• MIPS 2019—Fundamentals: Quakes, Fires, and Other Disasters!

    This content was excerpted from EyeNet’s MIPS 2019; also see the Academy’s MIPS hub page


    You can apply for an “extreme and uncontrollable” reweighting. You can apply to have your performance categories reweighted if you have difficulty reporting one or more performance categories due to “extreme and uncontrollable circumstances.” CMS opened the application process in August. The application period will close on Dec. 31, 2019.

    During a widespread catastrophe, CMS may waive the application requirement for individuals. For example, if the Federal Emergency Management Agency declares a major disaster or public health emergency, CMS may decide to implement an automatic extreme and uncontrollable circumstances policy, which would mean that affected clinicians could have their performance categories reweighted without having to go through the application process. However, this automated reweighting would only be applied to individuals; if you are reporting as part of a group, your group would have to apply for the reweighting. (Note: In past years, CMS has not been able to publish a list of affected areas eligible for an automatic exemption before the end of the calendar year. If you are in a disaster zone, and your area haasn't yet been flagged as eligible for an automatic exemption, consider applying for an "extreme and uncontrollable circumstances" reweighting before you miss the Dec. 31 deadline.)

    What is considered extreme and uncontrollable? It must be a rare event that is entirely outside of the control of yourself and of the facility where you work. The circumstances must prevent you—either altogether or for an extended period of time—from collecting information that you need to submit for a performance category. 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 performance category.

    How performance categories are reweighted. If CMS approves your application to reweight one or more performance categories to zero, they would be reweighted as shown in Table 5: Reweighting the Performance Categories.

    Don't submit data to CMS on performance categories that are due for reweighting. CMS will not reweight a performance category if you reported data for that category after the triggering extreme and uncontrollable event.

    Table 5: Reweighting the Performance Categories

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

    • It approves your application for an exclusion due to extreme and uncontrollable circumstances (see above).
    • You apply, and are approved for a promoting interoperability hardship exclusions, or one of the automatic PI exceptions applies.
    • CMS determines that you don’t meet the case minimum for any of the cost measures.

    Reweighting Scenario

    Weighting in MIPS Final Score

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