Govwatch

Introduced

In Committee

3

Passed One Chamber

4

Passed Both

5

Signed into Law

Sponsor

Gregory F. Murphy

Republican · NC · Representative

Votes with party: 98.8% (480 recorded votes)

Full profile: /officials/M001210

Source: Congress.gov · FEC

Cosponsors (52)

Members who have signed on to support this bill since introduction. Source: Congress.gov.

Latest Action

The most recent step in the bill's legislative path. Committee Activity below shows referrals and reports; the full action-by-action history including floor proceedings lives at Congress.gov →

Ordered to be Reported in the Nature of a Substitute by the Yeas and Nays: 44 - 0.

2026-05-21

Source: Congress.gov

Committee Activity

Currently in

House Committee on Ways and MeansMarkup By · 2026-05-21
House Committee on Energy and CommerceReferred To · 2026-03-30

Previously

Ways and Means CommitteeReferred To · 2026-03-30
Energy and Commerce CommitteeReferred To · 2026-03-30
House Committee on Ways and MeansReferred To · 2026-03-30

Plain-English Summary

This bill would establish more stable and predictable payment rates for doctors, hospitals, and other healthcare providers who treat Medicare and Medicaid patients, likely aiming to prevent sudden cuts or fluctuations in what the government reimburses them for medical services. The legislation would affect healthcare providers across the country and potentially influence the quality and availability of care for seniors and low-income patients who rely on these government programs. By creating more consistent payment policies, the bill seeks to help medical providers better plan their budgets and staffing while maintaining their ability to serve these vulnerable populations.

AI-assisted summary generated from the official bill metadata (title, subjects, actions) sourced from Congress.gov. Cached and reviewed. Always verify against the official text linked below.

Subjects

Health

Full Bill Text

Verbatim text published on Congress.gov via GovInfo. Use Cmd+F / Ctrl+F to search within this excerpt.

[Congressional Bills 119th Congress] [From the U.S. Government Publishing Office] [H.R. 8163 Introduced in House (IH)] <DOC> 119th CONGRESS 2d Session H. R. 8163 To amend title XVIII of the Social Security Act to ensure stability for provider payments under the Medicare program. _______________________________________________________________________ IN THE HOUSE OF REPRESENTATIVES March 30, 2026 Mr. Murphy (for himself, Mr. Schneider, Mr. Joyce of Pennsylvania, Mr. Suozzi, Mr. Onder, Mr. Panetta, Mrs. Miller-Meeks, Ms. Schrier, and Ms. Kelly of Illinois) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned _______________________________________________________________________ A BILL To amend title XVIII of the Social Security Act to ensure stability for provider payments under the Medicare program. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, SECTION 1. SHORT TITLE. This Act may be cited as the ``Provider Reimbursement Stability Act of 2026''. SEC. 2. UPDATING THE BUDGET NEUTRALITY THRESHOLD. Section 1848(c)(2)(B)(ii)(II) of the Social Security Act (42 U.S.C. 1395w-4(c)(2)(B)(ii)(II)) is amended-- (1) by striking ``Subject to'' and inserting the following: ``(aa) In general.--Subject to''; (2) in item (aa), as inserted by paragraph (1), by striking ``$20,000,000'' and inserting ``the amount specified in item (bb) for such year''; and (3) by adding at the end the following new items: ``(bb) Amount specified.-- For purposes of item (aa), subject to item (cc), the amount specified in this item is-- ``(AA) for years before 2027, $20,000,000; ``(BB) for 2027, $54,300,000; and ``(CC) for 2028 and each subsequent year, the amount specified in this item for the preceding year. ``(cc) Indexing limitation on annual adjustments.--For 2032 and every subsequent fifth year, the Secretary shall increase the amount specified in item (bb) for such year by the cumulative percentage increase in the MEI (as defined in section 1842(i)(3)) applicable to physicians' services for each year occurring during the 5-year period ending on the last day of the preceding year.''. SEC. 3. BUDGET NEUTRALITY CORRECTIONS RELATING TO ESTIMATED UTILIZATION. (a) In General.--Section 1848(c)(2)(B) of the Social Security Act (42 U.S.C. 1395w-4(c)(2)(B)) is amended by adding at the end the following new clause: ``(vii) Budget neutrality corrections relating to estimated utilization.-- ``(I) In general.--In the case of a budget neutrality adjustment applied pursuant to clause (ii)(II) for a year (beginning with 2027) that is determined in part using estimated utilization (as defined in subclause (II)(bb)) with respect to a specified service (as defined in subclause (II)(cc)), the Secretary shall, as part of the final rule establishing the physician fee schedule under this section for the assumption correction period (as defined in subclause (II)(aa)) with respect to such year-- ``(aa) determine the difference between expenditures for such service in such year using estimated utilization and actual utilization for such service (in a manner determined appropriate by the Secretary); and ``(bb) in the case that the Secretary determines the difference described in item (aa) is greater than the threshold amount (as defined in subclause (II)(dd)) for such year, adjust the conversion factor under this section for such assumption correction period by such amount to reconcile such difference (which may be positive or negative), as determined by the Secretary. ``(II) Definitions.--For purposes of this clause: ``(aa) Assumption correction period.--The term `assumption correction period' means, with respect to a year, the second year beginning after such year. ``(bb) Estimated utilization.--The term `estimated utilization' means an estimate of…

Show the remaining 591 words

utilization used for purposes of applying clause (ii)(II). ``(cc) Specified service.-- The term `specified service' means, with respect to a year, a service-- ``(AA) with expected expenditures for such year under this part based on estimated utilization that exceed the threshold amount (as defined in item (dd)) for such year; and ``(BB) for which payment had been bundled into payment for another service during the preceding year and for which a separate payment or add-on payment is made during such year. ``(dd) Threshold amount.-- The term `threshold amount' means, with respect to a year, 0.1 percent of the total estimated expenditures under this part for services furnished under this section during such year.''. (b) Nonapplication of Budget Neutrality to Reconciliation Adjustments.--Section 1848(c)(2)(B) of the Social Security Act (42 U.S.C. 1395w-4(c)(2)(B)) is amended-- (1) in clause (iv)-- (A) in subclause (V), by striking ``and'' at the end; (B) in subclause (VI), by striking the period and inserting ``; and''; and (C) by adding at the end the following new subclause: ``(VII) clause (vii)(I)(bb) for an assumption correction period (as defined in clause (vii)(II)) shall not be taken into account in applying clause (ii)(II) with respect to such period.''; and (2) in clause (v), by adding at the end the following new subclause: ``(XII) Reductions attributable to an assumption correction.--For an assumption correction period (as defined in clause (vii)(II)), reduced expenditures attributable to application of clause (vii)(I)(bb) with respect to such period.''. SEC. 4. TIMELY UPDATES TO DIRECT COSTS USED TO CALCULATE PRACTICE EXPENSE RVUS. Section 1848(c)(2)(B) of the Social Security Act (42 U.S.C. 1395w- 4(c)(2)(B)), as amended by section 3, is further amended by adding at the end the following new clause: ``(viii) Timely updates to direct costs used to calculate practice expense relative value units.-- ``(I) Simultaneous updates to direct cost inputs at least once every 5 years.--The Secretary shall, not less often than every 5 years, update the prices and rates, as applicable, on a category-wide basis for each of the categories of direct cost inputs described in subclause (II) used in the methodology for calculating the practice expense relative value units under this subsection for physicians' services. Updates made pursuant to the previous sentence shall be made in the same year for all categories of direct cost inputs described in such subclause. ``(II) Direct cost inputs categories described.--For purposes of this clause, the categories of direct cost inputs described in this subclause are clinical staff wage rates, prices of medical supplies, prices of equipment, and any other category of such inputs used in the methodology described in subclause (I) (as specified by the Secretary). ``(III) Consultation.--In making the updates under this clause, the Secretary shall consult with relevant stakeholders, including physician specialty societies.''. SEC. 5. LIMITATION ON YEAR-TO-YEAR CONVERSION FACTOR VARIANCE. Section 1848(c)(2)(B) of the Social Security Act (42 U.S.C. 1395w- 4(c)(2)(B)), as amended by sections 3 and 4, is further amended by adding at the end the following new clause: ``(ix) Limitation on conversion factor variance.-- ``(I) In general.--Beginning with 2027, the Secretary may not, for purposes of complying with clause (ii)(II), apply a budget neutrality adjustment to a conversion factor established under subsection (d) for such year that would cause such factor, not taking into account any adjustment to such factor for such year provided under such subsection, to vary by more than 2.5 percent compared to such factor so established for the preceding year. ``(II) Continued applicability of budget neutrality requirement.--Nothing in subclause (I) may be construed to alter the requirement described in clause (ii)(II).''. <all>

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