Reps. Mariannette Miller-Meeks, MD (R-IA) and Herb Conaway, MD (D-NJ) have introduced the Medicare Physician Data-driven Performance Payment System Act of 2026. This bipartisan bill that makes key, targeted reforms to the Merit-based Incentive Payment System (MIPS).
The changes included in the bill reflect months of American Medical Association-convened discussions among several medical societies, including ASGE. The bill reflects just one approach to reforming MIPS. ASGE remains actively engaged with policymakers and other stakeholders about reforming MIPS so it is less administratively burdensome and maximizes the value of clinician-led clinical data registries.
A fact sheet accompanying the bill’s release notes that MIPS has created significant challenges for physicians and disproportionately more penalties on small and rural health care practices, thus justifying the need for a more accurate, fair, and sustainable system.
Key provisions in the Medicare Physician Data-drive Performance Payment System Act of 2026 include:
- Freezing the current MIPS performance threshold at 75 for three years to promote stability in MIPS, as well as mandating GAO to conduct a study, in consultation with national medical specialty societies, to make recommendations to Congress and HHS about an alternative threshold methodology.
- Eliminating the MIPS win-lose “tournament style” payment adjustments (i.e., the +/- 9%) to ensure physicians are no longer subjected to steep penalties.
- In lieu of penalties, the legislation links physicians’ MIPS performance to a portion of their annual payment update (e.g., either the existing 0.25% under MACRA or the percentage increase in the Medicare Economic Index (MEI)).
- Mandating CMS to provide at least three quarters worth of MIPS feedback reports and Medicare claims data to physicians during a given performance year.
- Failure to provide these quarterly reports leads to physicians earning higher payments.