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CMS is Accepting PY 2023 MIPS EUC Reweighting Requests for Change Healthcare Cyberattack

Centers for Medicare & Medicaid Services Quality Payment Program
PY 2023 Change Healthcare Cyberattack Reweighting Requests Will Be Accepted Through 10/11/2024

We recognize that some clinicians and groups affected by the Change Healthcare cyberattack may not have been able to submit a Merit-based Incentive Payment System (MIPS) Extreme and Uncontrollable Circumstances (EUC) Exception Application for performance year (PY) 2023 before the April 15, 2024 deadline. As a result, we’re allowing clinicians, groups, subgroups, virtual groups, and Alternative Payment Model (APM) Entities to submit a request for reweighting of one or more MIPS performance categories under our EUC exception policies at 42 CFR 414.1380(c)(2) [ https://www.ecfr.gov/current/title-42/part-414/subpart-O#p-414.1380(c)(2) ] and 42 CFR 414.1317(b)(4) [ https://www.ecfr.gov/current/title-42/part-414/subpart-O#p-414.1317(b)(4) ] solely on the basis of the Change Healthcare cyberattack, for PY 2023 *now through October 11, 2024, at 8 p.m. ET*.

Any clinician, group, subgroup, virtual group, or APM Entity that wasn’t able to submit their MIPS data *solely* because of the Change Healthcare cyberattack can request reweighting.

*IMPORTANT: Because CMS is reopening the window for requesting reweighting of one or more MIPS performance categories for PY 2023 in response to the Change Healthcare cyberattack, CMS will only approve applications citing this cyberattack as the basis for requesting reweighting under the MIPS EUC Exception policies. **Any applications submitted for reasons outside of the Change Healthcare cyberattack will be denied. *


* How Can I Request PY 2023 Performance Category Reweighting? [ #link_2 ]
* What if We Already Submitted Data? [ #link_3 ]

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How Can I Request PY 2023 Performance Category Reweighting?

Due to technical limitations, we’re unable to reopen the PY 2023 MIPS EUC Exception Application form in our system, while the PY 2024 MIPS EUC Exception Application is open. Because of these technical limitations, we’re allowing PY 2023 reweighting requests under our EUC Exception policies to be submitted *through the MIPS Targeted Review* *form* until October 11, 2024, at 8 p.m. ET. You can access this form by signing in to qpp.cms.gov [ https://lnks.gd/l/eyJhbGciOiJIUzI1NiJ9.eyJidWxsZXRpbl9saW5rX2lkIjoxMDQsInVyaSI6ImJwMjpjbGljayIsImJ1bGxldGluX2lkIjoiMjAyMTA5MjcuNDY1NDM0OTEiLCJ1cmwiOiJodHRwczovL3FwcC5jbXMuZ292LyJ9.1Aox6ke9vbZ1PRmxrEhtWtVEp5WNjUT-y_Fy6GF97c4/s/755753191/br/112981555624-l ]_._

The MIPS EUC Exception Application form currently accessible when you sign in to qpp.cms.gov [ https://lnks.gd/l/eyJhbGciOiJIUzI1NiJ9.eyJidWxsZXRpbl9saW5rX2lkIjoxMDUsInVyaSI6ImJwMjpjbGljayIsImJ1bGxldGluX2lkIjoiMjAyMTA5MjcuNDY1NDM0OTEiLCJ1cmwiOiJodHRwczovL3FwcC5jbXMuZ292LyJ9.Emta8DdRtlX5viaC-NC5mHj6PCSIseMYjbzrCGefw40/s/755753191/br/112981555624-l ] is for PY 2024 applications only.* Don’t use the Exception Application form to request reweighting for PY 2023.*

Please review 2023 MIPS EUC Reweighting Requests Guide (PDF, 642 KB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3023/PY2023%20MIPS%20EUC%20Reweighting%20Requests%20for%20Change%20Healthcare%20Cyberattack_Extension%20Guide.pdf ] for step-by-step instructions with screenshots.

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What If We Already Submitted Data?

In accordance with our MIPS reweighting policies for individual clinicians, groups, subgroups, and virtual groups, we won’t reweight any performance category for which we’ve received data. If we received data for a MIPS performance category, we’ll calculate a score for that performance category. (Refer to 42 CFR 414.1380(c)(2) [ https://www.ecfr.gov/current/title-42/part-414/subpart-O#p-414.1380(c)(2) ])

If a MIPS eligible clinician is scored on 2 or more performance categories, we will calculate a MIPS final score in accordance with our weighting policies. If a MIPS eligible clinician is scored on fewer than 2 performance categories, then they will receive a final score equal to the performance threshold.

In accordance with our EUC policies for APM Entities, data submission for an APM Entity won’t override performance category reweighting for all four MIPS performance categories. (Refer to 42 CFR 414.1317(b)(4) [ https://www.ecfr.gov/current/title-42/part-414/subpart-O#p-414.1317(b)(4) ]) If we receive an EUC Exception application for an APM Entity for PY 2023 and we reweight all four MIPS performance categories, the MIPS eligible clinicians in the APM Entity will receive a 2023 MIPS final score equal to the performance threshold and a neutral MIPS payment adjustment in the 2025 MIPS payment year.

QPP Footer 2023 [ https://qpp.cms.gov/resources/help-and-support ]


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