Advocacy Update

July 16, 2021: Advocacy Update other news


The COVID-19 pandemic has impacted all clinicians across the United States and territories. As a result, Centers for Medicare & Medicaid Services (CMS) continues to use its extreme and uncontrollable circumstances policy to allow clinicians, groups, virtual groups and Alternative Payment Model (APM) entities to submit an application requesting reweighting of 2021 Merit-Based Incentive Program (MIPS) performance categories due to the current COVID-19 public health emergency. Physicians who apply to have all MIPS categories reweighted will be held harmless from a penalty of up to -9%. Therefore, the AMA greatly encourages physicians to apply for the exception, whether reporting traditional MIPS or the APM Performance Pathway (APP). The application period is open until Dec. 31.

Extreme and uncontrollable circumstances are defined as rare events entirely outside of your control and the control of the facility in which you practice, such as COVID-19. These circumstances would:

  • Cause you to be unable to collect information necessary to submit for a MIPS performance category.
  • Cause you to be unable to submit information that would be used to score a MIPS performance category for an extended period of time (for example, if you were unable to collect data for the quality performance category for 3 months).
  • Impact your normal processes, affecting your performance on cost measures and other administrative claims measures.

To register, you need a HCQIS Access Roles and Profile (HARP) account to submit an Extreme and Uncontrollable Circumstances Application. Once you sign into QPP with your HARP credentials, click "Exceptions Application” on the left-hand navigation and then select "Extreme and Uncontrollable Circumstances."

Surgeon General Vivek H. Murthy, MD, has released a public statement that calls attention to the current public health issue of health misinformation and provides recommendations for how that issue should be addressed. Limiting the prevalence and impact of misinformation will help all of us make more informed decisions about our health and the health of our communities and will require a whole-of-society effort. The advisory recommends:

  • Americans be equipped with the tools to identify misinformation and address health misinformation in their communities.
  • Expansion of research that deepens our understanding of health misinformation including how it spreads and evolves, who it affects and what strategies are most effective in addressing it.
  • Implementation of product design and policy changes on technology platforms to slow the spread of misinformation.
  • Investing in longer-term efforts to build resilience against health misinformation such as media, science, digital, data and health literacy programs and training for health practitioners, journalists, librarians and others.
  • Convening federal, state, local, territorial, tribal, private, nonprofit and research partners to explore the impact of health misinformation and identify best practices to prevent and address it.

Read the full advisory notice from the Surgeon General (PDF).

The Coronavirus Aid, Relief, and. Economic Security (CARES) Act Provider Relief Fund (PRF) Reporting Portal is open for recipients to report on payments exceeding $10,000 in aggregate and received from April 10, 2020 to June 30, 2020. Physician practices that are required to report have until Sept. 30 to register in the portal and submit the necessary information about how the funds were used on increased expenses and lost revenues due to the COVID-19 public health emergency. Physician practices that received $10,000 or less in payments during the April 10, 2020 to June 30, 2020 timeframe do not have to report on their use of these relief funds.

In addition, reimbursement for COVID-19 testing, treatment and vaccine administration for the uninsured or underinsured is exempt from reporting. Physician practices that received PRF payments exceeding $10,000 after June 30, 2020 may be required to report at a later time and cannot report on the use of those funds prior to Sept. 30, 2021. For more information about how to register and what information is required to be reported, including a registration user guide and data entry worksheet, please see the HHS website and register for an HHS technical assistance session on July 20, 2021 at 3 p.m. Eastern.

The AMA is interested in hearing from physicians about their experience reporting on the provider relief funds. Please share feedback via [email protected].

For more information about the programs established by the federal government to help physician practices offset the financial impact of COVID-19, access these AMA resources.

Please join the AMA Guides® Editorial Panel on July 29 from 6–8:00 p.m. Central. The tentative agenda includes an update on the following proposals to update the AMA Guides—review and discussion of the revisions to the proposal to address emotional or behavioral impairments associated with neurological impairment (PDF) and review and discussion of the revisions to the proposal to update mild traumatic brain injury (PDF).

Additionally, language to clarify that the 2022 content update to the AMA Guides Sixth Edition represents the most current evidence-based medicine will also be evaluated. Should the Editorial Panel approve the proposal, a public comment period will begin on Aug. 2. More information will be provided closer to the public comment period but to get started on the required confidentiality and nondisclosure agreements, please contact [email protected].

The AMA supports the adoption of the most current edition of the AMA Guides to provide fair and consistent impairment evaluations and considers AMA Guides Sixth Edition 2021 to be the most recent edition of the AMA Guides and the most current version of the AMA Guides Sixth.

The AMA Guides community is observing the July 1 effective date of the updated AMA Guides Sixth 2021. Here are a couple examples of what has been posted: read the press release from the Arizona Medical Association and a regulator bulletin from the Wyoming Department of Workforce Services.

Sign up for invitations to virtually attend the AMA Guides Editorial Panel meetings:

Learn more about AMA Guides Digital, review information on AMA Guides Sixth Edition 2021,visit the educational module on AMA EdHub™ or read about submitting a change proposal. For more information, contact [email protected].