The Automatic Extreme and Uncontrollable Circumstances policy applies to Merit-based Incentive Payment System (MIPS)-eligible clinicians who are located in a Centers for Medicare & Medicaid Services (CMS)-designated region that has been affected by an extreme and uncontrollable event (such as a Federal Emergency Management Agency (FEMA)-designated major disaster) during the 2020 MIPS performance period. For those clinicians, CMS aims to reduce their reporting burden by not requiring them to submit an application to reweight the performance categories under MIPS.

CMS will communicate information about events that trigger the Automatic Extreme and Uncontrollable Circumstances policy through the Quality Payment Program (QPP) listserv updates. In addition, CMS will update this fact sheet to identify any new events or changes to previously identified events.

Affected counties for the California Wildfires:

Additionally, once CMS identifies new events, you can find information about designated disaster areas on the FEMA-designated disaster areas page. Clinicians should monitor these pages for updates on designated disaster areas.

Qualifying Alternative Payment Model (APM) Participant (QP) thresholds are increasing beginning on January 1, 2021. If you were a QP for the 2020 performance year, you may not necessarily receive QP status for the 2021 performance year. Depending on your status in 2021, you may be required to participate in the MIPS even if you have not in previous years.

As a reminder, if you qualify as a QP, you may be eligible for the 5% APM incentive payment and be exempt from participating in MIPS.

CMS has posted a 2021 QP Quick Start Guide and 2021 MIPS Eligibility Decision Tree to provide more information on QP status and to help clinicians understand if they will need to participate in the MIPS.

CMS released a blog post and infographic to share preliminary participation data for the QPP in 2019.

The 2018 QPP Experience Report Public Use File (PUF) is now available. This file will allow you to drill down into the details behind the data presented in the previously released 2018 QPP Experience Report. As a reminder, the QPP Experience Report includes data regarding participation and performance in the MIPS and APMs tracks of the QPP during the 2018 performance year. It covers eligibility and participation, reporting options, performance categories, and final score and payment adjustments.

Please note: Since the PUF provides data at the TIN/NPI level, CMS has suppressed information on TIN/NPIs with fewer than 11 beneficiaries in 2018 per CMS rules. For that reason, the numbers in the PUF will not match those in the QPP Experience Report.

Implications of the Year 5 Final Rule for Solo and Small Group Practices  

Tuesday, December 8 at 3:30 p.m. ET

Thursday, December 10 at 11:00 a.m. ET

To prepare for the 2020–2021 performance year of the MIPS, CMS has posted new resources to the QPP Resource Library.

QPP Resources:

CMS COVID-19 Stakeholder Calls 

CMS has been hosting regular calls with a variety of clinicians, hospitals, other facilities, and states in an effort to keep stakeholders updated on their COVID-19 efforts. CMS understands that not everyone is available to attend the calls live, and is sharing access to recordings along with transcripts. CMS will continue to host calls and share information through their list serves and media.

CMS COVID-19 Office Hour Calls (twice a month on Tuesdays at 5–6 p.m. ET)

To keep up with the important work of the White House Coronavirus Task Force in response to COVID-19, visit https:/www.coronavirus.gov. For a complete and updated list of CMS actions, and other information specific to CMS, please visit the Current Emergencies Website.

CDC = Centers for Disease Control and Prevention

Each year, Health Services Advisory Group (HSAG) checks in with every eligible clinician and practice to ensure your plans for MIPS reporting are on track. You may receive phone calls, emails, and or fax communication from HSAG throughout the year. HSAG's goal is to ensure you are prepared to submit your best MIPS score. The team of QPP subject matter experts are excited to connect with you and learn more about your MIPS reporting plans this year. If your practice knows your MIPS reporting plans for 2020 now, click here to let HSAG know. By submitting your MIPS participation plans online, HSAG will not reach out via phone, and you can contact HSAG when you need to!

Bring your perspectives, best practices, and valuable lessons learned during your journey. By sharing your experience, you may assist another practice facing challenges with the QPP and/or MIPS reporting. Your practice may also be selected and featured in HSAG’s QPP Quest Digest and other educational platforms. Let HSAG know your interest by clicking the “Share your QPP Experience” icon and complete the online form. In the Comment box, add “Share your QPP Experience."

Below are a few Quality Measures that focus on December’s National Health Observances. Use the MIPS Explore Measures and Activities Tool to identify other applicable measures for your patient population.

New CMS Listserv for Rural Populations

CMS’s goal is to develop programs and policies that ensure rural Americans have access to high quality care, support rural providers and not disadvantage them, address the unique economics of providing health care in rural America, and reduce unnecessary burdens in a stretched system to advance our commitment to improving health outcomes for Americans living in rural areas. CMS has a new rural healthcare listserv dedicated to sharing information about programs, policies and resources to help ensure rural populations have access to quality healthcare.

To subscribe to the new topic, click here and enter your email! Look for Outreach and Education, and then Rural Health. In order to find more information on rural health activities at CMS, please visit go.cms.gov/ruralhealth or contact RuralHealth@cms.hhs.gov.

Invite your practice staff, practices you refer patients to, and other colleagues to subscribe to HSAG’s QPP Quest Digest! Stay informed of all monthly QPP updates, deadlines, no-cost webinars and best practices by subscribing here.

Don't forget to sign up on the CMS.gov QPP website. Once you've accessed the QPP page, scroll to [Subscribe to Updates] at the bottom of the page and insert your email address before clicking [Subscribe]. The QPP listserv is a valuable resource to stay informed of webinars and important QPP deadlines.