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Advocacy in Action - September 2026

Congress may have spent much of August away from Washington, but HRA’s advocacy work did not slow down. Over the past two months, we have continued building congressional support for policies affecting heart rhythm care, responding to federal research proposals, addressing restrictive coverage policies, and preparing advocates from across the country to bring our priorities directly to Capitol Hill. Here is the latest from Heart Rhythm Advocates.

Authorization Reform Advances in the House

The bipartisan Improving Seniors’ Timely Access to Care Act (H.R. 3514/S. 1816) took two important steps forward this summer. The House Ways and Means Committee approved the legislation by a vote of 42–0 on July 15, followed by a 45–0 vote in the House Energy and Commerce Committee on July 21.

 

The legislation would modernize prior authorization in Medicare Advantage by establishing an electronic prior-authorization process, improving transparency, and reducing unnecessary delays in medically necessary care.

 

HRA has continued urging lawmakers to advance the bill and has incorporated prior-authorization reform into congressional meetings, district outreach, and preparations for our September Advocacy Fly-In. The unanimous committee votes demonstrate unusually broad bipartisan agreement, but House passage (and eventual Senate action) will still be necessary before these reforms can become law.

HRA Launches Action on the Patients First Act

HRA has also added its support to the Patients First Act of 2026 (H.R. 9693), legislation intended to improve the transparency, accountability, and clinical integrity of Medicare payment policy.

 

HRA launched a grassroots alert encouraging members to contact their representatives and ask them to support the legislation. While H.R. 9693 is unlikely to advance as a stand-alone measure during the remaining months of this Congress, its provisions could help shape a larger year-end health or Medicare package.

 

The bill also provides another opportunity to educate lawmakers about the growing disconnect between the resources required to provide complex specialty care and the way physician services are currently valued.

Preparing for HRA’s First National Advocacy Fly-In

HRA is preparing to welcome approximately 30 physicians, allied professionals, patients, and other heart rhythm advocates to Washington for our first national Advocacy Fly-In, September 27–29.

Participants will receive advocacy training on September 28 before meeting with congressional offices on September 29. Meetings will focus on several of HRA’s principal priorities:

  • Protecting patient access through sustainable Medicare payment;

  • Reducing harmful prior-authorization delays;

  • Preserving access to remote-monitoring services;

  • Supporting cardiac research and the heart rhythm workforce;

  • Strengthening access to CPR and automated external defibrillators; and

  • Ensuring federal health policy reflects the realities of modern electrophysiology practice.

 

The Fly-In builds on more than 25 congressional meetings conducted since June, including 10 meetings involving members of the HRA Governing Board. It will also help establish relationships that will carry HRA’s advocacy into the next Congress.

Bringing CPR and AED Training to Capitol Hill

On July 24, HRA and HRS hosted a bipartisan CPR and AED training event for congressional staff in the Rayburn House Office Building.

 

Approximately 30 House and Senate staff members participated in two hands-on training sessions led by Relay Response. Dr. Mina Chung offered opening remarks emphasizing the importance of rapid intervention when sudden cardiac arrest occurs.

 

The event paired practical, potentially lifesaving instruction with education about the need for stronger cardiac-emergency preparedness. HRA continues to advocate for $50 million in FY 2027 funding to implement the HEARTS Act and for policies that expand access to AEDs and CPR training in schools, homes, and communities. HRA is also supporting the Residential AED and CPR Preparedness Act of 2026 (H.R. 9058), which would improve cardiac-emergency preparedness in federally assisted residential properties.

Defending the Integrity of NIH Peer Review

HRA developed comments in response to NIH Request for Information NOT-OD-26-088, which proposed changes to the way grant applications are scored and communicated.

HRA urged NIH to retain final impact scores and percentile rankings rather than replacing them with broad categorical assessments. Although no scoring system is perfect, sufficiently detailed scoring allows applicants to understand how their proposals were evaluated, make meaningful revisions, and have greater confidence in the peer-review process.

 

HRA also emphasized the importance of documenting circumstances in which funding decisions depart from peer-review recommendations. Transparency is particularly important for smaller research fields such as cardiac electrophysiology, where investigators may already face limited funding opportunities.

Supporting More Sustainable Clinical-Trial Funding

In separate comments responding to NIH Notice NOT-OD-26-095, HRA supported efforts to explore more flexible and sustainable approaches to clinical-trial funding.

 

Our comments emphasized the need for realistic research budgets, protected investigator time, reduced administrative burdens, and funding structures that complement - not replace - traditional NIH grant mechanisms.

 

HRA also urged NIH to consider how new funding models could affect early-career investigators, smaller institutions, community-based research sites, and fields with comparatively limited numbers of investigators and trial participants.

 

Together, these two NIH responses reflect HRA’s commitment to making science and research a more visible component of our advocacy agenda.

Reviewing Medicare Advantage Prior-Authorization Changes

HRA is reviewing newly released Medicare Advantage prior-authorization code information to determine which electrophysiology procedures and diagnostic services may be affected.

This analysis will help identify where announced reductions in prior authorization represent meaningful relief – and where plans may continue imposing unnecessary administrative barriers. Findings will inform HRA’s ongoing engagement with policymakers, payers, and coalition partners.

Examining Access to Ablation in Ambulatory Surgery Centers

HRA has also been investigating reports of policy or regulatory changes affecting the ability to perform intracardiac ablation procedures in California ambulatory surgery centers. The review is intended to distinguish changes in Medicare payment policy from California-specific facility, licensing, or payer requirements. Understanding those distinctions will help HRA provide accurate guidance to stakeholders and identify whether additional state or federal advocacy is warranted.

HRA Provides Expert Testimony to the Committee on Energy and Commerce Subcommittee on Health

The House Energy and Commerce Subcommittee on Health held a legislative hearing on September 15 examining proposals to reform Medicare physician payment and strengthen healthcare cybersecurity.

 

Among the measures under consideration are two bills supported by Heart Rhythm Advocates: the Patients First Act of 2026 (H.R. 9693) and the Provider Reimbursement Stability Act of 2026 (H.R. 8163). HRA submitted expert testimony addressing the concerns of electrophysiology professionals and patients with heart rhythm disorders.

HRS Weighs In on Medicare Physician Fee Schedule Proposals for Calendar Year 2027

On September 14, 2026, the Heart Rhythm Society (HRS) submitted comments to the Centers for Medicare & Medicaid Services (CMS) in response to several proposals included in the Medicare Physician Fee Schedule proposed rule for the upcoming 2027 calendar year. Notably, HRS voiced strong opposition to the suggested further reduction in the value for left atrial appendage closure (CPT code 33340). In a collaborative effort, HRS, along with the American College of Cardiology (ACC) and the Society for Cardiovascular Angiography and Interventions (SCAI), met with CMS on September 1st. The discussion focused on the potential implications of consecutive cuts to the work RVU for 33340, should the proposed reduction from 9.99 to 9.00 be implemented. The letter from HRS not only reiterated these critical concerns but also highlighted other significant issues. Changes to the practice expense methodology, the ambulatory specialty model, and the mandatory reporting requirements under the MIPS Value Pathways (MVPs) framework were all part of the comprehensive recommendations provided. 

HRS Joins More Than 230 Health Care Organizations Urging CMS Not to Finalize Proposed Remote Monitoring Restrictions

More than 230 health care organizations, including national patient advocacy groups, hospitals and health systems, and professional provider societies, sent a letter to CMS urging the agency not to finalize its policies for remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM) in the Medicare Physician Fee Schedule Proposed Rule for calendar year 2027.  The letter cautions CMS that the policy changes would cause immediate and significant disruption for over 1 million Medicare beneficiaries who rely on remote monitoring to manage chronic conditions, avoid preventable complications, and stay connected to their care teams.  While the proposed policies are not applicable to cardiac implantable electronic devices (CIEDs), the Society will continue to track CMS’ regulatory updates for remote monitoring services.

Looking Ahead

With Congress back in Washington, HRA is focused on making the most of the remaining months of the 119th Congress.

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Our immediate priorities include:

  • Securing additional support for the Improving Seniors’ Timely Access to Care Act;

  • Advancing Medicare payment and physician-valuation reforms;

  • Protecting access to remote monitoring and specialty care;

  • Supporting HEARTS Act implementation and AED access;

  • Elevating federal investment in heart rhythm research;

  • Responding to payer policies that restrict appropriate treatment; and

  • Preparing HRA’s policy agenda for 2027 and the next Congress.

 

August may have been quiet on Capitol Hill, but it was anything but inactive for HRA. The groundwork completed this summer will position our advocates to return to Washington with a clear message: patients need timely access to heart rhythm care, and the clinicians who provide that care need federal policies that allow them to keep doing so.

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