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Congress·In Committee·H.R. 7863

Promoting Fairness for Medicare Providers Act of 2026

Rep. Bilirakis Introduces Bill to Pay Doctors More for High-Cost Medicare Procedures

17 days ago·View on Congress.gov·Read full text

This bill is currently in the early stages of the legislative process and has been sent to the House Committees on Energy and Commerce and Ways and Means for review. It is actively moving through the initial committee phase, but no further votes or hearings have been scheduled yet.

Legislative Progress

House
Senate
President
Law

Key Points

  • This bipartisan bill changes how Medicare pays for surgeries done in a doctor's office that require expensive supplies costing more than $500. Starting in 2027, qualifying doctor's offices would receive 90% of the payment that ambulatory surgical centers get for the same procedures, helping cover the high cost of specialized implants and tools.

    From policy text

    “payment for facility services furnished in connection with such procedure shall be equal to 90 percent of the amount that would be payable for facility services furnished in connection with such procedure under section 1833(i) for such year if such procedure had been furnished in an ambulatory surgical center”
    View in full text
  • To receive these higher payments, a doctor's office must become a certified "office-based facility" that meets health and safety standards, accepts Medicare's payment as the full amount, and agrees to accept assignment for all covered procedures — meaning no surprise bills for patients.
  • The bill caps what patients pay out of pocket for these office-based surgeries. A patient's coinsurance cannot exceed the standard Medicare inpatient hospital deductible for that year, protecting seniors from unexpectedly large bills.

    From policy text

    “In no case shall the amount of coinsurance for facility services furnished in connection with a specified high supply cost surgical procedure in an office-based facility during a year exceed the amount of the inpatient hospital deductible established under section 1813(b) for that year.”
    View in full text
  • When a patient's coinsurance is capped, the doctor's office doesn't lose out — Medicare picks up the difference, ensuring providers are still paid the full amount for the procedure.
  • Starting in 2028, the Secretary must review and update which procedures qualify each year. New procedures can be added if they meet the cost threshold, and procedures may be removed if their supply costs fall below 80% of that threshold, keeping the list current with medical technology changes.
Healthcare

Impact Analysis

Personal Impact

Scores: 1 = low, 5 = highSentiment: -5 to +5 (net benefit)

Milestones

2 milestones2 actions
Mar 9, 2026House

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.

Mar 9, 2026

Introduced in House

Source Information

Document Type

Congressional Bill

Official Title

Promoting Fairness for Medicare Providers Act of 2026

Bill NumberHR 7863
Congress119th Congress
ChamberHouse of Representatives
Latest ActionReferred 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.
Read Full Bill Text

Sponsor

Cosponsors

(4)
D: 2R: 2

Analysis generated by AI. Always verify with official sources.