CMS News Center

Application of QPP Hardship Exception During 2017 Transition Year Now Open 

The Quality Payment Program’s (QPP’s) hardship exception application for the 2017 transition year is now available on the QPP website. Clinicians and groups eligible for the Merit-Based Incentive Payment System (MIPS) 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; or
• lack of control over the availability of certified electronic health record (EHR) technology (CEHRT).

There are some MIPS-eligible clinicians considered “special status” who will be automatically reweighted (or, exempted in the case of MIPS-eligible clinicians participating in a MIPS Alternative Payment Model) and do not need to submit a QPP hardship exception application. (For more information on special statuses, see news brief below.) 

In addition to submitting an application via the QPP website (https://qpp.cms.gov), clinicians may also contact the QPP service center (QPP@cms.hhs.gov) and work with a representative to verbally submit an application.

The following is required to submit an application: taxpayer identification number (for group applications) or national provider identifier (for individual applications); contact information for the person working on behalf of the individual clinician or group, including first and last name, email address, and telephone number; and selection of hardship exception category and supplemental information.

Those applying for a hardship exception based on the “extreme and uncontrollable circumstance” category must select one of the following and provide a start date and end date of when the circumstance occurred:

• disaster (eg, a natural disaster in which the CEHRT was damaged or destroyed);
• practice or hospital closure;
• severe financial distress (bankruptcy or debt restructuring); or
• EHR certification/vendor issues (CEHRT issues).

Note that once an application is submitted, applicants will receive a confirmation email that the application is pending, approved, or dismissed. Applications will be processed on a rolling basis. For more information, call 866-288-8292 (TTY: 877-715-6222). For more information, visit the QPP website (https://qpp.cms.gov). 

CMS Offers Explanation of "Special Status" Calculation

The Centers for Medicare and Medicaid Services (CMS) has introduced new information that indicates whether clinicians have “special status” for the Quality Payment Program (QPP).

To determine if one’s participation should be considered as special status under the QPP, 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 QPP 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 areas, rural communities, those who are non-patient facing, and hospital-based facilities and small practices. For more information, visit the QPP website (https://qpp.cms.gov) or email QPP@cms.hhs.gov.