# 119-s-5269: Pay PCPs Act of 2026

119-s-5269, Pay PCPs Act of 2026, is a 119th Congress bill sponsored by Sen. Whitehouse, Sheldon [D-RI] (D-RI); status introduced; PRIA reads it as touching household money (as of 2026-08-20).

- Canonical: https://policyrisk.com/legislation/119-s-5269
- As of: 2026-08-20
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-s-5269
- Congress: 119
- Title: Pay PCPs Act of 2026
- Status: introduced
- Introduced: 2026-08-05
- Sponsor: Sen. Whitehouse, Sheldon [D-RI] (D-RI)
- Cosponsors: 1
- Policy area: Health
- Touches household money: yes
- Last recorded action: 2026-08-20

## Summary

**Creates a hybrid payment framework for primary care** that pairs a monthly per-member-per-month payment with continued fee-for-service billing to support team-based care, care coordination, and better access for patients with complex needs or in rural or low-income communities. This approach is aimed at helping practices transform how they deliver primary care. - Families and beneficiaries: The bill would cut beneficiary Part B cost-sharing by 50% for primary care services paid through the hybrid model when a primary care provider is designated as the usual source of care and notified to CMS. It also requires a report to Congress within 180 days of implementation and yearly after that on utilization and possible fraud or abuse. - Primary care providers and clinics: It would let primary care providers receive a PMPM payment equal to 40% to 70% of expected annual allowed charges for included services while still billing fee-for-service for other services. The bill also appropriates $10.0 billion for fiscal years 2027 through 2031 to fund hybrid payments and does not force providers to participate. - CMS operations, quality, and oversight: The Secretary could set quality measures and bonuses and exempt participating providers from some Merit-based Incentive Payment System reporting. The bill creates a technical advisory committee and allows transfers from the Supplementary Medical Insurance Trust Fund up to $5.0 million and $10.0 million per year for implementation and research and development through 2031. *Would authorize $10.0 billion in appropriations for 2027–2031 and permit additional trust fund transfers for committee work, increasing federal outlays relative to current law.*

## Cosponsors (1)

- Sen. Cassidy, Bill [R-LA] (R-LA), 2026-08-05T00:00:00.000Z

## Provisions PRIA read

- Lower Medicare primary care costs: benefit, medium. If enacted, the bill would let HHS create a voluntary hybrid Medicare payment for primary care. Participating primary care providers would get a monthly per-member payment plus fee-for-service for services not covered by the monthly payment. The monthly payment would equal 40% to 70% of expected an…
- New CMS RVU advisory committee: benefit, medium. If enacted, the bill would create a 13-member technical advisory committee inside CMS to advise on relative value unit valuation under the physician fee schedule. The committee would include Medicare-billing providers, primary care clinicians, and technical experts and would be chaired and staffed…

## Related bills

- 119-s-4949: Water Resources Development Act of 2026
- 119-s-4744: Take Care of America’s Veterans Act
- 119-s-5071: Children's Safe Welcome Act of 2026
- 119-s-1748: Kids Online Safety Act
- 119-s-93: Harmful Algal Bloom and Hypoxia Research and Control Amendments Act of 2025
- 119-s-3990: PrEP Access and Coverage Act of 2026

## Sources
- [119-s-5269 on Congress.gov](https://www.congress.gov/bill/119th-congress/senate-bill/5269)

## Related
- [119-s-4949: Water Resources Development Act of 2026](https://policyrisk.com/legislation/119-s-4949)
- [119-s-4744: Take Care of America’s Veterans Act](https://policyrisk.com/legislation/119-s-4744)
- [119-s-5071: Children's Safe Welcome Act of 2026](https://policyrisk.com/legislation/119-s-5071)
- [119-s-1748: Kids Online Safety Act](https://policyrisk.com/legislation/119-s-1748)
- [119-s-93: Harmful Algal Bloom and Hypoxia Research and Control Amendments Act of 2025](https://policyrisk.com/legislation/119-s-93)
- [119-s-3990: PrEP Access and Coverage Act of 2026](https://policyrisk.com/legislation/119-s-3990)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-s-5269 (as of 2026-08-20).