AASM Backs Medicare Payment Reform Bills for Sleep Care

The American Academy of Sleep Medicine (AASM) has commended a recent House subcommittee hearing on Medicare payment reform. The group argues that stable physician payments are essential for patients needing care for conditions like sleep apnea, insomnia, and narcolepsy.

For sleep specialists, the current Medicare payment system is a growing concern. Payments have not kept pace with the rising costs of running a medical practice. Repeated short-term fixes have created uncertainty. This instability threatens access to critical services such as diagnostic testing, long-term treatment, and care coordination for sleep disorders.

Supported Legislative Proposals

The AASM voiced support for three specific bills discussed at the September 15 hearing held by the House Energy and Commerce Subcommittee on Health.

The first is the bipartisan H.R. 9693, the Patients First Act of 2026. This legislation seeks to stabilize Medicare physician payment with a permanent annual update tied to the Medicare Economic Index. It would modernize budget-neutrality policies and correct inaccurate utilization assumptions. The bill also proposes replacing the Merit-based Incentive Payment System (MIPS) with a new quality framework. The AASM states these reforms would better reflect the real costs of sleep medicine and reduce administrative burden.

The second bill is H.R. 8163, the Provider Reimbursement Stability Act of 2026. It aims to modernize budget-neutrality policies by increasing the adjustment threshold and using actual utilization data. The goal is to limit large annual swings in payment rates.

Abrupt payment fluctuations threaten the financial stability of physician practices, the AASM warns. This can make it harder for Medicare beneficiaries to receive timely sleep care. A more predictable system would help practices retain staff and continue serving older adults, particularly in rural areas.

Concerns Over an Efficiency Adjustment

The third piece of legislation is H.R. 7520, the Efficiency Adjustment Delay Act. The AASM supports delaying a proposed work relative value unit efficiency adjustment until at least 2030. The group calls for a transparent methodology and consultation with physicians.

The AASM contends that many sleep medicine services are time-intensive and have not become uniformly more efficient to provide. An across-the-board efficiency assumption could, it argues, undervalue complex patient care.

The Push for Structural Reform

Years of declining reimbursement, inflation, and rising costs have placed mounting pressure on physician practices. For patients, the consequences can include longer wait times and reduced access to specialized sleep services. The AASM urges Congress to move beyond temporary fixes and enact structural reforms.

The academy thanked Subcommittee Chairman Brett Guthrie and Health Subcommittee Chairman Morgan Griffith for examining the issues. It urged Congress to use the hearing as a springboard for bipartisan action. The group stated that patients with sleep disorders deserve reliable access to high-quality care, and professionals need a payment system that supports that mission.