Promoting Fairness for Medicare Providers Act of 2026

This bill changes how Medicare pays for certain surgical procedures that use supplies costing more than $500 when they are done in a physician's office. Starting in 2027, offices that meet federal standards and sign an agreement with Medicare could be paid as "office-based facilities," receiving a facility payment equal to 90 percent of what an ambulatory surgical center would get for the same procedure. Patient coinsurance for these facility services could not exceed the yearly Medicare inpatient hospital deductible, and Medicare would make up the difference to the office. Beginning in 2028, the Secretary of Health and Human Services would review the list of covered procedures each year, adding procedures that meet the cost criteria and possibly removing ones that fall below them.

Full text and official record on Congress.gov

Sponsors

• Gus M. Bilirakis Republican sponsor
• 4 cosponsors