CMS Updates 2019 Extreme and Uncontrollable Circumstances Policy for Some MIPS Clinicians

September 24, 2019

The Centers for Medicare & Medicaid Services (CMS) has determined that the automatic extreme and uncontrollable circumstance policy will apply to Merit-Based Incentive Payment System (MIPS) eligible clinicians in FEMA-identified Louisiana parishes affected by Hurricane Dorian.

The data submission period for the MIPS 2019 performance year of is January 2, 2020 to March 31, 2020. MIPS eligible clinicians in affected areas will be automatically identified and receive a neutral payment adjustment for the 2021 MIPS payment year. However, if automatically identified MIPS eligible clinicians choose to submit data to MIPS (Quality, Improvement Activities, and/or Promoting Interoperability), either as an individual or a group, they will be scored just like other MIPS eligible clinicians and their 2021 payment adjustment will be based on their 2019 MIPS final score.

The automatic extreme and uncontrollable circumstance policy will not apply to MIPS eligible clinicians in MIPS Alternative Payment Models (MIPS APMs) in 2019.

For more information:

Please reference the Extreme and Uncontrollable Circumstances Overview section on the MIPS > About Exception Applications page.

You can also contact the Quality Payment Program Service Center at (866) 288-8292/TTY (877) 715-6222, Monday through Friday, 8:00 a.m. ‒ 8:00 p.m. Eastern Time or by email at


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