In AAFP Win, CMS Reverses Course on MIPS Policy

The move — which reflects AAFP advocacy — updates EUC policy included in the agency’s 2022 Medicare physician fee schedule final rule; the rule, issued Nov. 2, noted that clinicians would have to apply for the EUC exception.

The Academy had called on CMS to take this step in its detailed response to the MPFS proposed rule. “It is vital that family medicine and other physician practices focus on providing patient care during this time and not be required to comply with a burdensome MIPS reporting process,” the AAFP wrote.

In its announcement, CMS said the update was meant to “provide relief where possible to clinicians responding to the 2019 Coronavirus (COVID-19) public health emergency.” The automatic EUC exception will be applied only for the 2021 performance year and only to MIPS-eligible clinicians who can participate as individuals. The exception will not be automatically applied to groups, virtual groups or alternative payment model entities, CMS said; those participants may instead apply for performance category reweighting on the Quality Payment Program website by Dec. 31.

In a Nov. 10 FPM Getting Paid blog post on the announcement, the Academy explained to members that

• no action would be required of eligible clinicians; and
• CMS would automatically identify them and reweight all four MIPS performance categories to 0%, meaning that
• eligible clinicians will receive a neutral payment adjustment for the 2023 MIPS payment year unless they submit data for two or more categories or have a higher final score from group or APM entity participation.

The post offered additional guidance for MIPS group participants not automatically eligible for the exception.

CMS also has reopened the EUC application for the 2020 performance year. Eligible clinicians, groups and APM entities can apply by submitting a targeted-review form until Nov. 29.