In response to advocacy from the American Medical Association and organized medicine about the ongoing impacts of the COVID-19 public health emergency (PHE), the Centers for Medicare & Medicaid Services (CMS) will continue to allow physicians and group practices to apply for a MIPS Extreme and Uncontrollable Circumstances hardship exception to avoid up to a -9% MIPS penalty in 2025 based on 2023 performance.
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. CMS expects to release the hardship exception application in spring 2023.
Terri Otten of the AMA says “This is a big relief for physicians and their patients because CMS estimated in the 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. We encourage you to spread the word to your members about this critical reprieve from up to a -9% penalty due to the COVID-19 PHE.”