Dr. Miller-Meeks Introduces Legislation to Reform Medicare Physician Payment System

WASHINGTON, D.C. – Congresswoman Mariannette Miller-Meeks, M.D. (IA-01), alongside Congressmen Herb Conaway Jr., M.D. (NJ-03) today introduced the Medicare Physician Data-Driven Performance Payment System Act, legislation to modernize Medicare’s physician payment system, reduce burdens on providers, and improve care for patients.

As a physician, Dr. Miller-Meeks is leading efforts to replace the Merit-based Incentive Payment System (MIPS), a program that has created significant administrative challenges for providers and raised concerns about fairness and effectiveness.

“For too long, Medicare’s current payment system has placed unnecessary burdens on physicians and failed to reflect the realities of patient care,” said Dr. Miller-Meeks. “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 healthcare, and ensures patients receive the care they deserve.”

“Providers across the country are working within a payment system that has become increasingly out of step with the realities of patient care,” said Congressman Conaway. “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. 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.”

Background

The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 established MIPS to evaluate physician performance using a combination of quality, cost, and reporting metrics. These scores determine whether physicians receive payment penalties or bonuses under a budget-neutral system.

In practice, MIPS has created significant challenges for providers across the country.

The program disproportionately impacts small and rural practices, with nearly half of solo clinicians receiving penalties and many facing the maximum 9 percent reduction in Medicare payments. Physicians also face a substantial administrative burden, spending an average of 202 hours annually and more than $12,000 per year per provider on compliance requirements.

At the same time, concerns remain about whether MIPS accurately measures quality, particularly for physicians serving higher-risk or lower-income patient populations. Specialists also face limited, often less relevant metrics that do not fully reflect the care they provide.

The Solution

The Data-Driven Performance Payment System (DPPS) offers a modern, physician-focused alternative.

The legislation replaces MIPS with a system designed to improve fairness, transparency, and clinical relevance while reducing unnecessary administrative burden.

Key reforms include:

• Reducing excessive penalties and creating a more balanced payment structure
• Reinvesting funds into quality improvement and support for under-resourced practices
• Providing quarterly performance feedback so physicians can make real-time improvements
• Increasing transparency in cost attribution to support better clinical decision-making
• Protecting physicians from penalties when sufficient performance data is not provided

The bill also provides stability by freezing the performance threshold, giving providers greater predictability as they transition to value-based care.

Support

The Data-Driven Performance Payment System has been endorsed by the American Medical Association and reflects principles supported by all state medical associations and more than 100 specialty societies nationwide.

“Physicians have grappled with a multitude of problematic issues associated with the Merit-based Incentive Payment System (MIPS) for more than a decade. The combination of steep penalties and burdensome measures that don’t lead to improved care quality or patient outcomes has overwhelmed physicians, especially those in private practice. Scholarly journal articles have found that compliance with MIPS costs physicians $12,800 per physician annually and requires more than 53 hours per year on quality assurance tasks. This reality of devoting significant time to tasks that do not improve patient health and yet still result in penalties is prompting private practices to close and exacerbating the trend of care shifting to higher cost settings. We commend Reps. Miller-Meeks and Conaway for their leadership in introducing this legislation that seeks to improve the MIPS program.” Dr. Bobby Mukkamala, president of the American Medical Association.

As one of the few physicians serving in Congress, Dr. Miller-Meeks has been a leading advocate for reducing healthcare costs, improving access, and ensuring federal programs work for both patients and providers.

“This is about making Medicare work better for the physicians who deliver care and the patients who rely on it,” Miller-Meeks added. “We need a system that rewards quality care, supports innovation, and allows doctors to focus on their patients.”

Click HERE for more information on the Medicare Physician Data-Driven Performance Payment System Act.

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