Advocacy Update

April 4, 2025: Advocacy Update spotlight on more flexibility to avoid MIPS penalties

| 3 Min Read
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  1. AMA advocacy results in more flexibility for physicians to avoid MIPS penalties
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AMA advocacy results in more flexibility for physicians to avoid MIPS penalties

AMA advocacy results in more flexibility for physicians to avoid MIPS penalties

In response to AMA advocacy (PDF) urging the Centers for Medicare & Medicaid Services (CMS) to hold physicians harmless from Merit-based Incentive Payment System (MIPS) penalties as a result of the nationwide IV fluid shortage and to reopen the MIPS Extreme and Uncontrollable Circumstances (EUC) hardship exception, the agency announced that it will accept new applications to avoid a MIPS penalty. 

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The AMA greatly appreciates CMS for recognizing that physicians and their patients continue to face hardships due to the nationwide shortage of IV fluids exacerbated by Hurricane Helene in September 2024 and a severe winter respiratory season leading to lower supply and increased demand for these drug products.  

Physicians will be able to submit an EUC hardship exception application between March 31, 2025, and April 14, 2025, to avoid a MIPS penalty of up to -9% if they were affected by the shortage. This hardship exception will apply to the 2024 performance period, which will adjust Medicare payments in 2026. To avoid a MIPS penalty, physicians who were affected by the IV fluid shortage should submit an EUC application requesting reweighting of all four MIPS categories—quality, cost, promoting interoperability, and improvement activities. Note that CMS will not reweight any performance category for which the agency has received data. However, if three performance categories are reweighted to 0% and only one performance category can be scored, then the physician or group will earn a final score equal to the performance threshold and avoid a MIPS penalty. Additionally, because the MIPS cost performance category relies entirely on claims-based measures that do not require submission from physicians or groups, the AMA recommends requesting reweighting of this category if a physician or group needed to conserve IV fluids, use alternatives, restrict access to elective surgery or take any other measures due to the nationwide IV fluid shortage. More information is available in the CMS 2024 MIPS EUC Exception Application User Guide (PDF). In addition, CMS is extending the MIPS data submission window for the 2024 performance period for two weeks from March 31, 2025, until April 14, 2025, at 8:00 p.m. Eastern time. 

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Table of Contents

  1. AMA advocacy results in more flexibility for physicians to avoid MIPS penalties
  2. More articles in this issue

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