Bipartisan Bill Introduced to Reform Medicare PFS

April 08, 2026

  • Legislation recently introduced in Congress would reform the Medicare PFS’s budget neutrality requirement.
  • ASCP believes the changes included in the bill would help minimize the negative impact that the budget neutrality requirement can have on the annual process of updating PFS payment rates


    On March 30, a bipartisan group of U.S. House members introduced the Provider Reimbursement Stability Act (H.R. 8163), aimed at updating the Medicare Physician Fee Schedule (PFS). The bill targets long‑standing “budget neutrality” rules that prevent overall PFS spending from increasing unless Congress adds new funding. Changing these requirements remains a key advocacy priority for ASCP.

    The policies outlined in H.R. 8163 would help minimize the negative impact that the budget neutrality requirement can have on the annual process of updating PFS payment rates. Reforming the budget neutrality requirement is an important advocacy goal for ASCP.

    Key provisions in H.R. 8163 include:

    • Raising the budget neutrality threshold from $20 million to $54.3 million.
    • Requiring HHS to revise spending estimates prospectively using actual claims data.
    • Mandating CMS to update direct practice expense inputs—clinical labor rates, medical supply prices, and equipment prices—at the same time and at least every five years.
    • Capping annual changes to the MPFS conversion factor at no more than ±2.5 percent, starting in 2027.

      • H.R. 8163 was introduced by Reps. Greg Murphy, MD (RNC), Tom Suozzi (DNY), John Joyce, MD (RPA), Bob Onder, MD (RMO), Brad Schneider (DIL), Jimmy Panetta (DCA), Mariannette Miller Meeks, MD (RIA), Kim Schrier, MD (DWA), and Robin Kelly (DIL).

       A joint press release from the House sponsors is available here.

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