[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7520 Introduced in House (IH)]
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119th CONGRESS
2d Session
H. R. 7520
To amend title XVIII of the Social Security Act to delay the
implementation of an efficiency adjustment to work relative value units
under the Medicare physician fee schedule.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 12, 2026
Mr. Estes (for himself and Mr. Suozzi) 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 delay the
implementation of an efficiency adjustment to work relative value units
under the Medicare physician fee schedule.
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 ``Efficiency Adjustment Delay Act''.
SEC. 2. DELAYING THE IMPLEMENTATION OF AN EFFICIENCY ADJUSTMENT TO WORK
RELATIVE VALUE UNITS UNDER THE MEDICARE PHYSICIAN FEE
SCHEDULE.
(a) In General.--Section 1848(c) of the Social Security Act (42
U.S.C. 1395w-4(c)) is amended by adding at the end the following new
paragraph:
``(9) Delayed implementation of work rvu efficiency
adjustment.--
``(A) Delayed implementation.--The Secretary may
not implement the policy established in the final rule
published on November 5, 2025 (90 Fed. Reg. 49266 et
seq.), that establishes an efficiency adjustment to
work relative value units, and makes corresponding
updates to the intraservice portion of physician time
inputs for non-time-based services, before January 1,
2030.
``(B) Report to congress.--Not later than 2 years
after the date of the enactment of this paragraph, the
Secretary shall submit to the Committee on Energy and
Commerce and the Committee on Ways and Means of the
House of Representatives, and to the Committee on
Finance of the Senate, a report containing an
assessment of whether it is necessary to apply a one-
time, across-the-board adjustment to work relative
value units, and to make corresponding updates to the
intraservice portion of physician time inputs for non-
time-based services, with respect to services that have
not been revalued or reviewed within the 10-year period
preceding the calendar year in which such one-time
adjustment would be applied. Such report shall include
supporting evidence for such assessment.
``(C) Limitations on future implementation.--
``(i) In general.--Subject to clause (ii),
in the case that the report under subparagraph
(B) supports the implementation of the
efficiency adjustment described in subparagraph
(A), the Secretary may implement such
adjustment on or after January 1, 2030, if the
following conditions are met:
``(I) Before implementing such
adjustment, the Secretary consults with
representatives of physician
specialties affected by the potential
implementation of such adjustment.
``(II) The Secretary does not
implement such adjustment with respect
to services that have been revalued or
reviewed within the 10-year period
preceding the calendar year in which
such one-time adjustment would be
applied.
``(III) The Secretary establishes a
methodology for calculating such
adjustment that does not rely on a
factor that is used for determining
productivity relative to inflation
unless the update to the nonqualifying
APM conversion factor under section
1848(d) for the year in which the one-
time adjustment would be applied is
greater than or equal to the percentage
increase in the consumer price index
for all urban consumers (all items;
United States city average) over the
previous year.
``(ii) Multiple adjustments prohibited.--
The Secretary may not implement such an
efficiency adjustment more than once.
``(D) Rule of construction.--Nothing in
subparagraph (A) shall be construed to prevent the
Secretary from revaluing misvalued codes for specific
services or assigning values to new or revised codes
for services.''.
(b) Adjustment to Conversion Factor.--Section 1848(d)(20) of the
Social Security Act (42 U.S.C. 1395w-4(d)(20)) is amended--
(1) by striking ``0.75 percent'' and inserting ``1.24
percent'';
(2) by striking ``0.25 percent'' and inserting ``0.74
percent'';
(3) by striking ``For 2026 and each subsequent year'' and
inserting the following:
``(A) Update for 2026.--For 2026''; and
(4) by adding at the end the following new subparagraph:
``(B) Update for 2027 and subsequent years.--For
2027 and each subsequent year, the update to the
qualifying APM conversion factor established under
paragraph (1)(A) is 0.75 percent, and the update to the
nonqualifying APM conversion factor established under
such paragraph is 0.25 percent.''.
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