September 18, 2026
The House Energy and Commerce Subcommittee on Health examined the bipartisan Patients First Act (H.R. 9693) on September 15. The bill would link annual Medicare physician payment updates to inflation, change quality reporting, and establish a new primary care payment model.
During the hearing, lawmakers discussed how Medicare payment uncertainty and reporting requirements affect physician practices and patient access. Rep. John Joyce (R-PA) described the Patients First Act as a response to pressures facing smaller and rural practices. Rep. Kim Schrier (D-WA) urged the subcommittee to move the legislation to markup rather than pursue another temporary payment fix. Rep. Raul Ruiz (D-CA), however, pressed for payment updates reflecting the full Medicare Economic Index, highlighting an unresolved question about how closely physician payments should track practice-cost inflation.
PALTmed supports the Patients First Act’s core goals and submitted comments urging lawmakers to ensure nursing facility clinicians and their patients are included in its primary care payment and quality-reporting provisions. The association emphasized that payment and eligibility should reflect the clinical work performed, not simply the site of service.
The subcommittee also reviewed the Provider Reimbursement Stability Act (H.R. 8163), which PALTmed supports. It would update Medicare’s budget-neutrality rules and require more regular updates to practice expense inputs, with the goal of making payments more predictable.
What’s next? Further Energy and Commerce action could include a markup to consider amendments and vote on the bills before potential House consideration. H.R. 8163 already advanced through the Ways and Means Committee in May, but that action did not make it law. Both proposals require additional congressional action.