New CMS Rule to Apply MIPS Exemption for the 2020 Performance Period

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New CMS Rule to Apply MIPS Exemption for the 2020 Performance Period

CMS announced flexibilities to provide relief to physicians responding to the (COVID-19) pandemic. For the 2020 performance period, CMS will be applying the Merit-based Incentive Payment System (MIPS) automatic extreme and uncontrollable circumstances (EUC) policy to all MIPS-eligible clinicians. They are also reopening the MIPS EUC application for individual MIPS-eligible clinicians, groups, virtual groups, and Alternative Payment Model entities through 8 p.m. ET on March 31, 2021. Please note that applications received between now and March 31, 2021, won’t override previously submitted data for individuals, groups, and virtual groups.

Individual clinicians, groups, and virtual groups that have not submitted data
Individual MIPS-eligible clinicians: You do not need to take any additional action to qualify for the automatic EUC policy. You will be automatically identified and will receive a neutral payment adjustment for the 2022 MIPS payment year unless (1) you submit data as an individual in two or more performance categories or (2) your practice reports as a group by submitting data for one or more performance category.
• Groups: You do not need to take any further action if you are not able to submit data for the 2020 performance period. Group participation is optional, and your individual MIPS-eligible clinicians qualify for the automatic EUC policy. They will have all 4 performance categories reweighted to 0% and receive a neutral payment adjustment for the 2022 MIPS payment year unless (1) they submit data in two or more performance categories as individuals or (2) the practice reports as a group by submitting data for one or more performance category.
• Virtual Groups: If you are unable to submit data for the 2020 performance period, you must submit an EUC application for all 4 performance categories by the deadline.

Individual clinicians, groups, and virtual groups that have submitted data
• Individual MIPS-eligible clinicians who have submitted data for a single performance category (such as Medicare Part B Claims measures submitted throughout the 2020 performance period):
o You do not need to take any additional action to be eligible for the automatic EUC policy.
o You will be automatically identified. All 4 performance categories will be reweighted to 0%, and you will receive a neutral payment adjustment for the 2022 MIPS payment year unless (1) you submit data for another performance category or (2) your group submits data for one or more performance category.
• Individual MIPS-eligible clinicians who have submitted data as an individual for two or three performance categories:
o You will receive a MIPS final score and MIPS payment adjustment for the 2022 MIPS payment year based on the data you have submitted.
o You will only be scored in the performance categories for which data are submitted.
o You cannot submit an application to override previously submitted data.
• Groups and virtual groups that have submitted data for a single performance category:
o If you are not able to complete data submission for other performance categories, you can submit an application to request reweighting in all 4 performance categories.
o This includes small practices that were automatically scored as a group on Medicare Part B Claims measures submitted throughout the 2020 performance period.
o If you don’t submit an application, your group will be scored in all performance categories unless you are eligible for reweighting in one or more performance categories.
o If your application is approved and data are not submitted for another performance category, your MIPS-eligible clinicians will receive a neutral payment adjustment for the 2022 MIPS payment year.
• Groups and virtual groups that have submitted data for two or three performance categories:
o Your MIPS-eligible clinicians will receive a MIPS final score and MIPS payment adjustment for the 2022 MIPS payment year.
o Your group will be scored in all performance categories unless you qualify for reweighting in one or more performance categories.
o You cannot submit an application to override previously submitted data.

Additional Resources
2020 MIPS Extreme and Uncontrollable Circumstances Application Resources
Quality Payment Program COVID-19 Response fact sheet

For more information, please see the Quality Payment Program (QPP) COVID-19 Response webpages of the QPP website. You can contact the QPP by phone at 1-866-288-8292 (TRS: 711), Monday through Friday, 8 a.m. to 8 p.m. ET, or by e-mail at QPP@cms.hhs.gov.