Medicare Payment Stability 

Board alignment:

• Medicare physician payment instability was identified as the most immediate threat to EP practices.

• The Board endorsed prioritizing the Medicare Patient Access and Practice Stabilization Act as HRA’s lead federal payment vehicle.

• This effort aligns EP with the broader physician community while allowing HRA to highlight specialty-specific impacts (remote monitoring, cognitive services, practice expense distortions).

 

HRA execution:

• This is a primary grassroots activation issue in 2026.

• Coordinate with national partners (ACC, AMA, specialty coalitions) while ensuring EP data and examples are visible.

• Frame payment stability as a capacity and access issue, not merely reimbursement.

 

Prior Authorization Reform 

Board alignment:

• Strong consensus that prior authorization delays create real patient harm, particularly for EP populations.

• The Board agreed that the Improving Seniors’ Timely Access to Care Act is the strongest federal vehicle and the appropriate focal point for HRA advocacy.

• Momentum from HHS and bipartisan congressional interest make this a credible 2026 opportunity.

 

HRA execution:

• Lead with a patient safety narrative: delays increase stroke risk, worsen heart failure, and drive avoidable hospitalizations.

• Reinforce EP’s reliance on evidence-based guidelines and time-sensitive interventions.

• Pair legislative advocacy with regulatory engagement and coalition pressure.

 

Guardrails for Remote Physiologic Monitoring

Board alignment:

• The Board supported advancing the Rural Patient Monitoring Access Act as a way to define EP as the model specialty for accountable remote monitoring.

• While legislative movement is uncertain, the bill plays a strategic role in shaping policy narratives and future vehicles.

 

HRA execution:

• Advocate for clear distinctions between active clinical surveillance and passive data collection.

• Emphasize interoperability, clinical availability, and outcomes reporting.

• Position EP as willing to accept accountability standards, unlike low-integrity monitoring models.

 

Site-of-Care Reform

Board alignment:

• Agreement that stand-alone site-of-care legislation is not viable in 2026.

• Site-of-care remains a core strategic priority, but progress this year will come primarily through CMS rulemaking and sub-regulatory guidance.

• Legislative options are expected to reopen in the next Congress.

 

HRA execution:

• Continue aggressive engagement with CMS/HHS on ASC coverage and physician-led site-of-care decisions.

• Maintain congressional relationships built in 2024–2025 to enable rapid legislative action in 2027.

• Treat site-of-care as a long-arc structural reform, not a near-term bill.

 

Fair Market Value (FMV) and Physician Compensation Integrity

Board alignment:

• The Board identified FMV misuse as an emerging threat to physician autonomy and fair compensation, particularly as hospitals and health systems use FMV narratives to justify downward pressure on EP reimbursement.

• There was explicit interest in developing profession-led, specialty-informed FMV frameworks rather than relying on opaque third-party benchmarks.

 

HRA execution:

• Explore pathways for EP-informed FMV standards, in coordination with HRS and allied specialties.

• Position FMV integrity as a capacity and workforce issue, not merely a contracting dispute.

• Lay groundwork in 2026 for broader policy or guidance discussions in subsequent years.

 

Non-Compete Restrictions and Physician Mobility

Board alignment:

• The Board flagged non-compete clauses and restrictions on physician mobility as increasingly relevant to access, workforce stability, and physician leverage.

• While not a stand-alone 2026 legislative vehicle, this issue aligns closely with HRA’s capacity and autonomy framework.

 

HRA execution:

• Monitor federal and state policy developments affecting non-compete enforcement.

• Integrate physician mobility into broader workforce and access narratives.

• Prepare for future advocacy as legislative and regulatory opportunities mature.