TMA Wins MIPS Exemption for Many Harvey-Affected Practices

Many physicians whose practices are located in areas affected by Hurricane Harvey will not be required to participate in the 2017 Merit-Based Incentive Payment System (MIPS) and will not face a 4-percent Medicare payment penalty in 2019, officials announced in December.

TMA pushed for the exemption after Harvey came ashore, causing widespread flooding that damaged thousands of homes, hospitals and practices.

“We believe the hardship due to the extreme and uncontrollable circumstances from this natural disaster will prevent many of our physician members from spending the time necessary to learn about program requirements,” TMA wrote in a September letter to David D. Teuscher, MD, the director of the U.S. Department of Health and Human Services (HHS) region that includes Texas. “Many physicians will be challenged and no longer in a position to submit data successfully on quality measures and activities in 2017.”

The exemption applies only to MIPS-eligible physicians who practice in affected areas designated by the Federal Emergency Management Agency and are outlined in the 2018 QPP Final Rule:

Aransas, Austin, Bastrop, Bee, Bexar, Brazoria, Burleson, Caldwell, Calhoun, Chambers, Colorado, Comal, Dallas, Dewitt, Fayette, Fort Bend, Galveston, Goliad, Gonzales, Grimes, Guadalupe, Hardin, Harris, Jackson, Jasper, Jefferson, Jim Wells, Karnes, Kleberg, Lavaca, Lee, Liberty, Madison, Matagorda, Milam, Montgomery, Newton, Nueces, Orange, Polk, Refugio, Sabine, San Augustine, San Jacinto, San Patricio, Tarrant, Travis, Tyler, Victoria, Walker, Waller, Washington, and Wharton counties.

The rule does not specify that practices had to have been physically damaged by Harvey to be exempt, only located in an affected area.

The exemption does not apply to clinicians who are participating in an Alternative Payment Model (APM), the other Medicare Quality Payment Program (QPP) pathway that was implemented last year under the Medicare Access and CHIP Reauthorization Act (MACRA).

The Centers for Medicare & Medicaid Services (CMS) will identify exempt physicians based on the practice location address listed in the Provider Enrollment, Chain and Ownership System (PECOS) and automatically adjust their 2019 MIPS payment to neutral, meaning no bonus payment or penalty. Exempt physicians who choose to submit data for any of the 2017 MIPS performance categories will be scored based on the data they submitted, officials said.

More information can be found on the CMS Fact Sheet. For questions, contact the CMS QPP Service Center at (866) 288-8292 or by email at QPP[at]cms[dot]hhs[dot]gov. As always, visit the TMA MACRA Resource Center for the latest information. 

Action, Dec. 15, 2017

Last Updated On

February 20, 2018