The "Protecting Access To Care in Hawaii Act" (PATCH Act) proposes to amend Title XVIII of the Social Security Act, specifically targeting Medicare payments for physicians' services in Hawaii. This legislation aims to establish a floor for the work geographic index , a factor used in calculating physician reimbursement rates. Under the bill's provisions, for services furnished in Hawaii on or after January 1, 2026 , if the calculated work geographic index falls below 1.5, it will be automatically increased to 1.5 . This adjustment is designed to enhance Medicare payments to physicians practicing in Hawaii. Significantly, the bill specifies that this increase will not be applied in a budget-neutral manner , ensuring a direct boost to reimbursement without requiring offsetting cuts elsewhere in the Medicare program.