The Patients First Act: What the 2026 Medicare Payment Reform Push Could Mean for Physicians

Physicians are the only category of Medicare provider that lacks a guaranteed, automatic annual payment update — a structural gap the American Medical Association and physician organizations have flagged for years. According to AMA advocacy materials, Medicare physician payment has fallen approximately 33% in inflation-adjusted terms since 2001. CMS’s proposed 2027 Medicare Physician Fee Schedule rule, released July 14, 2026, adds further near-term cuts on top of that long-run erosion, which is the immediate backdrop against which the bill discussed here was introduced.

On July 15, 2026, three physician-legislators introduced what its sponsors and several specialty societies describe as the most comprehensive Medicare physician payment reform package they have seen introduced in years: the Patients First Act (H.R. 9693). This article walks through what the bill’s actual text does — verified directly against the introduced bill text on file with the Government Publishing Office — and separates that from the advocacy framing surrounding it, so physicians can evaluate it on the merits.

A note on framing throughout this piece: statements describing what the bill “would do” reflect its text as introduced on July 15, 2026. This is a bill in early committee referral, not enacted law, and its provisions can change substantially — or the bill may not advance at all — before any of this takes effect.


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