Bill · S. 5180· Senate(119-S-5180)
Provider Reimbursement Stability Act of 2026
A bill to amend title XVIII of the Social Security Act to ensure stability for provider payments under the Medicare program.
- Introduced
- 7/30/2026
- Last activity
- 7/30/2026 — Read twice and referred to the Committee on Finance.
- Sponsored by
- John Boozman
- Cosponsors
- - 3 - 3
- Introduced
- In Committee
What this bill would do
The Provider Reimbursement Stability Act of 2026 aims to amend the Social Security Act to provide more stability for Medicare provider payments. It updates the budget neutrality threshold, increasing it over time and allowing for adjustments based on the Medical Expense Index. The bill also introduces corrections for budget neutrality based on the difference between estimated and actual service utilization. Additionally, it mandates timely updates to direct cost inputs used to calculate practice expense relative value units. Finally, the Act places a limit on how much the conversion factor can vary from year to year.
Yes· 3 of 4
Would business owners be better off under this?+6
The bill provides increased stability and predictable reimbursement rates for healthcare providers and their business operations.
Would people over 65 be better off under this?+5
The bill enhances Medicare stability, which directly benefits the senior population reliant on these services.
Would retired people be better off under this?+5
The bill improves the stability of Medicare, which is a critical component of healthcare for retirees.
The opposite
No question was scored the opposite.
Who it would affect, and how
Potential Positive Impacts for People
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Increased Budget Neutrality Thresholds: The bill increases the threshold amount for years 2028 and 2029, and requires the amount to increase in subsequent years based on the cumulative percentage increase in the MEI (Section 2, item (bb)). This change aims to ensure stability for provider payments.
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Utilization Reconciliation: The Secretary will determine the difference between expenditures using estimated utilization versus actual utilization. If the difference exceeds a specific threshold, the conversion factor will be adjusted to reconcile the difference (Section 3, clause (vii)(I)).
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Cost Input Updates: The Secretary is required to update prices and rates for direct cost inputs—such as clinical staff wage rates, medical supplies, and equipment—at least once every five years (Section 4, clause (viii)(I)). This includes consultation with relevant stakeholders and physician specialty societies (Section 4, clause (viii)(III)).
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Conversion Factor Stability: Starting in 2028, the Secretary is prohibited from applying a budget neutrality adjustment that causes the conversion factor to vary by more than 2.5 percent compared to the previous year (Section 5, clause (ix)(I)).
Potential Negative Impacts for People
- Budget Neutrality Adjustments: The Secretary is authorized to adjust the conversion factor by a positive or negative amount to reconcile differences between estimated and actual service utilization (Section 3, clause (vii)(I)(bb)).
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Hover a score for the reason it gave.
- Demographic And Interest Groups
- Good For Business Owners+6Good For Retirees+5Good For Seniors+5
- Healthcare
- Increases Medicare Funding+5
- 9/15/2026
- 2 Cosponsors added.
- 7/30/2026
- Read twice and referred to the Committee on Finance.
- 5 Cosponsors added.
- Introduced in Senate
2 bills Congress.gov lists as related to this one — companions in the other chamber, earlier versions, and bills this one absorbed or was folded into.
Jim BanksRepublican · Indiana
Tammy DuckworthDemocrat · Illinois
Angus KingIndependent · Maine
Roger MarshallRepublican · Kansas
Jeanne ShaheenDemocrat · New Hampshire
Thomas TillisRepublican · North Carolina
Peter WelchDemocrat · Vermont