ACOs, private equity) versus the physicians. ACP urged appropriators to provide $35 million for the U.S. Centers for Disease Control and Prevention (CDC), $25 million for the National Institutes of Health (NIH), and $1 million for the National Institute of Justice (NIJ) to conduct public health research into firearm morbidity and mortality prevention. Primary Care and the Physician Workforce: ACP urged Congress to support the Resident Physician Shortage Reduction Act of 2025 (S. 2439/ H.R. 4731), which would increase the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years. ACP supported the Conrad State 30 and Physician Access Reauthorization Act, S. 709 and H.R. 1585, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement. We supported the Resident Education Deferred Interest (REDI) Act (S 942/HR 2028) that, if passed, will allow borrowers to qualify for interest-free deferment on their student loans while serving in a medical or dental internship or residency program. ACP supported legislation for the H-1Bs for Physicians and Healthcare Workforce Act, H.R. 7961. The bill's primary goal is to exempt healthcare professionals from a $100,000 H-1B visa filing fee. Scope of Practice: ACP provided comments urging the House Ways and Means Committee during markup to oppose the Equitable Community Access to Pharmacist Services Act, which would expand Medicare coverage to permanently include select services provided by a pharmacist. Expand Patient Access: We urged Congress to reintroduce and pass the Chronic Care Management Improvement Act. This legislation would have removed the cost sharing requirement for patients to access chronic care management services. We also support allowing the physician that performs chronic care management services to waive the requirement that the patient pay the 20 percent coinsurance fee associated with this service. We urged Congress to protect the public health infrastructure, recognize evidence-based science and preserve healthcare agency staffing to inform and protect the public from infectious disease and other health emergencies. Incidences of previously well-controlled, vaccine-preventable diseases, such as pertussis (whooping cough) and measles, are increasing in the United States. Vaccines are vital to our ability to prevent diseases that threaten public health, including novel diseases and future pandemics. We urged Congress to utilize the best possible scientific evidence to guide public health legislation. It is critical that public health leaders support evidence-based medicine, including the use of vaccines and other effective public health strategies that protect the public. ACP conducted a Hill Briefing on using scientifically driven, evidenced-based vaccines. Clinical Labs: Supported the provision in H.R. 6366 that would delay payment reductions and data reporting periods for the Clinical Laboratory Fee Schedule under the Protecting Access to Medicare Act (PAMA). Legislation could improve patient access to laboratory tests used to diagnose, monitor, prevent, and manage diseases for Medicare beneficiaries. Prescription Drug Reform: Supported the Capping Prescription Costs Act, introduced by Senator Raphael Warnock. The legislation would lower prescription drug costs for millions of Americans by placing annual caps on out-of-pocket costs for prescription drugs at $2,000 for individuals and $4,000 for families with private insurance. Supported bipartisan Drug-price Transparency for Consumers (DTC) Act, a bill that would require price disclosures on advertisements for prescription drugs in order to empower patients and reduce Americans colossal spending on medications. The bill was introduced by Senators Dick Durbin and Chuck Grassley. ACP also supported the Saving Seniors Money on Prescriptions Act, H.R. 950, which aims to drive down the rising costs of prescription drugs for patients on Medicare by improving price transparency in Pharmacy Benefit Managers (PBMs) business practices. Urged Congress to reintroduce and pass: 1) the Lowering Drug Costs for American Families Act, to expand the number of prescription drugs which Medicare can negotiate under the Inflation Reduction Act from 20 to 50 starting in 2029; 2) the Medicare PBM Accountability Act, legislation aimed at lowering the costs of prescription drugs for seniors covered by Medicare Part D and Medicare Advantage plans; 3) the Increasing Access to Biosimilars Act of 2023, legislation which would encourage adoption of biosimilars in Medicare and improve biosimilar accessibility, by establishing a new pilot program - a voluntary, shared savings demonstration program - for providers of biosimilars in Medicare Part B; 4) the Cutting Copays Act, legislation which would eliminate cost-sharing for generic drugs for LIS beneficiaries, helping to incentivize the use of generic drugs; and the Drug Shortage Prevention Act of 2023, which would require that manufacturers of over-the-counter and prescription drugs notify Food & Drug Administration when they are unlikely to meet demand. ACP supported legislation, Drug-price Transparency for Consumers (DTC) Act, by Senators. Durbin and Grassley that requires Direct-to-Consumer advertisements for prescription drugs and biological products paid for by Medicare and Medicaid to include the list price or Wholesale Acquisition Cost (WAC) for a 30-month supply-which is the price set by manufacturers (and which is paid by uninsured patients, as well as the 50 percent of patients with high-deductible plans).