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Centers for Medicare & Medicaid Services Quality Payment Program
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Merit-based Incentive Payment System (MIPS) Automatic Extreme and Uncontrollable Circumstances (EUC) Policy Applied to MIPS Eligible Clinicians Following Hurricanes Helene and Francine

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The U.S. Department of Health and Human Services (HHS) Secretary Becerra recently released a letter to healthcare leaders and stakeholders on the impacts of Hurricane Helene, which can be found on the HHS website [ https://www.hhs.gov/about/news/2024/10/09/letter-health-care-leaders-stakeholders-impacts-hurricane-helene-secretary-becerra.html ]. 

In response to Hurricanes Helene and Francine, the Centers for Medicare & Medicaid Services (CMS) has determined that the MIPS automatic EUC policy will apply to MIPS eligible clinicians in the following designated affected counties of Florida, Georgia, North Carolina, South Carolina, Tennessee, and Louisiana: 


* HHS Public Health Emergency (PHE) declaration 
* Hurricane Helene: Florida [ https://aspr.hhs.gov/legal/PHE/Pages/Fl-Hurricane-Helene-Sept2024.aspx ], Georgia [ https://aspr.hhs.gov/legal/PHE/Pages/GA-Hurricane-Helene-Sept2024.aspx ], North Carolina [ https://aspr.hhs.gov/legal/PHE/Pages/NC-Hurricane-Helene-Sept2024-aspx.aspx ], South Carolina [ https://aspr.hhs.gov/legal/PHE/Pages/SC-TN-Hurricane-Helene-Sept2024.aspx ], and Tennessee [ https://aspr.hhs.gov/legal/PHE/Pages/SC-TN-Hurricane-Helene-Sept2024.aspx ]
* Hurricane Francine: Louisiana [ https://aspr.hhs.gov/legal/PHE/Pages/LA-Hurricane-Francine.aspx ] 


* Federal Emergency Management Agency (FEMA) disaster declaration  
* Hurricane Helene: DR-4828-FL [ https://www.fema.gov/disaster/4828 ], DR-4830-GA [ https://www.fema.gov/disaster/4830 ], DR-4827-NC [ https://www.fema.gov/disaster/4827 ], DR-4829-SC [ https://www.fema.gov/disaster/4829 ], and DR-4832-TN [ https://www.fema.gov/disaster/4832 ]
* Hurricane Francine: FEMA-4817-DR [ https://www.fema.gov/disaster/4817/designated-areas ] 

MIPS eligible clinicians in these areas will be automatically identified and have all 4 performance categories reweighted to 0% during the data submission period for the 2024 performance period (January 2 to March 31, 2025). This will result in a score equal to the performance threshold, and they'll receive a neutral payment adjustment for the 2026 MIPS payment year. 

However, if MIPS eligible clinicians in these areas submit data on 2 or more performance categories, they’ll be scored on those performance categories and receive a 2026 MIPS payment adjustment based on their 2024 MIPS final score. 

*NOTE:* The MIPS automatic EUC policy doesn’t apply to MIPS eligible clinicians participating in MIPS as a group, subgroup, virtual group, or Alternative Payment Model (APM) Entity. However, groups, virtual groups, and APM Entities can request reweighting through the EUC Exception application. Subgroups will inherit any reweighting approved for their affiliated group; they can’t request reweighting independent of their affiliated group’s status. 

*For More Information * 

Please reference the MIPS EUC Exception section on the Quality Payment Program Exception Applications webpage [ https://links-2.govdelivery.com/CL0/https:%2F%2Fqpp.cms.gov%2Fmips%2Fexception-applications%3Fpy=2024/1/0101019171b6e442-417efa3f-5690-47cb-b56f-dedf2bb090e8-000000/ngAn-AINZezt-xJ4oMJLgcnPbgFWPVn2SD1JbHLgQ4E=367 ]. 

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


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