Strengthening Medicare for Patients and Providers Act
Strengthening Medicare for Patients and Providers Act
Plain Language Summary
# Strengthening Medicare for Patients and Providers Act Summary **What the bill would do:** This bill would change how Medicare pays doctors starting in 2026. Currently, the payment system is set to create two different payment rates—one for doctors participating in "advanced alternative payment models" (newer care delivery systems) and one for traditional doctors. The bill would eliminate this split and instead use a single payment rate for all doctors, with annual increases tied to the Medicare Economic Index (which measures inflation in healthcare costs). **Who it affects:** The bill directly impacts Medicare physicians and the patients they serve.
It affects doctors who participate in advanced care models differently than those in traditional practice, as well as the broader Medicare system's ability to attract and retain physicians. **Key provisions:** Rather than the planned 0.75% annual increase for advanced practice model participants and 0.25% for others, all doctors would receive the same annual update based on the Medicare Economic Index, which typically reflects broader healthcare cost increases. **Current status:** The bill was introduced in the 119th Congress by Rep. Raul Ruiz (D-CA) and is currently in committee, meaning it has not yet been voted on by the full House.
CRS Official Summary
Strengthening Medicare for Patients and Providers ActThis bill modifies certain adjustments to payment amounts under the Medicare physician fee schedule.Payment amounts under the Medicare physician fee schedule are based on a service's relative value, a conversion factor, and a geographic adjustment factor. Current law provides for separate conversion factors for physicians that are qualifying participants in advanced alternative payment models (also known as qualifying APM participants) and for other physicians beginning in 2026, with an annual update of 0.75% and 0.25%, respectively.The bill replaces the separate conversion factors for qualifying APM participants and other physicians with a single conversion factor and provides for an update that is equal to the annual percentage increase in the Medicare Economic Index, beginning in 2026. (The Medicare Economic Index is a specialized index that is generally used to determine allowed charges for physician services based on annual price changes.)
Latest Action
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.