Quality Payment Program Hardship Exception Application for 2017 Now Open

Clinicians Can Now Submit Quality Payment Program Hardship Exception Applications

The Quality Payment Program Hardship Exception Application for the 2017 transition year is now available on the Quality Payment Program website.

MIPS eligible clinicians and groups may qualify for a reweighting of their Advancing Care Information performance category score to 0% of the final score, and can submit a hardship exception application, for one of the following specified reasons:

• Insufficient internet connectivity
• Extreme and uncontrollable circumstances
• Lack of control over the availability of Certified EHR Technology (CEHRT)

There are some MIPS eligible clinicians who are considered Special Status, who will be automatically reweighted (or, exempted in the case of MIPS eligible clinicians participating in a MIPS APM) and do not need to submit a Quality Payment Program Hardship Exception Application.

About the Hardship Exception Application Process

In addition to submitting an application via the Quality Payment Program website, clinicians may also contact the Quality Payment Program Service Center and work with a representative to verbally submit an application.

To submit an application, you’ll need:

• Your Taxpayer Identification Number (TIN) for group applications or National Provider Identifier (NPI) for individual applications;
• Contact information for the person working on behalf of the individual clinician or group, including first and last name, e-mail address, and telephone number; and
• Selection of hardship exception category (listed above) and supplemental information.

If you’re applying for a hardship exception based on the Extreme and Uncontrollable Circumstance category, you must select one of the following and provide a start and end date of when the circumstance occurred:

• Disaster (e.g., a natural disaster in which the CEHRT was damaged or destroyed)
• Practice or hospital closure
• Severe financial distress (bankruptcy or debt restructuring)
• EHR certification/vendor issues (CEHRT issues)

Please note: Once an application is submitted, you will receive a confirmation email that your application was submitted and is pending, approved, or dismissed. Applications will be processed on a rolling basis.

Explanation of Special Status Calculation

The Centers for Medicare and Medicaid Services (CMS) has introduced new information on the Quality Payment Program website that indicates whether clinicians have “special status” and can therefore be considered exempt from the Quality Payment Program.

To determine if a clinicians’ participation should be considered as special status under the Quality Payment Program, CMS retrieves and analyzes Medicare Part B claims data. A series of calculations are run to indicate a circumstance of the clinician’s practice for which special rules under the Quality Payment Program will affect the number of total measures, activities or entire categories that an individual clinician or group must report. These circumstances are applicable for clinicians in: Health Professional Shortage Area (HPSA), Rural, Non-patient facing, Hospital Based, and Small Practices.

For more information, please visit the Quality Payment Program website.