PRIA Logo™
HR8622119th CongressWALLET

Medicare Physician Data-driven Performance Payment System Act of 2026

Sponsored By: Representative Miller-Meeks, Mariannette [R-IA-1]

Introduced

Summary

Creates a Data-driven Performance Payment System (DPPS) to replace MIPS. It would swap the current Merit-based Incentive Payment System for a new, data-focused scoring and payment framework with new multipliers, temporary thresholds, and a savings-year incentive program starting in 2028.

Personalized for You

How does this bill affect your finances?

Personalize government policy and PRIA will tell you what this bill means for your household, plus every other piece of legislation we track. PRIA reads each provision against your financial profile to show you exactly what matters to your wallet.

Free to download

Bill Overview

Analyzed Economic Effects

4 provisions identified: 1 benefits, 0 costs, 3 mixed.

Medicare clinician pay increases and cuts

If enacted, beginning in 2028 clinicians would have their yearly Medicare conversion-factor update multiplied by one of four DPPS factors: 1.25 (+25%), 1.0 (no change), 0.75 (−25%), or 0.5 (−50% for lowest-treated scores). The Secretary would reduce the 1.25 increases if needed so total increases do not exceed total decreases (budget neutrality). The factor would not apply if the year's conversion-factor update is negative, and clinicians who did not receive required timely quarterly feedback could lose the 0.75 treatment. Coinsurance and deductible amounts for beneficiaries would be calculated as if the DPPS factor did not lower the conversion-factor update.

Lump-sum aid for small Medicare practices

If enacted, starting in 2028 the Secretary could pay lump-sum incentives to eligible small practices in a DPPS "savings year." A DPPS savings year would be one where estimated aggregate decreases from below-threshold clinicians exceed aggregate increases to above-threshold clinicians. To qualify a clinician would need required DPPS data for the year and an attestation that their practice has 15 or fewer professionals. Payments would have to be used for care management, addressing health-related social needs, certified EHR technology, improving DPPS performance, or joining value-based care, and the Secretary could prioritize rural, shortage-area, underserved, or low-scoring small practices.

New Medicare clinician payment system

If enacted, this bill would replace MIPS with a new system called the Data-driven Performance Payment System starting January 1, 2027. During the change, references to MIPS would count as DPPS and vice versa so forms and rules work smoothly. The Health and Human Services Secretary would be required to manage the transition and update regulations and terminology.

Temporary performance score cap and review

If enacted, the Secretary would cap DPPS performance thresholds at 75 points for each year 2028 through 2033. The Secretary could extend this 75-point rule for 2034 if extraordinary circumstances affect reporting or data. The Comptroller General would report to Congress and the Secretary with recommendations for a new, data-driven threshold method by December 31, 2029, and the Secretary would adopt a replacement method by notice-and-comment rulemaking after the special rule ends.

Sponsors & CoSponsors

Sponsor

Miller-Meeks, Mariannette [R-IA-1]

IA • R

Cosponsors

  • Rep. Conaway, Herbert C. [D-NJ-3]

    NJ • D

    Sponsored 4/30/2026

  • Rep. Krishnamoorthi, Raja [D-IL-8]

    IL • D

    Sponsored 5/12/2026

  • Rep. Morelle, Joseph D. [D-NY-25]

    NY • D

    Sponsored 7/6/2026

Roll Call Votes

No roll call votes available for this bill.

View on Congress.gov
Back to Legislation