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

November 29, 2021
 / 
Rick Gawenda
 / 

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

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

Answer #2

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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

The content here is for members only log in here or sign up.

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

Answer #6

The content here is for members only log in here or sign up.

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

Answer #7

The content here is for members only log in here or sign up.

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

All material posted on our website is intellectual property of Gawenda Seminars & Consulting, Inc. and can’t be used, reproduced, or posted as your own material without prior written approval of Gawenda Seminars & Consulting, Inc.


All material posted on our website is the intellectual property of Gawenda Seminars & Consulting, Inc. and can’t be used, reproduced, or posted as your own material without the prior written approval of Gawenda Seminars & Consulting, Inc.

This article is not intended to and does not serve as legal advice or as consultative services, but is for general information purposes only.

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