August 25, 2026
PALTmed has submitted comments to Rep. John Joyce, MD (R-PA) on the Patients First Act of 2026 (H.R. 9693), the emerging vehicle for Medicare physician payment reform. The letter supports the bill's core goals, tying physician payment to inflation, easing quality-reporting burden, and building a physician-led quality framework, while pressing one central point: payment and eligibility should follow the clinical work and the patient, not the site of service. PALTC clinicians deliver primary care; they simply furnish it in the nursing facility rather than the office.
The comments center on the following asks so the bill reaches these clinicians: counting nursing facility E&M services toward hybrid primary care demonstration eligibility, including PALTC representation and fair attribution in POINTS quality measure development, and ensuring the excluded practice definition does not cut PALTC patients off from the demonstration or penalize their clinicians.