Extreme and Uncontrollable Circumstances Policy for MIPS-Eligible Clinicians Affected by Hurricanes Florence and Michael

November 30, 2018
Policy Snapshot
Centers for Medicare and Medicaid (CMS), Alternative Payment Models (APM), Merit-Based Incentive Program Payment System (MIPS), Practice Management, Practitioners

The Centers for Medicare & Medicaid Services (CMS) understands that if you’re a clinician living or practicing in an area affected by Hurricane Florence and/or Hurricane Michael, you may experience difficulties collecting and submitting data for the Merit-based Incentive Payment System (MIPS) on time during the 2018 MIPS performance period. Most recently, for those affected by Hurricane Florence, Hurricane Michael, and/or the California Wildfires, CMS tried to lessen the burden by not requiring you to submit an application to reweight the performance categories under MIPS.

How Does It Work?

CMS will identify MIPS-eligible clinicians located in CMS-designated areas who have been affected by an extreme and uncontrollable circumstance based on the address associated with the clinician in the Provider Enrollment, Chain, and Ownership System (PECOS). 

For MIPS-eligible clinicians who are subject to the policy, all four performance categories will be weighted at 0%. You will automatically receive a score equal to the performance threshold that will result in a neutral payment adjustment (neither a positive or negative adjustment) for the 2020 MIPS payment year unless: 

  • You submit data for two or more MIPS performance categories (Quality, Improvement Activities, and/or Promoting Interoperability) as an individual
  • You are part of a group or virtual group that submits data on behalf of its clinicians

Please note that MIPS-eligible clinicians in APM entities who are subject to the APM scoring standard are not covered by the automatic extreme and uncontrollable circumstances policy.  However, a MIPS-eligible clinician who is subject to the APM scoring standard and identified as affected by an extreme and uncontrollable circumstance may apply for an exception in the Promoting Interoperability performance category.

More information can be found in the MIPS Automatic Extreme and Uncontrollable Circumstances Policy fact sheet.

Questions?

Contact the Quality Payment Program at 1-866-288-8292 (TTY 1-877- 715- 6222), Monday through Friday, 8 AM-8 PM ET or by email at QPP@cms.hhs.gov.