With the recently proposed 2027 Medicare Physician Fee Schedule Congress calling for an additional 2.8 percent Medicare payment reduction on January 1, 2027, and increased practice costs and care delays related to prior authorization policies, physician advocates can fight back by sharing their stories with legislators through emails, letters, calls, and local meetings. Additionally, physicians can advocate for passage of three legislative packages supported by the Michigan State Medical Society (MSMS) to address systematic problems with the Medicare physician payment system and preserve patient access to quality care are currently awaiting congressional action.
Provider Reimbursement Stability Act, HR 8163 and S 5180
This legislation takes a major step in modernizing Medicare physician payment. Led by Representatives Greg Murphy, MD (R-NC) and Tom Suozzi (D-NY) and Senators John Boozman (R-AR), Peter Welch (D-VT), Roger Marshall MD (R-KS), Angus King (I-ME), Thom Tillis (R-NC) and Jeanne Shaheen (D-NH), the Provider Reimbursement Stability Act would modernize key budget neutrality rules, ensuring fairness and predictability for medical practices and stability for physicians and patients.
HR 8163 and S 5180 promote reimbursement stability and protects physicians by 1) updating the budget neutrality threshold to $57.64 million (currently at $20 million) and indexing it every five years based on the cumulative percentage increase in the Medical Economic Index (MEI), 2) mandating that CMS evaluate the actual base costs for running a medical practice at least every five years, and 3) revising how CMS addresses incorrect billing codes.
S 5180 was newly introduced and now is the opportunity to contact your US senators and urge them to support common sense Medicare payment reforms by cosponsoring this bipartisan bill.
Patients First Act, HR 9693
On July 15, 2026, the bipartisan Doctors Caucus chairs - Representatives John Joyce, MD, Greg Murphy, MD, and Kim Schrier, MD - introduced the Patients First Act, a comprehensive proposal to reform the Medicare Access and CHIP Reauthorization Act (MACRA) and the Medicare physician payment system. If enacted, the bill is positioned to make a number of changes to positively impact access to care including a greater investment in primary care, an annual positive inflationary updates for Part B physician payment, and a higher threshold for triggering budget neutrality.
Provisions in the Patient First Act:
- Tie physician reimbursement to an inflationary measure.
- Establish a primary care hybrid payment pilot program that pays PCPs a per-member-per-month payment along with regular services, better capturing the work PCPs do.
- Establish the POINTS program, which creates a physician and clinician-led task force at CMS to develop quality metrics that are streamlined and reduce administrative burden.
- Freeze A-APM participation thresholds for three years and creates notice and comment periods for CMMI mandatory models.
- Increase the budget neutrality threshold from $20 million to $54.3 million.
The Improving Seniors’ Timely Access to Care Act, HR 3514 and S 1816
The Improving Seniors' Timely Access Act would modernize the Medicare Advantage (MA) prior authorization process by establishing electronic prior authorization, strengthening transparency and accountability, increasing proper government oversight, and streamlining determinations for medically necessary care. Those reforms would enable more than 35 million seniors, individuals with disabilities, and veterans enrolled in MA to choose and receive reliable and predictable care.
Led by Representatives Mike Kelly (R-PA), Suzan DelBene (D-WA), John Joyce, MD (R-PA), and Ami Bera, MD (D-CA), along with Senators Roger Marshall, MD (R-KS), and Mark Warner (D-VA), HR 3514 is co-sponsored by 298 House members and S 1816 has 71 bipartisan cosponsors. Click here to urge Congress to pass the “Improving Seniors’ Timely Access to Care Act.”
Questions on these three legislative packages can be directed to Stacey P. Hettiger, MSMS Senior Director of Advocacy and Payor Relations, at shettiger@msms.org or 517-336-5766.