Congress delays Medicare efficiency cuts for physicians, cuts payment growth instead
H.R. 7520 — Efficiency Adjustment Delay Act · Filed by Ron Estes (R-KS) · 14 cosponsors · Introduced Feb 12, 2026 · Referred to committee
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What it does
This bill delays until January 1, 2030 a Medicare rule (finalized November 2025) that would adjust physician payment rates to account for efficiency gains in medical services. It requires the Secretary of Health and Human Services to study whether such an adjustment is necessary and, if implemented after 2030, imposes conditions: consultation with affected physician specialties, exemption for recently revalued services, and a one-time-only restriction. The bill also modifies the annual conversion factor updates for Medicare physician payments, reducing 2026 updates and setting 2027+ updates at 0.75% for qualifying APM providers and 0.25% for non-qualifying providers.
Why we flagged it
The bill's core function is to postpone a specific Medicare efficiency adjustment rule and modify physician conversion factor updates. It is a targeted payment-policy amendment, not a broad reform or appropriation.
What the text implies
- The 4-year delay (2026–2029) allows physician specialties to lobby for exemptions or modifications before 2030 implementation, potentially weakening the efficiency adjustment's scope or impact.
- The conversion factor reductions (0.75%–0.25% for 2027+) are substantially below historical Medicare payment updates and inflation, effectively cutting physician compensation growth independent of the efficiency adjustment delay.
The full analysis lists 5 implications of this text.
Who stands to gain
physician practices and specialties (delayed payment reductions); healthcare providers billing Medicare (preserved reimbursement rates during delay period)