CMS to Apply MIPS Automatic Extreme and Uncontrollable Circumstances Policy for the 2021 Performance Year

On November 10, 2021, the Centers for Medicare and Medicaid Services announced they will apply the MIPS Automatic Extreme and Uncontrollable Circumstances Policy for the 2021 Performance Year. In this article, I will answer the following questions:

1. Who does the MIPS Automatic Extreme and Uncontrollable Circumstances Policy apply to?
2. Who does the MIPS Automatic Extreme and Uncontrollable Circumstances Policy not apply to?
3. Do I have to submit an application for the MIPS Automatic Extreme and Uncontrollable Circumstances Policy?
4. What if I submit data to CMS on Quality Measures and Improvement Activities for the 2021 MIPS Performance Period; will I still qualify for the Automatic Extreme and Uncontrollable Circumstances Policy?
5. I submit Quality Measures via Medicare Part B claims. Since I have been submitting the measures the entire year on the CMS-1500 claim form, will the MIPS Automatic Extreme and Uncontrollable Circumstances Policy still apply to me?
6. What if my practice submits MIPS data as a group for the 2021 Performance Period?
7. Where can I get additional information regarding the MIPS Automatic Extreme and Uncontrollable Circumstances Policy?

Let’s Begin!

Question #1
Who does the MIPS Automatic Extreme and Uncontrollable Circumstances Policy apply to?

Answer #1

Question #2
Who does the MIPS Automatic Extreme and Uncontrollable Circumstances Policy not apply to?

Answer #2

Question #3
Do I have to submit an application for the MIPS Automatic Extreme and Uncontrollable Circumstances Policy?

Answer #3[restrict paid-true]
No! If you are required to participate in MIPS in 2021 as an individual, CMS will automatically reweight all of your categories to 0% and you will receive a final score equal to the performance threshold (60 points in 2021) and will receive a neutral payment adjustment in 2023.[/mepr-show]

Question #4
What if I submit data to CMS on Quality Measures and Improvement Activities for the 2021 MIPS Performance Period; will I still qualify for the Automatic Extreme and Uncontrollable Circumstances Policy?

Answer #4[restrict paid=true]
No, you would not qualify for the Automatic Extreme and Uncontrollable Circumstances Policy. Per the CMS Fact Sheet, “Data submission by individual clinicians voids the 0% performance category
weight on a category-by-category basis.”[/mepr-show]

Question #5
I submit Quality Measures via Medicare Part B claims. Since I have been submitting the measures the entire year on the CMS-1500 claim form, will the MIPS Automatic Extreme and Uncontrollable Circumstances Policy still apply to me?

Answer #5

Question #6
What if my practice submits MIPS data as a group for the 2021 Performance Period?

Answer #6

Question #7
Where can I get additional information regarding the MIPS Automatic Extreme and Uncontrollable Circumstances Policy?

Answer #7

I hope you found this article to be informative. Thank you for being a Gold Member!

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