In response to advocacy from the AMA and organized medicine about the ongoing impacts of the COVID-19 public health emergency (PHE), physicians may now apply for an Extreme and Uncontrollable Circumstances hardship exception to avoid an up to 9% penalty in the Merit-based Incentive Payment System (MIPS). The penalty would apply in 2025 based on the 2023 performance period. The exception will not be automatic, and interested physicians and groups must actively request reweighting of one or more MIPS performance categories due to the COVID-19 PHE. Requesting reweighting of all four MIPS performance categories will avoid a MIPS penalty in 2025. Applications can be submitted through Jan. 2, 2024.
This is a big relief for physicians and their patients because CMS estimated in the 2023 MIPS final rule that up to one-third of MIPS eligible clinicians would have received a penalty due to the increasingly stringent requirements to participate in MIPS in 2023. It is also likely that small, rural and practices serving underserved populations would have been disproportionately impacted by these penalties.