Physicians and healthcare groups urge Congress to bolster No Surprises Act, physicians’ stories needed for ongoing advocacy
The AMA, 50 state medical societies and 46 healthcare groups sent a letter (PDF) to congressional leaders this week supporting bipartisan, bicameral legislation designed to strengthen enforcement of the No Surprises Act. The legislation (H.R. 4710/S. 2420) responds to the widespread problem of health plans failing to comply with the law’s clear payment requirements after physicians prevail in the Independent Dispute Resolution (IDR) process.
Physicians across the country report that health plans continue to delay payments beyond the statutory 30-day timeframe or refuse to pay altogether. These practices place significant financial strain on independent physician practices that have limited ability to challenge insurers’ noncompliance. This recent letter follows a separate letter from the AMA and 111 specialty societies and state medical association to administration officials warning that health plans are undermining the No Surprises Act and urging federal regulators to increase enforcement and transparency.
In our efforts to continue challenging efforts by payers to undermine the No Surprises Act, the AMA is currently soliciting examples of payer noncompliance with NSA requirements and wants to hear from you. We are looking for examples of, but not limited to, untimely and incomplete final payments, inappropriate cost-shifting onto patients, and misusing technical guidance to reopen closed IDR cases. Share your story by emailing [email protected].
Physicians have until June 11 to preview their 2024 MIPS data prior to public posting
The AMA urges physicians and group practices to review their 2024 Merit-based Incentive Payment System (MIPS) performance data for accuracy before it appears in the Provider Data Catalog (PDC) and on clinician and group profile pages on the Medicare.gov compare tool. To review the secure preview, please go to the QPP website.
To question or contest any data before it goes live, physicians and group practices must contact the Service Desk before the Preview Period closes on Thursday, June 11, 2026, at 8 p.m. ET (5 p.m. PT). Questions about publicly reported data in the PDC or on the Medicare.gov compare tool, may be directed to the Quality Payment Program Service Center by emailing [email protected], by creating a QPP Service Center ticket, or by calling 1-866-288-8292 (Monday through Friday 8 a.m. – 8 p.m. ET).
For help accessing the QPP website or getting a Health Care Quality Improvement Systems (HCQIS) Access Roles and Profile (HARP) user role, email the QPP Service Center at [email protected]. To learn how to sign up for a HARP account, please review the QPP Access User Guide (ZIP).
CMS now accepting 2026 Quality Payment Program exception applications
The 2026 Quality Payment Program (QPP) exception applications are now available through Dec. 31, 2026, at 8 p.m. ET. There are two (2) types of exception applications that allow participants to indicate why they cannot report data for one or more MIPS performance categories.
1. MIPS Promoting Interoperability Performance Category Hardship Exception Application
Individual clinicians, groups, and virtual groups (or their third-party representative) reporting traditional MIPS, a MIPS Value Pathways (MVP), or the Alternative Payment Model (APM) Performance Pathway (APP) can submit a MIPS Promoting Interoperability Performance Category Hardship Exception application for the following reasons:
You have decertified Electronic Health Record (EHR) technology (must be decertified under the Office of the National Coordinator for Health Information Technology (ONC) Health IT Certification Program).
You have insufficient internet connectivity.
You face extreme and uncontrollable circumstances such as a disaster, practice closure, severe financial distress or vendor issues.
You lack control over the availability of certified EHR technology (CEHRT).
As this application is specific to the MIPS Promoting Interoperability performance category, successful applicants will not be required to report data for this performance category.
2. MIPS Extreme and Uncontrollable Circumstances Exception Application
Individual clinicians, groups, and virtual groups (or their third-party representative) reporting traditional MIPS, an MVP, or the APM Performance Pathway can submit a MIPS Extreme and Uncontrollable Circumstances (EUC) Exception application for one or more MIPS performance categories (quality, cost, improvement activities, and Promoting Interoperability) due to extreme and uncontrollable circumstances, which are defined as rare events entirely outside of your control and the control of the facility in which you practice.
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.
Successful applicants will not be required to report data for the performance category or categories included in their approved application.
It is extremely important to note, however, that a qualifying data submission will override approved reweighting, on a category-by-category basis. That is, any qualifying data submitted by the applicant or on the applicant’s behalf will be scored, and those performance categories will contribute to the applicant’s final score.
Alternative Payment Model Entities
Alternative Payment Model (APM) Entities including Medicare Shared Savings Program (Shared Savings Program) Accountable Care Organizations (ACOs) can also submit exception applications, but they must apply for all performance categories. If the application is approved, these applicants will not be required to report data for MIPS, and any data submitted will not be scored for purposes of MIPS.
How to apply
To submit either exception application:
Sign in to the QPP website with your Health Care Quality Information System (HCQIS) Access Roles and Profile (HARP) account.
Choose “Exceptions Application.”
Click “Add New QPP Exception.”
Choose your exception type.
