Starting March 31, physicians will have a 15-day window to submit hardship exceptions related to last fall’s IV fluid shortages to address potential Merit-Based Incentive Payment System (MIPS) penalties.
The data submission period was similarly extended to April 14 for physicians unaffected by the shortages.
Following advocacy by the American Medical Association (AMA), the Centers for Medicare & Medicaid Services (CMS) announced that it will reopen applications for the MIPS Extreme and Uncontrollable Circumstances (EUC) hardship exception for performance year 2024, which impacts 2026 Medicare payment adjustments.
Physicians may submit EUC applications starting March 31 through April 14 at 7 pm CT. They can request reweighting of all four MIPS categories – quality, cost, promoting interoperability, and improvement activities – to avoid a MIPS penalty of up to 9% if they were affected by the shortage.
To apply for this specific hardship exception, physicians are directed to log into the QPP site and follow the instructions.
Texas Medical Association staff advises physicians applying for the hardship exception to document their IV fluid shortages and how those led to a hardship impacting MIPS performance, in preparation for any audits CMS might choose to conduct in the future.
“Note that CMS will not reweight any performance category for which the agency has received data,” AMA said in an email notification. “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, we recommend 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.”
As Texas Medicine Today reported in October, Texas physicians and hospitals were among those impacted by Hurricane Helene’s damage to Baxter International’s North Cove manufacturing site in Marion, N.C., supplying 60% of IV solutions in North America.
In a March 12 letter to CMS asking for the EUC hardship exception, AMA likened the IV fluid shortage to the COVID-19 pandemic and the February 2024 Change Healthcare cyberattack, terming them “two catastrophic situations that jeopardized the livelihood of private physician practices and access to care for older Americans and Americans with disabilities.”
AMA called for CMS to exercise the same flexibility to “reduce the regulatory burden of MIPS data submission” and “to hold [physicians] harmless from MIPS financial penalties” that might have resulted from the shortage.
Phil West
Associate Editor
(512) 370-1394
phil.west[at]texmed[dot]org
Phil West is a writer and editor whose publications include the Los Angeles Times, Seattle Times, Austin American-Statesman, and San Antonio Express-News. He earned a BA in journalism from the University of Washington and an MFA from the University of Texas at Austin’s James A. Michener Center for Writers. He lives in Austin with his wife, children, and a trio of free-spirited dogs.