For the fourth performance year in a row, the Centers for Medicare and Medicaid Services (CMS) is making adjustments to the Merit-based Incentive Payment System (MIPS) program as a result of the COVID-19 public health emergency.
2021 Cost Performance Category Reweighted
For the 2021 performance year, CMS recently announced that they are reweighting the cost performance category from 20 percent to 0 percent. The 20 percent from the cost performance category weight will be redistributed to other performance categories.
According to CMS, this change affects providers who are reporting as a group, as the cost performance category had already been reweighted to 0% for all individual MIPS eligible clinicians under the automatic extreme and uncontrollable circumstances (EUC) policies.
“Our analysis of the underlying data for the 2021 performance period shows similar results at the group- and individual-level across measures,” CMS said. “As a result, we believe that reweighting shouldn’t depend on whether you choose to report as a group or individual.”
Providers who reported MIPS data for 2021 will receive the following category weighting, depending on how many performance categories were reported:
No provider action is needed since the cost performance category relies on administrative claims data.
If a MIPS eligible clinician is scored on one performance category weighted at 100 percent or if all performance categories are weighted at 0 percent for the 2021 performance year, they’ll receive a final score equal to the performance threshold and a neutral MIPS payment adjustment for the 2023 MIPS payment year.
2022 Exception Applications Now Open
CMS is now accepting 2022 MIPS Extreme and Uncontrollable Circumstances Exception and MIPS Promoting Interoperability Performance Category Hardship Exception Applications.
MIPS eligible clinicians, groups, and virtual groups can apply to have any or all MIPS performance categories reweighted if they’ve been affected by extreme and uncontrollable circumstances that have caused them to be unable to collect or submit information necessary for a MIPS performance category or that have impacted their performance on cost or other administrative claims measures.
Over the past three years, CMS has used the extreme and uncontrollable circumstances policy to provide relief to clinicians, groups, virtual groups, and APM Entities due to the COVID-19 public health emergency. For 2022, COVID-19 also will count as an extreme and uncontrollable circumstance for the purposes of this policy.
Learn more in the 2022 MIPS Extreme and Uncontrollable Circumstances Application Guide {AUTOMATIC DOWNLOAD}.
MIPS eligible clinicians, groups, and virtual groups who have decertified EHR technology, have insufficient Internet connectivity, face extreme and uncontrollable circumstances, or lack control over the availability of certified EHR technology (CEHRT) can apply for a MIPS Promoting Interoperability Performance Category Hardship Exception.
Some eligible clinicians or groups may qualify for automatic reweighting of the Promoting Interoperability performance category based on their clinician type or special status (see page 16 of the 2022 MIPS Promoting Interoperability User Guide for a list) and do not need to apply.
Learn more in the 2022 Promoting Interoperability Hardship Application Guide {AUTOMATIC DOWNLOAD}.
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