Bipartisan bill targets MIPS overhaul, draws MGMA and AMA support

A bipartisan pair of physician-lawmakers introduced legislation on April 30 to scrap the Merit-based Incentive Payment System (MIPS) and replace it with a framework the Medical Group Management Association (MGMA) says would address one of its members’ longest-running frustrations with Medicare.

The Medicare Physician Data-Driven Performance Payment System Act of 2026, introduced April 30 by Rep. Mariannette Miller-Meeks, M.D. (R-Iowa), and Rep. Herb Conaway Jr., M.D. (D-New Jersey), would replace MIPS with what its sponsors call the Data-Driven Performance Payment System, or DPPS. The bill freezes the performance threshold, ends the budget-neutral structure that pits practices against one another and requires CMS to deliver quarterly performance feedback.

“For too long, Medicare’s current payment system has placed unnecessary burdens on physicians and failed to reflect the realities of patient care,” said Miller-Meeks, an ophthalmologist and former director of the Iowa Department of Public Health. “As a physician, I’ve seen how MIPS creates excessive red tape, disproportionately impacts small and rural practices, and does not always capture the quality of care being delivered. This legislation takes a more practical, data-driven approach that supports providers, strengthens rural health care and ensures patients receive the care they deserve.”

For practice administrators who have spent the better part of a decade navigating MIPS reporting cycles, the proposal represents the most concrete legislative move yet to unwind a program that costs physicians an average of $12,800 and more than 53 hours per year per provider in compliance work.

What would the Data-Driven Performance Payment System Act change about MIPS?

Established under the Medicare Access and CHIP Reauthorization Act in 2015, MIPS evaluates physicians on quality, cost, improvement activities and interoperability, then adjusts Medicare payments up or down based on the resulting score. Because the program is budget-neutral, bonuses for high performers are funded by penalties on low performers — the structure MGMA calls the “tournament model.”

According to Miller-Meeks’ office, nearly half of solo clinicians receive MIPS penalties, with many facing the maximum 9% reduction in Medicare payments. Specialists have also raised concerns about the clinical relevance of available measures.

“Rather than driving better outcomes, the Merit-based Incentive Payment System has imposed significant administrative burdens and financial uncertainty, hitting smaller and independent practices the hardest,” said Conaway, who continues to practice internal medicine while in office and serves as director of the internal medicine clinic at St. Francis Medical Center in Trenton, New Jersey.

The DPPS legislation would scrap the tournament-style scoring in favor of what its sponsors describe as a more balanced payment structure, reinvest funds into quality improvement and support for under-resourced practices, increase transparency in how cost is attributed to individual physicians, protect physicians from penalties when sufficient performance data isn’t available and freeze the performance threshold to give practices more predictability.

“Physicians are forced to devote valuable time and resources to compliance requirements that offer little clinical benefit, ultimately diverting attention from patient care. I’m proud to support legislation that advances a streamlined, patient-centered approach,” Conaway said.

The bill has been endorsed by the American Medical Association (AMA) and reflects principles supported by all state medical associations and more than 100 specialty societies, according to the announcement from Miller-Meeks’ office.

Why is MGMA backing the bill?

In a statement issued the same day the bill was introduced, Anders Gilberg, MGMA’s senior vice president of government affairs, said the legislation directly tackles structural problems his members have flagged for years. He noted that MGMA members have grown frustrated with the administrative burden tied to MIPS reporting and pointed to the program’s tournament-style structure as a key driver.

“This burden is exacerbated by the MIPS program’s tournament-style model, which increases payments to practices that meet onerous quality reporting requirements by cutting payments to practices that don’t,“ Gilberg said.

He added that the bill makes important changes by eliminating the tournament-style model, freezing the performance threshold and ensuring medical groups receive timely performance feedback from CMS, and said MGMA looks forward to working with Congress to pass the measure.

In a recent conversation with Physicians Practice about MGMA’s 2026 Regulatory Burden Report — which found that 95% of practices say administrative and regulatory burden has grown over the past several years — Gilberg told Physicians Practice Managing Editor Keith A. Reynolds that almost two-thirds of practices remain in MIPS, a program that was meant to serve as a bridge to alternative payment models a decade ago. Many MGMA members, he said, simply don’t have clinically relevant APMs to move into.

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“They’re stuck in MIPS, and that remains a huge challenge,” Gilberg said. “They report that to be a burden, not a quality improvement exercise.”

In that same conversation, when asked which policy shifts he would prioritize for Congress in 2026, Gilberg pointed squarely at physician payment. “What [Congress] really needs to do is reform physician payment, and do away with some of the problems with the current system,” he said. “That involves MIPS, and removing the tournament model from MIPS.”

What happens next for the MIPS reform bill?

The bill will need to move through committee before reaching the House floor. MGMA said it plans to work with Congress to advance the legislation, and the AMA has signaled it will lobby in support.

Whether the measure gains traction in a crowded legislative calendar remains to be seen, but early backing from major physician groups suggests a level of consensus that has been hard to come by on Medicare payment reform.