• MIPS 2018 – Nuts and Bolts: Quakes, Fires, and Other Disasters!

    Written By: Rebecca Hancock, Flora Lum, MD, Chris McDonagh, Cherie McNett, Jessica Peterson, MD, MPH, and Sue Vicchrilli, COT, OCS

    This content was excerpted from EyeNet’s MIPS 2018; also see the Academy’s MIPS hub page


    If you have difficulty reporting one or more performance categories due to the impact of “extreme and uncontrollable circumstances” – for example, a fire destroyed your EHR system – you can apply to have your performance categories reweighted. You would need to submit your application no later than Dec. 31, 2018.

    What is considered extreme and uncontrollable? It must be a rare event that is entirely outside of the control of the physician and of the facility where he or she works. For example, a fire that destroys the only facility where a clinician works could be considered extreme and uncontrollable, but the inability to renew a lease for that facility wouldn’t. CMS will take into account the type of event, date of event, length of time over which the event took place, and other pertinent details that might impact your ability to report each individual performance category.

    How performance categories are reweighted. If CMS approves your application to reweight one or two performance categories to a zero weighting, the other categories would be reweighted as shown in Table 3 (below). However, if CMS only scores you on one performance category, CMS would assign you a MIPS final score of 15 points, which is the 2018 performance threshold, which would be enough to avoid a payment penalty.

    Table 3: Reweighting the Performance Categories

    CMS can reweight the way performance categories contribute to your MIPS final score as shown below. It would do this in the following situations:

    Reweighting Scenario

    Maximum Point Contribution to Final Score (0-100 Points)

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    Previous: Nuts and Bolts: Small or Large Practice?

    Next: Nuts and Bolts: Use the IRIS Registry for MIPS Reporting.

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