Medicare physician payment debate: What sleep physicians need to know, what the AASM is doing, and what you can do

Recent physician payment debate in Congress

Over the past several years, physician payment has remained one of the most urgent health policy issues before Congress. For sleep physicians, Medicare payment policy directly affects practice stability, access to care, and the ability to provide evaluation and management services, care coordination, testing, and interpretation for older adults with sleep disorders. The central challenge is that payment under the Medicare Physician Fee Schedule has not kept pace with rising practice costs, while annual budget-neutrality rules and temporary congressional fixes have created ongoing uncertainty for physician practices.

In the last few years, lawmakers have considered both long-term reform and short-term relief. The Strengthening Medicare for Patients and Providers Act offered a structural solution by tying physician payment updates to the Medicare Economic Index, rather than relying on inadequate statutory updates. But after CMS finalized the calendar year 2025 Physician Fee Schedule rule, and Congress did not enact a year-end fix, the payment cut took effect. In response, lawmakers introduced H.R. 879, the Medicare Patient Access and Practice Stabilization Act of 2025, a bipartisan bill to reverse the cut and provide additional payment support.

Together, these proposals highlight the core debate in Congress: whether to continue relying on temporary patches, or finally adopt a permanent payment framework that provides stable, inflation-sensitive updates.

What the AASM is doing now

The American Academy of Sleep Medicine is actively working to advance physician payment reform by bringing the perspective of sleep medicine directly to lawmakers. During AASM Hill Day in April 2026, members met with congressional offices to explain how repeated Medicare payment instability affects access to care and the services patients need. The AASM also used those meetings to highlight the reintroduced H.R. 6160, the Strengthening Medicare for Patients and Providers Act, and H.R 7520, the Efficiency Adjustment Delay Act.

A key focus of that advocacy is support for H.R. 8163, the Provider Reimbursement Stability Act of 2026. As the AASM highlighted, the bill would modernize Medicare’s budget-neutrality rules to reduce volatility in the Physician Fee Schedule, while also addressing some of the structural factors that contribute to sudden payment swings. The legislation would raise the budget-neutrality threshold, allow corrections when utilization assumptions are inaccurate, require more regular updates to practice expense inputs, and limit annual changes in the conversion factor beginning in 2027.

From the work done on and around our visit to the Hill, several representatives we connected with have cosponsored H.R. 8163, and it became a central focus of the House Energy and Commerce hearing in May.

Rep. Morgan Griffith, chairman of the Subcommittee on Health, summarized the challenges in a recent hearing: “Despite efforts in MACRA to move past annual ‘doc fixes’ and enhance seniors’ quality of care, we have continued to see physician payment instability in the Medicare program. This uncertainty, in addition to other regulatory burdens, creates challenges for providers and, ultimately, the beneficiaries they serve.”

By advocating for H.R. 8163 alongside other physician payment reforms, the AASM is urging Congress to move beyond temporary patches and toward a more predictable Medicare payment system that better supports sleep physicians and protects patient access to care.

What you can do

Meaningful Medicare physician payment reform will require sustained advocacy from the sleep medicine community. There are several ways you can make your voice heard:

Contact your members of Congress
One of the most effective ways to influence policy is by communicating directly with your federal representatives. Through the AASM’s Action Center, you can quickly send prewritten messages to your senators and representative urging action on physician payment reform, making it easy to take action in just a few clicks. Also review the Advocacy Toolkit for additional resources.

Meet with lawmakers in your district
Members of Congress rely on input from constituents — especially physicians and clinical professionals — to understand how federal policies affect care delivery. When lawmakers are home in their districts (often in August and other recess periods), consider requesting a meeting with the member of Congress or their staff.

These in-person interactions are highly impactful and help build long-term relationships that strengthen the AASM’s advocacy efforts.

Support advocacy through the AASM PAC
Another important way to advance the AASM’s advocacy priorities is by supporting the AASM Political Action Committee (PAC), which helps support candidates who understand and champion issues important to sleep medicine. To learn more about how the PAC supports these efforts and how to get involved, visit the AASM Political Action Committee page.

Contributions to the AASM PAC are voluntary and are not tax deductible for federal income tax purposes. You may refuse to contribute without reprisal. Federal law requires us to use our best efforts to collect and report the name, address, occupation, and employer of individuals whose contributions exceed $200 in a calendar year. Contributions are limited to eligible individuals under federal law.