Goodsurance

Policy & oversight

Three Doctor-Lawmakers Introduce Bipartisan Bill to Restructure Medicare Physician Pay

The Patients First Act, introduced July 15, would replace the current cycle of year-to-year payment patches with inflation-tied annual updates, a new primary-care payment pilot, and a simplified quality-reporting system.

By the Goodsurance editorial teamJuly 17, 2026

Representatives John Joyce, Greg Murphy, and Kim Schrier, the respective chairs and co-chairs of the House Republican and Democratic Doctors Caucuses, introduced H.R. 9693, the Patients First Act, on July 15, 2026. All three are physicians, and the bill reflects a diagnosis shared across specialties and party lines: the current Medicare physician payment system does not keep pace with the rising cost of running a medical practice.

Under the current framework, Congress has repeatedly passed short-term patches to prevent automatic payment cuts under the Sustainable Growth Rate's successor formula. The Patients First Act would replace that cycle with an annual update tied to a measure of medical-sector inflation, providing more predictability for practices.

Three physician-lawmakers just introduced a bipartisan bill to end Medicare's annual doctor-pay fix cycle.

The bill also proposes a five-year hybrid payment pilot for primary care beginning in 2027, combining a monthly per-patient payment with fee-for-service payments for individual visits. Sponsors say the model is meant to encourage primary care in underserved and rural areas. To that end, the bill extends the rural work Geographic Practice Cost Index floor, a provision that benefits physicians in 34 states.

Starting in 2032, the existing Merit-based Incentive Payment System would be replaced by a new framework called the Patient Outcome Improvement National Tabulation System, or POINTS, which sponsors describe as simpler and more clinician-led. The bill had 30 co-sponsors at introduction and drew early endorsements from multiple medical specialty societies.

In plain words

On July 15, three doctor-members of Congress introduced a bill to change how Medicare pays physicians. Right now, Congress often has to pass last-minute fixes to prevent pay cuts. This bill would give doctors steady, inflation-tied pay increases instead. It also would test a new monthly payment for primary care doctors, especially in rural areas, and replace the current quality-reporting system with a simpler one starting in 2032.

Source: Rep. John Joyce (house.gov)
Read at the source →

More news

Other stories on what is moving in Medicare.

Policy & oversight

CMS Barred a Puerto Rico Medicare Advantage Plan From Accepting New Members for 2027

The Centers for Medicare and Medicaid Services issued an enrollment suspension notice on September 3 prohibiting MMM Healthcare LLC from enrolling new Medicare Advantage beneficiaries under contract H7522 for contract year 2027. Existing members are not affected.

September 23, 2026

Policy & oversight

Missouri Receives More Than 45 Million Dollars in Federal Rural Health Grants for Hospitals, Behavioral Care, and EMS Training

Today's announcement directs funds to facility upgrades at 20 rural hospitals, psychiatric consultation access for children and families, and training for hundreds of emergency medical workers.

September 22, 2026

Policy & oversight

OIG Found About 2.3 Million Dollars in Medicare Telehealth Billing Violations That CMS Safeguards Did Not Catch

A federal audit found that Medicare paid for virtual check-ins and e-visits that violated billing timing rules because CMS and its contractors lacked automated detection tools.

September 21, 2026

Policy & oversight

New Mexico Receives 74 Million Dollars in Federal Rural Health Funds to Expand Specialty Care Across Frontier and Tribal Communities

Six Regional Hub Organizations will use the five-year grant to bring telehealth, e-consults, chronic disease management, and workforce support closer to rural, frontier, and Tribal residents statewide.

September 21, 2026

Policy & oversight

Traditional Medicare Required Prior Authorization for Certain Services in Six States for the First Time Starting January 2026, KFF Finds

A KFF examination of the WISeR Model, active in Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington, found it targets services whose spending grew about 400 percent between 2019 and 2024.

September 21, 2026

Policy & oversight

CMS Releases Final Mandatory Participant List for New Medicare Specialist Payment Model Starting January 2027

Cardiologists and certain pain, orthopedic, and neurosurgery specialists treating Medicare patients for heart failure or low back pain in selected areas are now on notice that a mandatory payment model ties their Part B reimbursement to outcomes beginning January 1.

September 20, 2026