This bill would change how Medicare delays and reviews an "efficiency adjustment" to work relative value units (work RVUs) that are used to set physician payments. It would bar the Secretary of Health and Human Services from putting into effect the efficiency adjustment made by the final rule published on November 5, 2025, before January 1, 2030.
The bill requires the Secretary to send a report to specific congressional committees within 2 years of the law's enactment. The report must assess whether a one-time, across-the-board adjustment to work RVUs is needed for services that have not been revalued or reviewed within the prior 10 years and must include supporting evidence.
If the report supports the adjustment, the bill lets the Secretary implement it on or after January 1, 2030 only if several conditions are met: consult with affected physician specialties; do not apply the adjustment to services revalued or reviewed in the prior 10 years; use a methodology that generally does not rely on a productivity-versus-inflation factor unless a specified nonqualifying APM conversion factor update meets or exceeds the prior year's CPI-U increase; and only allow such an efficiency adjustment once. The bill also says the Secretary can still revalue misvalued codes and set values for new or revised codes.
The bill also amends statutory percentage updates to conversion factors under section 1848(d)(20) of the Social Security Act. It replaces certain percentage figures to make the 2026 updates 1.24 percent (qualifying APM) and 0.74 percent (nonqualifying APM), and it sets the 2027 and later annual updates to 0.75 percent (qualifying APM) and 0.25 percent (nonqualifying APM).
No publicly available information on estimated federal costs or savings. The bill text changes the statutory percentages used to update conversion factors for 2026 and for 2027 and later, but it does not include a budget estimate or detail amounts of spending changes.
No publicly available information.
No publicly available information.