H.R. 8622 Introduced To Reform Medicare’s MIPS Program For Greater Physician Fairness

Representatives Mariannette Miller-Meeks, R-Iowa, and Herb Conaway, D-N.J., introduced H.R. 8622, the Medicare Physician Data-driven Performance Payment System Act of 2026, on April 30 to reform Medicare’s Merit-based Incentive Payment System. The bill aims to replace MIPS with a new payment system that freezes performance thresholds, eliminates steep penalties, and provides greater feedback to physicians, according to a press release from Miller-Meeks’ office.

H.R. 8622, titled the Medicare Physician Data-driven Performance Payment System Act of 2026, proposes to replace the Merit-based Incentive Payment System (MIPS) with a new payment framework called the Data-driven Performance Payment System (DPPS), effective Jan. 1, 2027. The legislation, introduced April 30 by Representatives Mariannette Miller-Meeks (R-Iowa) and Herb Conaway (D-New Jersey), aims to freeze the performance threshold at 75 points from 2028 through 2033, according to a press release from Miller-Meeks’ office. This measure intends to provide greater payment stability for physicians under Medicare.

The bill eliminates the current tournament-style penalties, which can reach as high as 9%, and instead ties payment adjustments to annual updates such as the Medicare Access and CHIP Reauthorization Act (MACRA) increases or the Medicare Economic Index (MEI).

Under the new system, physicians with higher performance scores would receive larger positive payment adjustments beginning in 2028. The legislation also mandates that the Centers for Medicare & Medicaid Services (CMS) provide quarterly feedback reports and Medicare claims data during the performance year, with a specific provision protecting physicians from negative payment adjustments if CMS fails to deliver these reports.

H.R. 8622 emphasizes budget neutrality, ensuring that payment adjustments based on quality and cost metrics do not increase overall Medicare spending. CMS would be responsible for setting performance thresholds but would be restricted from exceeding 75 points through 2033, records show. The bill also requires quarterly performance data to be provided in real time, which officials say will enable physicians to make ongoing improvements in care delivery.

The legislation targets support for solo practitioners, small practices with 15 or fewer professionals, rural providers, and those serving underserved communities. It proposes lump-sum incentive payments to encourage care management and adoption of technology in these settings. CMS data cited in the bill’s background documentation reportedly show that the majority of small and rural practices face the highest penalty cuts under the current MIPS structure. The bill seeks to reinvest funds into quality improvement initiatives for under-resourced providers and offers additional incentives during years when DPPS generates savings through value-based care participation.

Administrative relief is a key component of the proposed reforms. According to the bill, physicians currently spend an average of 202 hours and $12,000 annually on administrative tasks related to MIPS compliance. The new system would reduce this burden by requiring CMS to provide at least three-quarters of feedback reports annually and increase transparency in cost attribution, officials said. The bill also aims to protect physicians from penalties caused by delayed or insufficient data provision from CMS.

The American Medical Association (AMA) publicly commended Representatives Miller-Meeks and Conaway for their leadership in introducing H.R. 8622, as noted in the AMA National Advocacy Update dated May 8, 2026. The American Society for Radiation Oncology (ASTRO) also expressed support for the bill’s targeted reforms, specifically the freeze on performance thresholds. Miller-Meeks stated the legislation “modernizes physician payments, reduces burdens, and improves patient care,” while Conaway highlighted the bill’s focus on a “streamlined, patient-centered approach” that reduces wasted compliance efforts, according to their respective statements in the press release.

MIPS was established following the passage of MACRA in 2015 but has faced criticism for causing payment volatility and disproportionate penalties, especially among solo and rural clinicians. CMS performance data, referenced in the bill’s supporting documents, indicate that nearly half of solo practitioners receive the maximum 9% Medicare payment reductions. The system has been criticized for diverting physician time from patient care to administrative compliance with limited clinical benefit, according to analyses by the AMA and Quiver Quantitative summaries cited in PALTmed’s May 4, 2026, report on the bill.

The introduction of H.R. 8622 follows ongoing calls from organized medicine for statutory reforms to address MIPS’s shortcomings. The legislation now awaits consideration in the House, with stakeholders monitoring potential impacts on Medicare physician payment policies in the coming years.