Provider Reimbursement Stability Act of 2026

Summary

Provider Reimbursement Stability Act of 2026 This bill allows for larger annual adjustments to the Medicare physician fee schedule. It also requires the Centers for Medicare & Medicaid Services (CMS) to make certain corrections to compensate for expenditures under the fee schedule that exceed a certain amount in a given year, and it limits how much certain adjustment factors may vary each year. Current law prohibits annual adjustments to the Medicare physician fee schedule that would result in a more than $20 million difference between the adjusted amount and the non-adjusted amount of total expenditures. The bill increases this threshold to $54.3 million beginning in 2027, with adjustments for inflation every five years beginning in 2032. Additionally, for certain services, the bill requires the CMS to determine the difference between expenditures based on estimated utilization of the service and expenditures based on actual utilization. If this difference exceeds a certain percentage of total expenditures under the fee schedule, the CMS must reconcile this difference by adjusting payments for the following year. This requirement applies to services for which payment was bundled with another service and there was a separate or add-on payment during the previous year. Finally, the CMS must update the prices and rates of each category of direct costs that affect payments (e.g., prices of equipment) at least every five years, with updates made to each category in the same year. The bill also prohibits the CMS from varying a certain adjustment factor by more than 2.5% each year.

Summary from the Congressional Research Service. How we handle summaries

Where it stands

Out of committee and scheduled for a vote by the full chamber.

House Committee on Energy and Commerce · U.S. House of Representatives

Also referred to House Committee on Ways and Means · U.S. House of Representatives.

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Cosponsors

Related bills

• H.R. 9693To amend title XVIII of the Social Security Act to modify certain physician payments under the Medicare program.Related bill
• S. 5180A bill to amend title XVIII of the Social Security Act to ensure stability for provider payments under the Medicare program.Related bill

As identified by Congress.gov.

Full history

1. Jun 10, 2026

   Introduced

   Introduced in U.S. House

   U.S. House

2. May 21, 2026

   Committee vote

   Committee Consideration and Mark-up Session Held

3. May 21, 2026

   Committee vote

   Committee Consideration and Mark-up Session Held

4. May 21, 2026

   Committee vote

   Committee Consideration and Mark-up Session Held

5. May 21, 2026

   Reported out of committee

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

Read the record

• Read on Congress.gov (opens in a new tab) The official record on Congress.gov.