Senators Introduce Companion Legislation to the Provider Reimbursement Stability Act

A Senate Companion for Physician Payment Reform

On July 30, a bipartisan group of six U.S. Senators, John Boozman (R-AR), Peter Welch (D-VT), Roger Marshall, M.D. (R-KS), Angus King (I-ME), Thom Tillis (R-NC), and Jeanne Shaheen (D-NH), introduced the Provider Reimbursement Stability Act in the Senate, a companion to the House bill (H.R. 8163) that ASE has supported since it was introduced this spring. The Senate bill would modernize the Medicare Physician Fee Schedule (MPFS) in the same ways as its House counterpart:

• Raising the budget-neutrality threshold from $20 million to $57.64 million and indexing it to the Medicare Economic Index (MEI) every five years
• Requiring CMS to revise spending estimates using actual claims-based utilization data, mandating regular updates to the direct cost inputs used to calculate practice expense relative value units
• Limiting year-to-year swings in the conversion factor to no more than 2.5%

The Senate legislation carries the same broad coalition support that helped the House bill advance out of the Ways and Means Committee by a unanimous 44-0 vote in May. ASE is named among more than 35 supporting organizations, alongside the American Medical Association and dozens of other national medical specialty societies.

Why This Matters for Echocardiography

Medicare physician payment has declined 33% in real terms since 2001, even as practice costs, including sonographer salaries, equipment, and overhead, have continued to climb. The MPFS remains the only major Medicare payment system without an automatic inflation update, and the budget-neutrality threshold that can trigger across-the-board payment cuts has not been adjusted since 1992. For echo practices, that means even routine code revaluations can trigger permanent reductions, and CMS’s cost inputs consistently undervalue the overhead required to run a modern ultrasound lab. A Senate companion gives this reform a second legislative track and signals growing momentum toward a package that could move as part of a broader deal.

ASE’s Advocacy on This Issue

ASE has been engaged on the Provider Reimbursement Stability Act since before it was introduced. In April, ASE sent an independent letter of support to the bill’s House sponsors, emphasizing that echocardiography is particularly exposed to the MPFS’s structural flaws: stale cost inputs that undervalue echo overhead, and a utilization-correction process that matters increasingly as echo expands into point-of-care ultrasound, 3D imaging, and AI-assisted interpretation, areas where CMS projections have historically overshot actual use. ASE also joined an Alliance of Specialty Medicine coalition letter and an American Medical Association letter backing the bill.

That advocacy continued on the ground. On Tuesday, July 21, ASE joined the Alliance of Specialty Medicine’s Advocacy Conference and Hill Day, meeting directly with congressional offices to press for co-sponsorship of H.R. 8163 in the House and for introduction of Senate companion legislation, alongside asks on prior authorization and step therapy reform. Those meetings, and the relationships built through them, are part of what helped bring six senators together to introduce this bill just over a week later.

ASE has also supported the broader package of reforms surrounding the Provider Reimbursement Stability Act, including the Strengthening Medicare for Patients and Providers Act (H.R. 6160), which would establish a permanent MEI-based payment update, and continues to track related efforts including the MACRA modernization discussion draft and the Efficiency Adjustment Delay Act (H.R. 7520).

What You Can Do

Congressional action on physician payment reform is moving faster than it has in years, and having a Senate companion bill in play increases the odds that meaningful reform gets across the finish line. Members can help keep that momentum going.

• Contact your senators and representative. Use ASE’s Take Action portal to urge support for the Provider Reimbursement Stability Act in both chambers.
• Share how payment instability affects your practice. Real examples from echo labs strengthen the letters and testimony ASE brings to Congress. Reach out to [email protected].
• Stay informed. Visit ASE’s Physician Payment Reform page for the latest on this and related legislation, and watch for future action alerts as the bill moves through committee.

Resources

• Boozman Press Release: Senators Introduce Bipartisan Provider Reimbursement Stability Act
• ASE Medicare Physician Payment Reform Priority Page
• House Legislation:
  • ASE Sends a Letter of Support for the Provider Reimbursement Stability Act
  • ASE Joins Letter of Support for the Provider Reimbursement Stability Act
  • ASE Joins AMA Letter of Support for the Provider Reimbursement Stability Act
• Congress Is Acting on Physician Payment: Where Things Stand and ASE’s Advocacy
• ASE Take Action Portal