Provider Reimbursement Stability Act of 2026
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed House
- Passed Senate
- To President
- Became Law
Overview
The Provider Reimbursement Stability Act of 2026 aims to stabilize Medicare payments to healthcare providers by adjusting the budget neutrality threshold and updating how utilization estimates are used in payment calculations. Specifically, it increases the amount used to determine budget neutrality, introduces a mechanism to account for differences between estimated and actual utilization, and mandates more frequent updates to direct cost inputs used in calculating physician reimbursement rates. The bill also limits the amount a conversion factor can vary year-to-year due to budget neutrality adjustments.
Key provisions
- Increases the budget neutrality threshold for Medicare payments.
- Establishes a process to reconcile differences between estimated and actual utilization when calculating payments.
- Requires the Secretary to update direct cost inputs (clinical staff wages, supplies, equipment) at least every 5 years.
- Limits the annual variance of the conversion factor due to budget neutrality adjustments to 2.5 percent.
- Modifies how budget neutrality adjustments are applied during assumption correction periods.
Who is affected
- Healthcare providers (physicians, etc.)
- Medicare beneficiaries
- The Centers for Medicare & Medicaid Services (CMS)
- Hospital systems
- Physician specialty societies
Notable changes
Bill text
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Sponsors
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80 on record
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Cosponsors
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