The Centers for Medicare & Medicaid Services (CMS) is now accepting applications from individual physicians and medical groups that believe they are due hardship exceptions from the Quality Payment Program for the 2017 transition year.
As a reminder, physicians and groups eligible for the Merit-based Incentive Payment System (MIPS) under QPP must submit data in the advancing care information performance category with Certified Electronic Health Record Technology (CEHRT). The advancing care information category makes up 25 percent of the participant’s final score under MIPS. The program allows participants to have this performance category zeroed out and the 25 percent reallocated to the participant’s quality performance category if they qualify for a hardship exception.
The physician or group seeking the hardship exception must submit an application through the QPP website for one of three reasons:
Besides submitting an application online, physicians can also contact the QPP Service Center at 1-866-288-8292 (TTY: 1-877-715-6222) and verbally submit an application.
To submit an application, you will need:
If you are applying for a hardship exception based on extreme and uncontrollable circumstances, there are four types allowed:
Applicants must select which type they are claiming and provide a start and end date for when the circumstance occurred.
After you submit an application, CMS will send a confirmation email that your application was submitted and is either pending, approved, or dismissed. CMS will process applications on a rolling basis.
Certain physicians are considered “special status” by CMS and automatically receive a QPP exception without having to submit an application. To determine if a physician has ‘special status” under QPP, CMS analyzes Medicare Part B claims data and calculates whether certain circumstances of the practice will affect the number of total measures, activities, or entire categories that the practice must report. These circumstances apply to:
For more information, you can contact the QPP Service Center at 1-866-288-8292 (TTY: 1-877-715-6222) or by email at QPP@cms.hhs.gov. You can also visit the QPP website.
– Kent Moore, Senior Strategist for Physician Payment for the American Academy of Family Physicians
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