S 5672: Patients First Act of 2026

S 5672 in plain English: This bill modifies how Medicare pays doctors and other health professionals. It creates a temporary program offering monthly, flat-rate payments for primary care services such as care management, behavioral health, telehealth, and phone consultations, and it updates the Merit-based Incentive Payment System (MIPS) by renaming it, adding care efficiency measures, and reducing some performance bonuses. It also allows Medicare physician fee schedule updates to be tied to inflation and sets rules to correct for overspending.

Stated purpose

The bill aims to modify how Medicare pays doctors, including creating a new monthly payment option for primary care services and updating payment rates to better reflect inflation, in order to strengthen patient access to care.

Key points

• Creates a temporary opt-in monthly payment program for primary care services including telehealth and care management
• Renames MIPS and adds performance measures focused on care efficiency, such as reducing avoidable hospitalizations
• Reduces performance-based payment bonuses, especially for providers owned by non-practitioners
• Ties annual Medicare physician fee schedule adjustments to inflation
• Sets a spending threshold at $20,000,000 before 2028, rising to $57,640,000 in 2028, with further adjustments in subsequent years

Arguments supporters make

• Tying Medicare payment updates to inflation helps prevent doctor pay from falling behind rising costs, making it more financially viable for physicians to keep seeing Medicare patients.
• The new monthly payment option gives primary care doctors a steadier, more predictable income and rewards keeping patients healthy rather than just billing for each visit.
• Favoring independent, doctor-owned practices over corporate health systems helps preserve patient choice and competition in local health care markets.

Arguments opponents make

• Limiting bonuses for hospital-owned and corporate practices could reduce their incentive to improve quality, potentially harming patients who rely on those larger health systems.
• The monthly payment model runs only through 2031 and is temporary, so doctors who reorganize their practices around it face uncertainty when it expires.
• Inflation-linked payment increases could raise overall Medicare spending, putting pressure on the program's long-term budget and potentially shifting costs to taxpayers or other parts of the health system.

Tradeoffs

Paying doctors more in line with inflation and rewarding doctor-owned practices may improve access and independent care, but could increase Medicare program costs or disadvantage the large health systems that serve many patients in underserved areas.

Current status in Congress: In committee.

NewsClear — neutral news & congressional tracking · Bill of the Week