What's in the 2027 Medicare Physician Fee Schedule Proposed Rule, and why should physicians care?

The 2026 midterm elections could reshape healthcare policy by changing the makeup of Congress, committee leadership, and the legislative priorities affecting physicians and healthcare organizations. From physician reimbursement and administrative reform to artificial intelligence in healthcare, the next Congress could play an important role in determining which healthcare issues move forward and where opportunities for bipartisan progress emerge. In this episode of Zotec Answers, Henry Isenberg, the Advocacy Summer Intern, sits down with Mark Isenberg, Executive Vice President of Healthcare Advocacy at Zotec Partners, to answer an important question: Will a new Congress change the future of healthcare? Together, they explore what healthcare leaders should be watching as the 2026 midterm elections approach, how changes in Congress could affect federal healthcare priorities, and why physicians and clinicians have an important role to play in shaping the policies that affect their practices and patients. In this episode, you'll learn: How the 2026 midterm elections could influence the future of healthcare policy What congressional turnover and changing committee leadership could mean for physicians and healthcare organizations Where opportunities for bipartisan healthcare legislation may emerge What a new Congress could mean for physician reimbursement and payment reform Why reducing administrative burden remains an important priority for physicians and healthcare organizations How artificial intelligence in healthcare could become an increasingly important federal policy issue Why physician and clinician perspectives matter when lawmakers develop healthcare policy How healthcare leaders can engage with policymakers and advocate effectively Why healthcare advocacy remains important before, during, and after an election How healthcare organizations can prepare for changing federal healthcare priorities How could the 2026 midterm elections affect healthcare policy? The midterm elections could change the makeup of Congress, committee leadership, and the legislative agenda. Those shifts could influence which healthcare priorities receive attention and create new opportunities for action on issues affecting physicians, healthcare organizations, and the business of healthcare. What could a new Congress mean for physician reimbursement? Changes in congressional leadership and priorities could create opportunities for renewed conversations around physician reimbursement, payment reform, and the financial pressures facing medical practices. These policies have implications beyond reimbursement itself because financially sustainable physician practices are essential to preserving patient access to care. Why should physicians and healthcare leaders engage with Congress? Healthcare policy is stronger when policymakers hear directly from the people working within the healthcare system. Physicians, clinicians, and healthcare leaders can provide lawmakers with valuable real-world insight into how federal policies affect reimbursement, administrative burden, practice operations, and ultimately, patients. Preparing for the next chapter of healthcare policy Election outcomes can change the political landscape, but meaningful healthcare advocacy cannot begin and end on Election Day. Staying informed, building relationships with policymakers, and communicating the real-world impact of healthcare policy can help ensure physician perspectives remain part of the conversation as the next Congress establishes its priorities. What should healthcare leaders be watching ahead of the 2026 midterm elections, and where could the next opportunities for meaningful healthcare reform emerge? Listen to the full episode of Zotec Answers to hear Mark and Henry explore what a new Congress could mean for physicians, healthcare organizations, and the future of healthcare.

Take Action Now Contact your lawmakers today to support the No Surprises Act Enforcement Act (H.R. 4710/S. 2420). On the go? Simply text ZPNSA to 50457.   The No Surprises Act (NSA) was designed around two important goals: protecting patients from surprise medical bills and establishing a fair process for physicians and insurers to resolve out-of-network payment disputes. But as use of the Independent Dispute Resolution (IDR) process has grown, so has the debate over why physicians are filing disputes and winning so many of them. In this episode of Zotec Answers, Ed Gaines, Vice President of Regulatory Affairs and Industry Liaison at Zotec Partners, is joined by Dave Walker, Chief Revenue Officer of Radiology Associates of North Texas (RANT), one of the nation’s largest independent radiology practices and a longtime Zotec client. Together, they take a closer look at claims that physicians are “gaming” the No Surprises Act IDR process and ask a more fundamental question: Is the process functioning the way Congress intended? In this episode, you'll learn: Why physician groups are increasingly turning to the No Surprises Act IDR process How insurer initial payments can contribute to payment disputes reaching arbitration What happens after a physician submits a claim and where the process can begin to break down Why high physician success rates in IDR do not necessarily mean physicians are “gaming” the system What physician arbitration wins may reveal about insurers’ initial payment amounts Why winning a legally binding IDR decision does not necessarily mean a physician practice has received payment How delayed or unpaid arbitration awards can affect independent physician practices Whether stronger enforcement and compliance could reduce the need for IDR disputes Why patient protections and fair physician reimbursement are complementary goals What a more transparent, balanced, and effective No Surprises Act process could look like A closer look at IDR payment challenges One of the most striking examples discussed in the episode comes from RANT. The practice has reportedly won nearly $5 million in arbitration awards while receiving only about $1 million, highlighting an important distinction in the No Surprises Act debate: winning an IDR dispute and actually receiving payment are not necessarily the same thing. The episode examines whether better compliance with arbitration decisions, more accurate initial insurer payments, and stronger enforcement of existing requirements could help the IDR process function more effectively while preserving the patient protections at the heart of the No Surprises Act.

Take action Congress is considering H.R. 8163, the Provider Reimbursement Stability Act, a long-term solution aimed at addressing ongoing Medicare physician payment instability. Physicians and stakeholders can make their voices heard by participating in advocacy efforts referenced in this episode by clicking here or by texting ZPPAY to 50457.   The Centers for Medicare & Medicaid Services (CMS) has released the 2027 Medicare Physician Fee Schedule (MPFS) Proposed Rule, introducing significant payment and policy changes that could impact physician reimbursement, practice operations, and patient access beginning January 1, 2027. In this episode of Zotec Answers, Mark Isenberg, Executive Vice President of Healthcare Advocacy, and Ed Gaines, Vice President of Regulatory Affairs and Industry Liaison, explain what healthcare organizations need to know before the rule is finalized. In this episode, you'll learn: Why CMS is proposing another reduction to physician reimbursement How payment updates differ for APM participants versus MIPS participants Which physician specialties could experience the greatest financial impact Why the proposed Evaluation & Management (E/M) payment changes are generating concern New opportunities to support primary care and coordinated, longitudinal care What CMS's Requests for Information (RFIs) reveal about the future of Medicare payment policy Why physician advocacy during the public comment period can influence the final rule Key dates July 14, 2026: CMS released the proposed rule September 14, 2026: Public comment period closes Early to mid-November 2026: Final rule expected January 1, 2027: Expected effective date

This episode of Zotec Answers explores the evolving landscape of artificial intelligence (AI) policy and its implications for healthcare. The discussion centers on how AI governance is shifting from creating policies to implementing them, while individual states continue introducing their own AI regulations, creating both opportunities and challenges for healthcare organizations.

This episode recaps EDPMA's recent Day on Capitol Hill, where emergency medicine leaders met with members of Congress to advocate for policies that strengthen physician reimbursement and protect patient access to emergency care. Ed Gaines shares the organization's top legislative priorities, explains the value of building relationships with lawmakers, and highlights how data, including contributions from Zotec, is playing an increasingly important role in supporting advocacy efforts and influencing healthcare policy.

In this episode of Zotec Answers, Jennifer Fox and Megan Applegarth explore how AI is reshaping healthcare and why the conversation is shifting from what AI can do to the outcomes it produces. From growing regulatory scrutiny of AI companies to the impact of AI on healthcare spending, documentation, reimbursement, and accountability, they discuss what healthcare leaders, physicians, and policymakers need to consider as AI adoption accelerates.

Take Action Today! On the go? Simply text ZPPAY to 50457 to take action. 

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In this episode of Zotec Answers, Jennifer Fox and Megan Applegarth explore how AI, health data privacy, and healthcare regulation are colliding as patient information moves beyond traditional healthcare settings. From HIPAA and evolving state AI laws to growing concerns around transparency, accountability, and patient data protection, they break down what healthcare leaders, physicians, and policymakers need to understand as AI impacts the future of healthcare.

In this episode of Zotec Answers, Mark Isenberg joins Jennifer Fox and Megan Applegarth to unpack Indiana’s controversial downcoding policy and the growing scrutiny surrounding it. They explore how these changes impact physicians, practice revenue, and patient access, while breaking down what it means for the future of healthcare reimbursement.