The American Academy of Sleep Medicine commends the House Energy and Commerce Subcommittee on Health for convening its Sept. 15 legislative hearing, “Examining Legislative Proposals to Reform Medicare Provider Payment and Bolster Health Care Cybersecurity.” The hearing offers Congress an important opportunity to advance durable solutions to persistent Medicare physician payment challenges while considering policies that can make the nation’s health care infrastructure more resilient.
For sleep physicians and their patients, this discussion is especially critical. Medicare payment has not kept pace with the rising costs of operating a medical practice, and repeated short-term interventions have created uncertainty for clinicians. Sleep medicine depends on sustained access to evaluation and management, care coordination, diagnostic testing and interpretation, and longitudinal treatment for conditions such as obstructive sleep apnea, insomnia, narcolepsy and circadian rhythm sleep-wake disorders.
AASM-supported legislation in the hearing:
H.R. 9693, the Patients First Act of 2026 The AASM supports this bipartisan legislation that would help stabilize Medicare physician payment through a permanent annual update tied to the Medicare Economic Index, modernize budget-neutrality policies, correct inaccurate utilization assumptions and update practice-expense inputs with physician specialty-society consultation. The bill also would replace MIPS with a more clinically meaningful quality framework and advance care-efficiency and value-based models while preserving physician judgment and access to medically necessary services. These patient-centered reforms would better reflect the real costs and clinical complexity of sleep medicine, reduce administrative burden, and protect access to high-quality care.
H.R. 8163, the Provider Reimbursement Stability Act of 2026 This bill would modernize Medicare Physician Fee Schedule budget-neutrality policies by increasing the adjustment threshold, using actual utilization data to correct inaccurate projections, updating clinical labor and other practice-expense inputs more regularly, and limiting annual conversion factor swings.
These reforms matter because abrupt payment fluctuations threaten the financial stability of physician practices and can make it harder for Medicare beneficiaries to receive timely sleep care. A more accurate and predictable payment system would help practices plan, retain clinical staff, invest in appropriate technology and continue serving older adults particularly in rural and underserved settings.
H.R. 7520, the Efficiency Adjustment Delay Act The AASM also supports delaying the proposed work relative value unit efficiency adjustment until at least 2030, requiring a transparent and evidence-based methodology, consulting physicians, and reporting to Congress. Many sleep medicine services are time and labor-intensive and have not become more efficient to provide uniformly; an across-the-board assumption could undervalue complex care.
Building a sustainable Medicare payment system
Years of declining reimbursement, inflation and rising operating costs have placed mounting pressure on physician practices. For patients, the consequences can include longer wait times, fewer participating clinicians and reduced access to specialized services. Congress should move beyond temporary fixes and enact structural reforms that provide stable, fair and predictable payment.
The AASM thanks Chairman Brett Guthrie, Health Subcommittee Chairman Morgan Griffith and members of the subcommittee for examining these consequential issues. We urge Congress to use the hearing as a springboard for bipartisan action on these bills as part of a comprehensive approach to Medicare physician payment reform. Patients with sleep disorders deserve reliable access to high-quality care, and sleep medicine professionals need a payment system that supports that mission.
