Bill · S. 5672· Senate(119-S-5672)
Patients First Act of 2026
- Introduced
- 9/30/2026
- Last activity
- 9/30/2026 — Read twice and referred to the Committee on Finance.
- Sponsored by
- Roger Marshall
- Cosponsors
- None
- Introduced
- In Committee
What this bill would do
This bill, known as the Patients First Act of 2026, makes several changes to how physicians are paid under the Medicare program. It updates payment conversion factors and sets up a hybrid payment model for certain primary care services. The legislation also reforms the Merit-based Incentive Payment System by renaming it to the Patient Outcome Improvement National Tabulation System. Additionally, it creates a Quality Reform Task Force to issue recommendations on quality and efficiency measures. Finally, the bill adjusts budget neutrality rules and places limits on year-to-year conversion factor variances to help protect against steep payment drops.
Yes· 3 of 12
Does this make health care easier to get in general?+8
The legislation introduces a hybrid payment model for primary care services with zero patient cost-sharing and protects access in high-cost areas.
Would people over 65 be better off under this?+7
Medicare beneficiaries over 65 benefit from improved primary care access and zero cost-sharing under the new hybrid payment model.
Would retired people be better off under this?+7
Retirees relying on Medicare benefit from strengthened primary care payment models and enhanced provider participation rules.
The opposite
No question was scored the opposite.
Who it would affect, and how
Potential Positive Impacts for People
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Section 102: Establishes a hybrid payment model for primary care services that provides monthly payments to qualifying suppliers without applying cost-sharing requirements to patients. This could benefit individuals by lowering out-of-pocket costs for essential primary care.
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Section 103: Implements a work geographic floor adjustment during high inflationary years, which helps ensure that doctors in high-cost areas continue to receive fair payments. This protects patient access to local medical care regardless of broader economic inflation.
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Section 203: Creates a Quality Reform Task Force with strong representation from medical professionals and specialists. This ensures that the rules and measures used to judge doctors' performance are grounded in real clinical guidelines rather than arbitrary bureaucracy.
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Section 204: Requires the government to provide timely, quarterly feedback to professionals on administrative claims-based measures and prevents negative payment adjustments if the government fails to provide this necessary feedback. This holds officials accountable and protects doctors from unfair financial penalties when the government makes administrative errors.
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Section 404: Places a limit on year-to-year conversion factor variance by restricting budget neutrality adjustments from changing the conversion factor by more than 2.5 percent compared to the previous year. This shields both doctors and the healthcare system from sudden, drastic drops in Medicare payments.
Potential Negative Impacts for People
- Section 204: Reduces positive payment adjustments by 50 percent for MIPS-eligible professionals who are part of an excluded practice. This could create financial burdens for certain larger or corporate-backed medical practices that rely on these bonuses to cover operational costs.
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 Retirees+7Good For Seniors+7Good For Low Income Households+6Good For Rural Residents+6Good For Business Owners+5
- Healthcare
- Improves Healthcare Access+8Increases Medicare Funding+7Increases Research Funding+5Improves Mental Health Access+4
- Economy And Finance
- Improves Small Business Support+6
- Education And Technology
- Improves Intellectual Property Fairness+6
- Governance And Ideology
- Improves Government Transparency+6
- 9/30/2026
- Read twice and referred to the Committee on Finance.
- Introduced in Senate