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  4. Relentless CAP Advocacy Wins MIPS Relief for Pathologists; No Medicare MIPS Penalties During Pandemic

Relentless CAP Advocacy Wins MIPS Relief for Pathologists; No Medicare MIPS Penalties During Pandemic

The Centers for Medicare & Medicaid Services (CMS) will not enforce reporting penalties for 2020 reporting due to the COVID-19 public health emergency. The CMS will apply the Extreme and Uncontrollable Circumstances Hardship Exception policy to all MIPS eligible clinicians who do not submit any MIPS data for the 2020 performance period and avoid a 2022 payment penalty. This will include physicians, including pathologists, who will be held harmless from up to 9% Merit-based Incentive Payment Program (MIPS) penalties. The CAP has advocated to reduce reporting burdens for pathologists and asked for relief from MIPS penalties.

To qualify for the Extreme and Uncontrollable Circumstances Hardship Exception policy, the CMS reopened the MIPS Extreme and Uncontrollable Circumstances (EUC) hardship application for group practices, virtual groups, and alternative payment model entities who missed the previous 2020 deadline. The reopened application deadline is March 31. Note, groups and eligible clinicians who submit data in at least two MIPS categories will override the hardship exception and be eligible to earn a bonus from the exceptional performance bonus pool or potentially be subject to a penalty.

For individual physicians and physician groups who have not submitted MIPS data, the CMS advises not to take any additional action to qualify for the automatic EUC policy. You will be automatically identified and will receive a neutral payment adjustment for the 2022 MIPS payment year unless 1) you submit data as an individual in 2 or more performance categories or 2) your practice reports as a group by submitting data for one or more performance category.

If you have questions about this process or other aspects of the MIPS program, email the CAP’s experts at mips@cap.org.