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S 1624119th CongressIn Committee
PATCH Act
Introduced: May 6, 2025
HealthcareSocial Services
Standard Summary
Comprehensive overview in 1-2 paragraphs
The PATCH Act would create a targeted floor for Medicare physician payments in Hawaii by amending the Social Security Act. Starting January 1, 2026, if the work geographic index (WGI) used to determine physician payments would be below 1.5 for Hawaii, the Secretary must raise it to 1.5. This floor would apply specifically to Hawaii and is not budget neutral, meaning the increase would not be offset by cuts elsewhere. The aim is to protect and potentially improve access to care for Hawaii residents by ensuring physician payments reflect geographic cost differences in that state.
Key Points
- 1Establishes a floor on the work geographic index (WGI) for physician services furnished in Hawaii.
- 2Effective date: for services on or after January 1, 2026.
- 3If Hawaii’s WGI, after its standard calculation, would be less than 1.5, the Secretary must increase it to 1.5.
- 4The floor is not applied in a budget-neutral manner (no offsets elsewhere to balance the cost).
- 5The bill is titled the Protecting Access To Care in Hawaii Act (PATCH Act).
Impact Areas
Primary: Physicians and other clinicians who bill Medicare Part B for services rendered in Hawaii; hospitals and clinics in Hawaii that rely on Medicare payment rates for physician services.Secondary: The Medicare program as a whole (increased Part B expenditures for Hawaii) and Hawaii’s health care system, potentially affecting access to care and provider participation.Additional impacts: Private payers that benchmark to Medicare rates could experience indirect effects; state-level budgeting and federal program costs would reflect the higher payments for Hawaii starting in 2026.
Generated by gpt-5-nano on Oct 7, 2025