H.R. 7520

[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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