# 119-hr-9693: Patients First Act of 2026

119-hr-9693, Patients First Act of 2026, is a 119th Congress bill sponsored by Rep. Joyce, John [R-PA-13] (R-PA); status introduced; PRIA reads it as touching household money (as of 2026-10-24).

- Canonical: https://policyrisk.com/legislation/119-hr-9693
- As of: 2026-10-24
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-hr-9693
- Congress: 119
- Title: Patients First Act of 2026
- Status: introduced
- Introduced: 2026-07-15
- Sponsor: Rep. Joyce, John [R-PA-13] (R-PA)
- Cosponsors: 69
- Policy area: Health
- Touches household money: yes
- Last recorded action: 2026-10-24

## Summary

**Medicare physician payment reform** would redraw how doctors get paid and how performance is measured in Medicare, with new conversion‑factor rules and a test of monthly primary care payments. - Families and Medicare patients would see a new hybrid primary care payment option through 2031 that pays a monthly amount per attributed beneficiary with no beneficiary cost sharing and lets most Part B enrollees pick or be assigned a primary care supplier. - Physicians and practices would face conversion‑factor updates tied to the Medicare Economic Index, with non‑APM updates set at MEI minus 1.0 percentage point and qualifying APM updates boosted by 0.5 percentage points, plus limits on year‑to‑year conversion factor swings and new five‑year practice expense update rules. - Quality programs and registries would shift toward a POINTS system starting 2032, create a practitioner‑majority Task Force to set measures, expand registry access to claims data, protect registry intellectual property, and tighten imaging decision support rules starting 2027.

## Cosponsors (69)

- Rep. Houlahan, Chrissy [D-PA-6] (D-PA), 2026-09-28T00:00:00.000Z
- Rep. Gonzalez, Vicente [D-TX-34] (D-TX), 2026-09-28T00:00:00.000Z
- Rep. Sorensen, Eric [D-IL-17] (D-IL), 2026-09-28T00:00:00.000Z
- Rep. Vasquez, Gabe [D-NM-2] (D-NM), 2026-09-28T00:00:00.000Z
- Rep. Budzinski, Nikki [D-IL-13] (D-IL), 2026-09-28T00:00:00.000Z
- Rep. Lofgren, Zoe [D-CA-18] (D-CA), 2026-09-28T00:00:00.000Z
- Rep. Rutherford, John H. [R-FL-5] (R-FL), 2026-09-28T00:00:00.000Z
- Rep. Van Orden, Derrick [R-WI-3] (R-WI), 2026-09-28T00:00:00.000Z
- Rep. Kennedy, Mike [R-UT-3] (R-UT), 2026-10-01T00:00:00.000Z
- Rep. Kennedy, Timothy M. [D-NY-26] (D-NY), 2026-10-05T00:00:00.000Z
- Rep. Pocan, Mark [D-WI-2] (D-WI), 2026-10-05T00:00:00.000Z
- Rep. Goodlander, Maggie [D-NH-2] (D-NH), 2026-10-05T00:00:00.000Z
- Rep. Thanedar, Shri [D-MI-13] (D-MI), 2026-10-05T00:00:00.000Z
- Rep. Levin, Mike [D-CA-49] (D-CA), 2026-10-05T00:00:00.000Z
- Rep. Chu, Judy [D-CA-28] (D-CA), 2026-10-06T00:00:00.000Z
- Rep. Davids, Sharice [D-KS-3] (D-KS), 2026-10-22T00:00:00.000Z
- Rep. Riley, Josh [D-NY-19] (D-NY), 2026-10-22T00:00:00.000Z
- Rep. McBride, Sarah [D-DE-At Large] (D-DE), 2026-10-22T00:00:00.000Z
- Rep. Walkinshaw, James R. [D-VA-11] (D-VA), 2026-10-22T00:00:00.000Z
- Rep. Schrier, Kim [D-WA-8] (D-WA), 2026-07-15T00:00:00.000Z
- Rep. Murphy, Gregory F. [R-NC-3] (R-NC), 2026-07-15T00:00:00.000Z
- Rep. Bera, Ami [D-CA-6] (D-CA), 2026-07-15T00:00:00.000Z
- Rep. Dunn, Neal P. [R-FL-2] (R-FL), 2026-07-15T00:00:00.000Z
- Rep. Conaway, Herbert C. [D-NJ-3] (D-NJ), 2026-07-15T00:00:00.000Z
- Rep. Harris, Andy [R-MD-1] (R-MD), 2026-07-15T00:00:00.000Z
- Rep. Morrison, Kelly [D-MN-3] (D-MN), 2026-07-15T00:00:00.000Z
- Rep. Miller-Meeks, Mariannette [R-IA-1] (R-IA), 2026-07-15T00:00:00.000Z
- Rep. Dexter, Maxine [D-OR-3] (D-OR), 2026-07-15T00:00:00.000Z
- Rep. Harshbarger, Diana [R-TN-1] (R-TN), 2026-07-15T00:00:00.000Z
- Rep. Veasey, Marc A. [D-TX-33] (D-TX), 2026-07-15T00:00:00.000Z
- Rep. Carter, Earl L. "Buddy" [R-GA-1] (R-GA), 2026-07-15T00:00:00.000Z
- Rep. Sewell, Terri A. [D-AL-7] (D-AL), 2026-07-15T00:00:00.000Z
- Rep. Onder, Robert F. [R-MO-3] (R-MO), 2026-07-15T00:00:00.000Z
- Rep. DelBene, Suzan K. [D-WA-1] (D-WA), 2026-07-15T00:00:00.000Z
- Rep. Babin, Brian [R-TX-36] (R-TX), 2026-07-15T00:00:00.000Z
- Rep. Panetta, Jimmy [D-CA-19] (D-CA), 2026-07-15T00:00:00.000Z
- Rep. McCormick, Richard [R-GA-7] (R-GA), 2026-07-15T00:00:00.000Z
- Rep. Suozzi, Thomas R. [D-NY-3] (D-NY), 2026-07-15T00:00:00.000Z
- Rep. Biggs, Sheri [R-SC-3] (R-SC), 2026-07-15T00:00:00.000Z
- Rep. Fletcher, Lizzie [D-TX-7] (D-TX), 2026-07-15T00:00:00.000Z
- Rep. Bilirakis, Gus M. [R-FL-12] (R-FL), 2026-07-15T00:00:00.000Z
- Rep. Trahan, Lori [D-MA-3] (D-MA), 2026-07-15T00:00:00.000Z
- Rep. Miller, Carol D. [R-WV-1] (R-WV), 2026-07-15T00:00:00.000Z
- Rep. LaHood, Darin [R-IL-16] (R-IL), 2026-07-15T00:00:00.000Z
- Rep. Kelly, Robin L. [D-IL-2] (D-IL), 2026-07-15T00:00:00.000Z
- Rep. Van Drew, Jefferson [R-NJ-2] (R-NJ), 2026-07-15T00:00:00.000Z
- Rep. Barragán, Nanette Diaz [D-CA-44] (D-CA), 2026-07-16T00:00:00.000Z
- Rep. Van Duyne, Beth [R-TX-24] (R-TX), 2026-07-23T00:00:00.000Z
- Rep. Landsman, Greg [D-OH-1] (D-OH), 2026-07-27T00:00:00.000Z
- Rep. Peters, Scott H. [D-CA-50] (D-CA), 2026-08-06T00:00:00.000Z
- Rep. Houchin, Erin [R-IN-9] (R-IN), 2026-08-06T00:00:00.000Z
- Rep. Gallagher, James [R-CA-1] (R-CA), 2026-08-06T00:00:00.000Z
- Rep. Meuser, Daniel [R-PA-9] (R-PA), 2026-08-10T00:00:00.000Z
- Rep. Hinson, Ashley [R-IA-2] (R-IA), 2026-08-10T00:00:00.000Z
- Rep. Bynum, Janelle S. [D-OR-5] (D-OR), 2026-08-20T00:00:00.000Z
- Rep. Thompson, Bennie G. [D-MS-2] (D-MS), 2026-08-20T00:00:00.000Z
- Rep. Fitzpatrick, Brian K. [R-PA-1] (R-PA), 2026-08-20T00:00:00.000Z
- Rep. Correa, J. Luis [D-CA-46] (D-CA), 2026-08-20T00:00:00.000Z
- Rep. Keating, William R. [D-MA-9] (D-MA), 2026-09-01T00:00:00.000Z
- Rep. Finstad, Brad [R-MN-1] (R-MN), 2026-09-03T00:00:00.000Z
- Rep. Carbajal, Salud O. [D-CA-24] (D-CA), 2026-09-10T00:00:00.000Z
- Rep. Bishop, Sanford D. [D-GA-2] (D-GA), 2026-09-14T00:00:00.000Z
- Rep. Morelle, Joseph D. [D-NY-25] (D-NY), 2026-09-14T00:00:00.000Z
- Rep. Dingell, Debbie [D-MI-6] (D-MI), 2026-09-14T00:00:00.000Z
- Rep. Carter, Troy A. [D-LA-2] (D-LA), 2026-09-15T00:00:00.000Z
- Rep. DesJarlais, Scott [R-TN-4] (R-TN), 2026-09-15T00:00:00.000Z
- Rep. Weber, Randy K. Sr. [R-TX-14] (R-TX), 2026-09-15T00:00:00.000Z
- Rep. Moore, Tim [R-NC-14] (R-NC), 2026-09-16T00:00:00.000Z
- Del. Norton, Eleanor Holmes [D-DC-At Large] (D-DC), 2026-09-16T00:00:00.000Z

## Provisions PRIA read

- Monthly primary care payments for Medicare: benefit, medium. If enacted, the bill would create a nationwide hybrid primary care model for 2027 through 2031. Qualifying suppliers would be paid a monthly amount (one‑twelfth of the national average payment for designated primary care services, estimated as if no Part B cost sharing applied), adjusted for geogra…
- Clinical registries get Medicare data: benefit, medium. If enacted, the Secretary would let qualified clinical data registries request Medicare claims data by January 1, 2027. The Secretary could also allow Medicaid and CHIP data. Registries applying on or after that date must meet new standards and would get 3‑year designations (extendable). Registries…
- New Medicare physician payment rules: mixed, high. If enacted, this package would change how Medicare updates physician payments starting in 2027. Non‑APM updates would be set as the Medicare Economic Index estimate minus 1.0 percentage point, with the non‑qualifying update floored at 25% and capped at 75% of the MEI estimate, and qualifying APM up…
- MIPS replaced by POINTS system: mixed, medium. If enacted, the Merit‑based Incentive Payment System (MIPS) would be replaced by a new POINTS system starting January 1, 2032, with a required transition. The bill would create a Quality Reform Task Force to recommend quality, resource‑use, and new care‑efficiency measures for POINTS and require th…
- New rules for imaging decision support: mixed, medium. If enacted, for imaging on or after January 1, 2027 qualified clinical decision support systems would have new reporting duties and must provide specified information to the Secretary. The ordering clinician's national provider identifier would be required on applicable imaging claims. The bill exp…
- Tighter review and reports for models: mixed, medium. If enacted, the bill would require more notice‑and‑comment rulemaking for certain federal health models and limit early termination of expanded models to actions that follow notice‑and‑comment. Reports starting in 2027 would have to describe any savings generated by each tested model. These steps i…

## Related bills

- 119-hr-3514: Improving Seniors’ Timely Access to Care Act of 2025
- 119-hr-909: Crime Victims Fund Stabilization Act of 2025
- 119-hr-842: Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act
- 119-hr-2102: Major Richard Star Act
- 119-hr-1262: Mikaela Naylon Give Kids a Chance Act
- 119-hr-879: Medicare Patient Access and Practice Stabilization Act of 2025

## Sources
- [119-hr-9693 on Congress.gov](https://www.congress.gov/bill/119th-congress/house-bill/9693)

## Related
- [119-hr-3514: Improving Seniors’ Timely Access to Care Act of 2025](https://policyrisk.com/legislation/119-hr-3514)
- [119-hr-909: Crime Victims Fund Stabilization Act of 2025](https://policyrisk.com/legislation/119-hr-909)
- [119-hr-842: Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage A…](https://policyrisk.com/legislation/119-hr-842)
- [119-hr-2102: Major Richard Star Act](https://policyrisk.com/legislation/119-hr-2102)
- [119-hr-1262: Mikaela Naylon Give Kids a Chance Act](https://policyrisk.com/legislation/119-hr-1262)
- [119-hr-879: Medicare Patient Access and Practice Stabilization Act of 2025](https://policyrisk.com/legislation/119-hr-879)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-hr-9693 (as of 2026-10-24).