Medicare Physician Data-driven Performance Payment System Act of 2026
Sponsored By: Representative Miller-Meeks, Mariannette [R-IA-1]
Introduced
Summary
Data-driven Performance Payment System (DPPS) would replace the Merit-based Incentive Payment System and recast how Medicare pays physicians by tying payment adjustments to composite performance scores and creating targeted incentives for small and under-resourced practices.
Show full summary
- Medicare clinicians: Payments would rise or fall based on a composite performance score using multipliers of 1.25, 1.0, 0.75, and 0.5 for above, at, below, and lowest scores respectively.
- Performance thresholds: The performance threshold would be capped at 75 points from 2028 through 2033 and could be extended to 2034 for major disruptions. The Secretary may adopt a replacement threshold method after reviewing recommendations from the Comptroller General.
- Small and under-resourced practices: The bill would authorize lump-sum incentives in "DPPS savings years" to help small practices and under-resourced providers join value-based care. A "small practice" is defined as 15 or fewer professionals, with priority for rural, health-professional-shortage, medically underserved, or low-scoring small practices.
*Would be designed to preserve budget neutrality for aggregate allowed charges from 2028 onward, so it is not intended to increase net Medicare physician spending.*
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Bill Overview
Analyzed Economic Effects
2 provisions identified: 0 benefits, 0 costs, 2 mixed.
New Medicare payment system and rates
This bill would replace MIPS with a new Medicare system called DPPS starting January 1, 2027. For 2028 and later, DPPS would set payment multipliers of 1.25, 1.0, 0.75, and 0.50 based on a provider's composite score versus the performance threshold. The Secretary could reduce positive multipliers so total increases do not exceed total decreases (budget neutrality). A provider would lose an adjustment for a year if they did not get required quarterly confidential feedback within 60 days. If the conversion-factor update is negative, DPPS multipliers would not apply that year. For Medicare patients, coinsurance and deductible calculation would be held harmless and computed as if DPPS adjustments did not change the conversion-factor update.
One-time incentive payments for small practices
This bill would create a DPPS "savings year" rule starting in 2028. A year would be a DPPS savings year when estimated decreases in provider payments exceed estimated increases. In a DPPS savings year, the Secretary could pay lump-sum incentives to eligible DPPS professionals who furnished services and submitted required data and a small-practice attestation. A small practice is generally 15 or fewer professionals, and the Secretary could prioritize small practices in rural areas, shortage areas, or medically underserved areas. The total incentive money for a year could not exceed the computed net savings amount for that year.
Sponsors & CoSponsors
Sponsor
Miller-Meeks, Mariannette [R-IA-1]
IA • R
Cosponsors
Conaway
NJ • D
Sponsored 4/30/2026
Rep. Krishnamoorthi, Raja [D-IL-8]
IL • D
Sponsored 5/12/2026
Roll Call Votes
No roll call votes available for this bill.
View on Congress.gov