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- CMS to Again Offer COVID Exemptions from -9% MIPS Penalty; Physicians Must Apply
Physicians may again apply this spring for a COVID hardship exemption and receive relief from future Medicare payment penalties, the Centers for Medicare & Medicaid Services (CMS) announced. The continuation of the exemption from penalties under Medicare’s Merit-based Incentive Payment System (MIPS) was in response to advocacy from the American Medical Association (AMA), the CAP, and the rest of organized medicine concerning the ongoing impacts of the COVID-19 public health emergency. The CAP has consistently advocated for relief from Medicare payment penalties to pathologists throughout the pandemic.
The CMS said it would allow physicians and group practices to apply for a MIPS Extreme and Uncontrollable Circumstances hardship exception to avoid up to a -9% MIPS penalty in 2025 based on 2023 performance. The exception will not be automatic, and interested physicians and groups must actively request reweighting of one or more MIPS performance categories due to the public health emergency. If accepted by CMS, practices’ hardship exemption would apply to 2023 reporting, and 2025 payment adjustments. The CMS expects to release the hardship exception application this spring.
Pathologists who believe they will qualify for an exemption should apply early. Exemptions are not automatic and if the CMS declines to approve an exemption, a pathologist can make other plans to stop the -9% penalty in 2025.