Efficiency Adjustment Delay Act

[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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