SHM’s Letters to Policymakers

On behalf of the Society of Hospital Medicine (SHM) and the nation’s more than 50,000 hospitalists, we write to urge immediate action to address the administrative backlog currently affecting the Department of Health and Human Services (HHS) J-1 Exchange Visitor Waiver Program. This delay poses a direct and urgent threat to the care of hospitalized patients in rural and underserved communities across the United States.

On behalf of the undersigned organizations, we are writing to strongly support the introduction of the “H-1Bs for the Physicians and Healthcare Workforce Act” (H.R. 7961). This bipartisan legislation would exempt physicians and other health professionals from the new $100,000 H-1B fee, thereby ensuring patients continue to have access to the physicians and health care workers that millions of Americans depend on.

The Society of Hospital Medicine (SHM), representing the nation’s more than 50,000 hospitalists, is writing to urge you to reconsider the facility Practice Expense (PE) cuts finalized in the 2026 Physician Fee Schedule rule and reopen the policy in the FY 2027 Physician Fee Schedule proposed rule.

On behalf of the Society of Hospital Medicine (SHM) and the 50,000 hospitalists practicing across the United States, SHM submits this statement for the record. We thank the Subcommittee on Health for the opportunity to submit a statement for the record on one of the most pressing challenges facing American patients and families: the affordability of hospital-based healthcare.

To meet the needs of America’s patients, researchers, providers, and health systems, 259 leading organizations call for the Agency for Healthcare Research and Quality (AHRQ) to be fully funded at $500 million in FY27 and that the Agency have sufficient staff to manage its statutory obligations.

On behalf of the Society of Hospital Medicine (SHM), we appreciate the opportunity to provide comments to the U.S. Department of Health and Human Services (HHS) regarding the responsible development, regulation, and adoption of artificial intelligence (AI) in clinical care.

SHM signs on to joint letter urging DHS to create a health care sector exemption for new H-1B visa petitions to prevent additional strain on the health care workforce.

Hospitalists have a range of experience with participating in the two MACRA pathways (MIPS and Advanced Alternative Payment Models (APMs)), including having been major participants in the Bundled Payment for Care Improvement models. It is from these perspectives that we offer our comments on your questions.

The undersigned organizations, representing health care clinicians, public health professionals, scientists, patients, and family advocates, urge you to conduct swift and robust oversight regarding the abrupt changes to the U.S. childhood vaccine schedule announced on Jan. 5, 2026. It is essential that action is promptly taken to protect vaccine availability and coverage for all previously recommended immunizations for all families, including through the Vaccines for Children program.

SHM signs multi-stakeholder letter in strong support of (H.R. 3514/S. 1816), the “Improving Seniors’ Timely Access to Care Act of 2025” which would streamline and standardize prior authorization requirements within the Medicare Advantage (MA) program, addressing one of the most persistent barriers to timely, medically necessary care for America’s seniors.

Hospitalists face an estimated 7% cut to their Medicare reimbursement due to the PE reduction. This will significantly decrease available resources for patient-focused quality improvement efforts, innovation, and clinician recruitment, which are all critical for purposes of delivering high quality care and maintaining patient access. Congress must act immediately to stop this arbitrary cut prior to its implementation on January 1, 2026.

Aetna's proposed inpatient claims process presents as reducing administrative burden, it effectively redefines inpatient and observation, undermining statutory protections and Medicare’s own coverage rules.

This legislation would provide much-needed stability and certainty to Hospital at Home Programs by extending waiver flexibilities through 2030 — thereby avoiding another cliff that Hospital at Home programs are currently experiencing after the current authorities expired on September 30, 2025.

This change would create unnecessary administrative burdens, disrupt physician training, and threaten patient care—especially in underserved communities that rely on international medical graduates.

SHM joins the AMA and 54 national medical groups requesting physicians be exempt from the new, higher H-1B filing fees per the National Interest Waiver language within the September 19th Presidential proclamation.

SHM Comments to CMS on the proposed elimination of the Inpatient Only list.

The Society of Hospital Medicine opposes CMS's proposed cuts to facility-based Practice Expense Relative Value Units (PE RVUs), fearing substantial impacts on hospital medicine groups and patient care. They advocate for collaborative discussions on PE concerns, support eliminating telehealth frequency limits, and caution against mandatory reporting changes in the Quality Payment Program.

Letter expresses concerns and continued frustration with the Centers for Medicare & Medicaid Services (CMS) process for reviewing and selecting quality measures for its programs.

SHM supports this bipartisan legislation that will recapture unused employment-based visas and utilize them to help fill health care staffing shortages by expediting processing for immigrant physicians and nurses.

SHM joins the Moving Health Home Alliance on a letter to Congressional leaders asking for a five year extension of the acute hospital care at home waiver program.