Provider Reimbursement Stability Act of 2026

Stable Medicare doctor payment rules

This bill would change how Medicare pays doctors under the physician fee schedule. It would set the budget-neutrality trigger at $20,000,000 before 2028 and $57,640,000 for 2028. Starting in 2033 and every five years after, the Secretary would raise that amount by the five-year Medicare Economic Index increase. Beginning in 2029, the Secretary would compare estimated versus actual Part B spending for certain services. If the difference exceeds 0.1% of Part B spending, CMS would adjust the conversion factor in the second year after the year measured. The bill would require CMS to update practice expense cost inputs at least every five years, covering clinical staff wages, supplies, and equipment, and the updates must occur in the same year across categories. Beginning in 2028, budget-neutrality adjustments would not be allowed to change the conversion factor by more than 2.5% from the prior year.