April 5, 2024: Medicare Payment Reform Advocacy Update

Based on direct AMA advocacy to the administration (PDF), the Centers for Medicare & Medicaid Services (CMS) has now reopened the 2023 Merit-based Incentive Payment System (MIPS) Extreme and Uncontrollable Circumstances (EUC) hardship application due to the Change Healthcare cyberattack. The deadline to apply for an exemption is April 15.

The 2023 MIPS EUC hardship exemption is not automatic and requires physicians to apply. Because CMS is reopening the 2023 MIPS EUC Exception Application window in response to the cyberattack, CMS will only approve applications citing this cyberattack as the basis for requesting reweighting under the MIPS EUC Exception. Any applications submitted for reasons outside of the Change Healthcare cyberattack will be denied.

The AMA notes that submission of MIPS data will override the EUC hardship exception. Therefore, if a physician or practice has already submitted data and would like to take advantage of this flexibility, it requires logging into the CMS portal and updating the submission. Individual MIPS eligible clinicians, groups, virtual groups and Alternative Payment Model (APM) Entities participating in MIPS (including Shared Savings Program Accountable Care Organizations) who anticipate being unable to submit data for the 2023 performance year, or complete their data submission, before the extended deadline because of the Change Healthcare cyberattack, can submit a 2023 MIPS EUC Exception Application until 7:00 p.m. Central time on April 15.

Physicians and practices can submit an application to request reweighting for any or all MIPS performance categories. Reweighting of all performance categories will result in avoiding a MIPS penalty of up to -9 percent. If a physician or practice would like to still be scored on the 2023 MIPS Program, the extended deadline to submit data remains April 15.

For more information on the MIPS EUC exception application:

• 2023 MIPS Extreme and Uncontrollable Circumstances Exception Application Guide (PDF)
• QPP Exception Applications

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