Provider Reimbursement Stability Act of 2026

Today's wording of each part of the law, with what would be struck out and added. Each change also gives the bill's own instruction, word for word.

1. 42 U.S.C. 1395w-4(c)(2)(B)(ii)(II)changedby H.R. 8163 Sec. 2(1)

   The bill says: by striking "Subject to" and inserting the following:

   Bill text · Current law (42 U.S.C. 1395w-4)

2. 42 U.S.C. 1395w-4(c)(2)(B)(ii)(II)(aa)changedby H.R. 8163 Sec. 2(2)

   The bill says: in item (aa), as inserted by paragraph (1), by striking "$20,000,000" and inserting "the amount specified in item (bb) for such year"; and

   Bill text · Current law (42 U.S.C. 1395w-4)

3. 42 U.S.C. 1395w-4(c)(2)(B)(ii)(II)added (bb)by H.R. 8163 Sec. 2(3)

   (bb) Amount specified.— For purposes of item (aa), subject to item (cc), the amount specified in this item is—(AA) for years before 2027, $20,000,000;(BB) for 2027, $54,300,000; and(CC) for 2028 and each subsequent year, the amount specified in this item for the preceding year.(cc) Indexing limitation on annual adjustments.— For 2032 and every subsequent fifth year, the Secretary shall increase the amount specified in item (bb) for such year by the cumulative percentage increase in the MEI (as defined in section 1842(i)(3)) applicable to physicians’ services for each year occurring during the 5-year period ending on the last day of the preceding year.

   The bill says: by adding at the end the following new items:

   Bill text · Current law (42 U.S.C. 1395w-4)

4. 42 U.S.C. 1395w-4(c)(2)(B)added (vii)by H.R. 8163 Sec. 3(a)

   (vii) Budget neutrality corrections relating to estimated utilization.—(I) In general.— In the case of a budget neutrality adjustment applied pursuant to clause (ii)(II) for a year (beginning with 2027) that is determined in part using estimated utilization (as defined in subclause (II)(bb)) with respect to a specified service (as defined in subclause (II)(cc)), the Secretary shall, as part of the final rule establishing the physician fee schedule under this section for the assumption correction period (as defined in subclause (II)(aa)) with respect to such year—(aa) determine the difference between expenditures for such service in such year using estimated utilization and actual utilization for such service (in a manner determined appropriate by the Secretary); and(bb) in the case that the Secretary determines the difference described in item (aa) is greater than the threshold amount (as defined in subclause (II)(dd)) for such year, adjust the conversion factor under this section for such assumption correction period by such amount to reconcile such difference (which may be positive or negative), as determined by the Secretary.(II) Definitions.— For purposes of this clause:(aa) Assumption correction period.— The term assumption correction period means, with respect to a year, the second year beginning after such year.(bb) Estimated utilization.— The term estimated utilization means an estimate of utilization used for purposes of applying clause (ii)(II).(cc) Specified service.— The term specified service means, with respect to a year, a service—(AA) with expected expenditures for such year under this part based on estimated utilization that exceed the threshold amount (as defined in item (dd)) for such year; and(BB) for which payment had been bundled into payment for another service during the preceding year and for which a separate payment or add-on payment is made during such year.(dd) Threshold amount.— The term threshold amount means, with respect to a year, 0.1 percent of the total estimated expenditures under this part for services furnished under this section during such year.

   The bill says: Section 1848(c)(2)(B) of the Social Security Act (42 U.S.C. 1395w–4(c)(2)(B)) is amended by adding at the end the following new clause:

   Bill text · Current law (42 U.S.C. 1395w-4)

5. 42 U.S.C. 1395w-4(c)(2)(B)(iv)(V)changedby H.R. 8163 Sec. 3(b)

   The bill says: in subclause (V), by striking "and" at the end;

   Bill text · Current law (42 U.S.C. 1395w-4)

6. 42 U.S.C. 1395w-4(c)(2)(B)(iv)(VI)changedby H.R. 8163 Sec. 3(b)

   The bill says: in subclause (VI), by striking the period and inserting "; and"; and

   Bill text · Current law (42 U.S.C. 1395w-4)

7. 42 U.S.C. 1395w-4(c)(2)(B)(iv)added (VII)by H.R. 8163 Sec. 3(b)

   (VII) clause (vii)(I)(bb) for an assumption correction period (as defined in clause (vii)(II)) shall not be taken into account in applying clause (ii)(II) with respect to such period.

   The bill says: by adding at the end the following new subclause:

   Bill text · Current law (42 U.S.C. 1395w-4)

8. 42 U.S.C. 1395w-4(c)(2)(B)(v)added (XII)by H.R. 8163 Sec. 3(b)

   (XII) Reductions attributable to an assumption correction.— For an assumption correction period (as defined in clause (vii)(II)), reduced expenditures attributable to application of clause (vii)(I)(bb) with respect to such period.

   The bill says: in clause (v), by adding at the end the following new subclause:

   Bill text · Current law (42 U.S.C. 1395w-4)

From the bill's official text on GovInfo and the U.S. Code, 2024 edition, which may not yet show changes made since.