Strengthening Medicare for Patients and Providers Act

Strengthening Medicare for Patients and Providers Act

This bill modifies certain adjustments to payment amounts under the Medicare physician fee schedule.

Payment amounts under the Medicare physician fee schedule are based on a service's relative value, a conversion factor, and a geographic adjustment factor. Current law provides for separate conversion factors for physicians that are qualifying participants in advanced alternative payment models (also known as qualifying APM participants) and for other physicians beginning in 2026, with an annual update of 0.75% and 0.25%, respectively.

The bill replaces the separate conversion factors for qualifying APM participants and other physicians with a single conversion factor and provides for an update that is equal to the annual percentage increase in the Medicare Economic Index, beginning in 2026. (The Medicare Economic Index is a specialized index that is generally used to determine allowed charges for physician services based on annual price changes.)

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6160 Introduced in House (IH)]

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119th CONGRESS
  1st Session
                                H. R. 6160

   To amend title XVIII of the Social Security Act to provide for an 
 update to a single conversion factor under the Medicare physician fee 
         schedule that is based on the Medicare economic index.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           November 19, 2025

 Mr. Ruiz (for himself, Mr. Bilirakis, Mr. Panetta, Mr. Bera, and Ms. 
   Schrier) introduced the following bill; which was referred to the 
 Committee on Energy and Commerce, and in addition to the Committee on 
   Ways and Means, for a period to be subsequently determined by the 
  Speaker, in each case for consideration of such provisions as fall 
           within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
   To amend title XVIII of the Social Security Act to provide for an 
 update to a single conversion factor under the Medicare physician fee 
         schedule that is based on the Medicare economic index.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Strengthening Medicare for Patients 
and Providers Act''.

SEC. 2. TRANSITION TO AN UPDATE TO A SINGLE CONVERSION FACTOR UNDER THE 
              MEDICARE PHYSICIAN FEE SCHEDULE BASED ON THE MEDICARE 
              ECONOMIC INDEX.

    (a) In General.--Section 1848(d)(2) of the Social Security Act (42 
U.S.C. 1395w-4(d)(20)) is amended to read as follows:
            ``(20) Update for 2026 and subsequent years.--The update to 
        the single conversion factor established in paragraph (1)(C) 
        for 2026 and each subsequent year shall be equal to the 
        Secretary's estimate of the percentage increase in the MEI (as 
        defined in section 1842(i)(3)) for the year.''.
    (b) Conforming Amendment To Provide for a Single Conversion Factor 
After 2025.--Section 1848(d)(1)(A) of the Social Security Act (42 
U.S.C. 1395w-4(d)(1)(A)) is amended--
            (1) by striking ``and ending with 2025''; and
            (2) by striking ``There shall be two separate conversion 
        factors'' and all that follows through the end of the 
        subparagraph.
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