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H.R. 8163119th Congress
Official title: Provider Reimbursement Stability Act of 2026
Introduced:
Read the official bill on Congress.govThe plain-language version leads. The official text is always the reference.
The bill raises the $20 million Medicare payment-adjustment threshold to about $54 million and caps yearly payment swings at 2.5%.
45-second read · 4 questions answered below
This bill changes how Medicare's physician fee schedule calculates payments by raising the budget-neutrality adjustment threshold from $20 million to about $54 million in 2027, with periodic inflation updates. It also requires checking usage estimates for new services against actual data, mandates updates to practice expense cost data at least every five years, and caps year-to-year changes in the payment conversion factor at 2.5%.
Doctors, medical practices, and other health care providers who bill Medicare are primarily affected. Medicare beneficiaries, mostly people 65 and older and some people with disabilities, could be indirectly affected.
Raising the threshold means smaller spending changes will no longer automatically trigger across-the-board payment adjustments, altering how provider payments are set year to year. The changes are intended to make payment calculations more predictable, though they do not alter patient benefits or eligibility.
AI-drafted summary. Verify it against the official text before you act on it. Read the official bill on Congress.gov
Right now: a House committee is reviewing it. If the Senate changes it, it goes back to the House before reaching the President.
Latest action: — Ordered to be Reported in the Nature of a Substitute by the Yeas and Nays: 44 - 0.