Patients First Act with ROOT Act Introduced in Senate

U.S. Sen. Roger Marshall, MD (R-KS), introduced the Patients First Act of 2026 (S. 5672), a comprehensive Medicare physician payment reform package that includes the ACR^®-supported Radiology Outpatient Ordering Transmission (ROOT) Act. The bill was referred to the Senate Committee on Finance.

The Senate bill is the companion to the U.S. House version (H.R. 9693), the bipartisan Patients First Act introduced by Reps. John Joyce, MD (R-PA), Greg Murphy, MD (R-NC), and Kim Schrier, MD (D-WA), chairs of the GOP and Democratic Doctors Caucuses.

The ROOT Act provisions would modernize implementation of Medicare’s Appropriate Use Criteria (AUC) program for advanced diagnostic imaging. Under the proposal, providers would use AUC-based clinical decision support tools when ordering applicable imaging services.

The Patients First Act also includes broader Medicare physician payment reforms, including annual payment updates tied to the Medicare Economic Index, changes to Medicare budget-neutrality policies and reforms to quality reporting requirements.

For questions or more information, contact Ashley Walton, ACR Government Affairs Director.