- Medicare physician reimbursement has fallen approximately 33% over the past 25 years, after adjusting for inflation.
- Congress has repeatedly relied on temporary payment fixes rather than addressing the underlying problems with Medicare physician payment.
- The Efficiency Adjustment Delay Act would delay CMS efficiency-related cuts until at least 2030.
- The Provider Reimbursement Stability Act would strengthen budget neutrality protections and limit abrupt payment changes.
- The Patients First Act would establish more predictable updates and reform key aspects of Medicare physician payment.
Over the past 25 years, Medicare physician reimbursement has fallen by approximately 33% after adjusting for inflation, even as the cost of delivering care has continued to rise. This widening gap threatens patient access to care, places increasing financial pressure on physician practices, and undermines the long-term sustainability of the physician workforce.
Rather than enacting a sustainable reform Congress has repeatedly relied on temporary, last-minute payment fixes creating a cycle of uncertainty that makes it difficult for physician practices to plan, invest, and continue delivering high-quality care.
This year, Congress has introduced three bills aimed at reforming aspects of physician payment. STS is tracking each proposal closely.
H.R. 7520: The Efficiency Adjustment Delay Act
On January 1, 2026, the Centers for Medicare & Medicaid Services (CMS) implemented a 2.5% efficiency adjustment that reduced non-time-based work RVUs, with additional cuts scheduled every three years. This policy is based on CMS’ assumption that, over time, performing these services has become more efficient. STS data and other published analyses — including the Study on Surgical Procedure Efficiency Contradicts CMS Misperception — do not support this assumption. The continued implementation of an efficiency adjustment threatens the stability of surgical practices.
Representatives Ron Estes (R-KS) and Tom Suozzi (D-NY) introduced the Efficiency Adjustment Delay Act to delay this flawed policy. The legislation would postpone these cuts until no earlier than January 1, 2030. During that time, CMS would be required to produce empirical evidence supporting the policy and provide a more targeted, evidence-based implementation strategy. The agency also would be required to report to Congress on the justification for any future across-the-board cuts.
STS, along with a broad coalition of surgical and physician organizations, endorsed this legislation, which was referred to the House Energy and Commerce and House Ways and Means Committees on February 12.
Tell your representatives to cosponsor this bill.
H.R. 8163: The Provider Reimbursement Stability Act
Introduced on March 31 by Representatives Greg Murphy, MD (R-NC) and Tom Suozzi (D-NY), along with a bipartisan group of cosponsors, the Provider Reimbursement Stability Act would address the need for budget neutrality reform. The legislation would raise the Medicare Physician Fee Schedule’s budget neutrality trigger from $20 million to $54.3 million and then peg any future increases to the Medicare Economic Index. The bill also would allow corrections for CMS’ inaccurate utilization assumptions and cap year-to-year conversion factor adjustments at 2.5%, preventing sudden, steep cuts from taking effect all at once.
The legislation cleared the House Ways and Means Committee by a vote of 44-0, reflecting strong bipartisan support. STS officially endorsed the bill and continues to advocate for full House passage.
In the Senate, a companion bill was introduced by 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 legislation mirrors the House bill but incorporates a slightly higher budget neutrality trigger of $57.6 million.
Tell your representatives to cosponsor this bill.
H.R. 9693: The Patients First Act
On July 15, 2026, Representatives John Joyce, MD (R-PA), Greg Murphy, MD (R-NC), and Kim Schrier, MD (D-WA) introduced the Patients First Act. The bill would overhaul the current Medicare physician payment system through changes such as:
- Providing a predictable annual payment update tied to a measure of medical inflation;
- Raising the budget-neutrality threshold to $57.6 million;
- Revamping the current Merit-based Incentive Payment System (MIPS) measure review process; and
- Requiring federal claims data to be made available to clinician-led clinical data registries.
The bill was referred to the House Energy and Commerce and House Ways and Means Committees. STS supports many aspects of this legislation and is working closely with staff on both sides of the aisle to refine the bill further.
STS will continue to monitor each of these bills as they move through Congress and will keep members updated on opportunities to advocate for meaningful Medicare payment reform.
