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What the subcommittee took up
On September 15 the House Energy and Commerce Subcommittee on Health held a legislative hearing on more than a dozen bills covering Medicare provider payment and health care cybersecurity. For hospital leaders, the physician payment proposals matter most, because they would reshape how employed physician groups are paid for years to come.
Three bills stand out:
- Patients First Act of 2026 (H.R. 9693): Ties the annual fee schedule update to the Medicare Economic Index minus one percentage point, creates a primary care pilot with per-member-per-month payments, replaces the Merit-based Incentive Payment System with a new program called POINTS, freezes alternative payment model thresholds for three years and raises the budget neutrality threshold.
- Provider Reimbursement Stability Act of 2026 (H.R. 8163): Raises the budget neutrality threshold, which limits how much CMS can shift payment when it revalues services.
- Medicare Physician Data-driven Performance Payment System Act of 2026 (H.R. 8622): Replaces MIPS with a new system, freezes the performance threshold at 75 points for three years, requires quarterly feedback from CMS and adds incentives for small rural and underserved practices.
The catch for health systems
In a statement for the hearing, the American Hospital Association backed an inflation-linked update, the higher budget neutrality threshold and the threshold freeze. It flagged a design problem in the Patients First Act: the primary care pilot and the top POINTS bonuses would be limited to independent clinicians. Hospital and provider-based physicians would see their POINTS payouts capped at half the adjustment, with the difference redirected to independent practices. The association asked lawmakers to open both features to employed clinicians.
It also argued the proposed update is too small, citing a 13% decline in the conversion factor from 2001 to 2026 and a 33% cut once inflation is counted. The association supported the MIPS replacement in H.R. 8622.
What leaders should do
- Quantify the gap: Ask finance to estimate how much your employed groups would lose if bonus pools excluded them.
- Engage your delegation: These bills are still at the hearing stage. Concrete local examples of hospital-employed primary care in underserved areas carry weight.
- Track quality reporting changes: A switch away from MIPS would change reporting work and dashboards, so keep quality and informatics teams briefed.
Archive entry for Sep 16, 2026, added Nov. 11, 2026.