A House Energy and Commerce health subcommittee hearing on Sept. 15 examined the Patients First Act of 2026 and four related bills addressing Medicare physician payment, budget neutrality, MIPS, practice expenses, and healthcare cybersecurity. The Patients First Act would link annual Medicare physician fee schedule updates to inflation through the Medicare Economic Index (MEI), rather than the current fixed updates under MACRA. Starting in 2027, the proposed formula would set updates at MEI minus 1 percentage point for clinicians outside advanced APMs, with qualifying APM participants receiving an additional 0.5 percentage point.
The proposals would also modify budget neutrality, including raising the threshold at which CMS must offset spending changes and requiring later adjustments when utilization estimates for new services prove substantially inaccurate. The legislation would also require periodic updates to practice-expense inputs such as clinical staff wages, supply prices, and equipment costs.