The American Medical Association (AMA) has petitioned the Centers for Medicare & Medicaid Services (CMS) not to inflict financial penalties on physicians due to any care quality issues that arose due to a shortage of IV fluids.
Citing ongoing challenges and administrative burdens, the physicians group is also asking the CMS to reopen an application window for quality reporting hardship exemptions, which closed at the end of the calendar year.
The IV shortage was fueled by September’s Hurricane Helene, which sidelined production at a major manufacturing plant for about a month and a half. Providers reported at the time that the interruption in supply was forcing procedure cancellations and other rationing strategies through the end of the year.
The challenges and mitigation effort could affect some physicians’ performance in the Merit-based Incentive Payment System (MIPS), the quality program that can impact their Medicare Part B reimbursements, according to a March 12 AMA letter to the CMS’ acting commissioner that was highlighted in a Friday release.
Specifically, AMA CEO and Executive Vice President James Madara, M.D., raised concerns that MIPS quality and cost measures during the 2024 performance year “may be impacted due to circumstances outside of their control. Physicians should not be forced to choose between preserving their performance in MIPS or appropriately rationing critical medical supplies during the current emergency situation.”
In light of the hardship, the AMA asked the CMS to promptly reopen applications for MIPS’ Extreme and Uncontrollable Circumstances (EUC) exemption—a request for reweighing of any or all performance categories due to circumstances outside of providers’ control.
The CMS had recently permitted physicians to make use of the exemption in light of the COVID-19 pandemic and in 2024 with the Change Healthcare cyberattack, with the application window for the latter closing Dec. 31.
The agency’s flexibility during those “catastrophic” events lightened private practice physicians’ regulatory burdens and helped maintain access to care, the AMA said. Those same goals should be considered for the IV fluid shortage and its contingency efforts—which the AMA noted are still in effect thanks in part to this winter’s “severe” levels of respiratory virus cases.
“Practices that would otherwise have been able to divert clinical or administrative staff time to apply for an EUC hardship exception or submit MIPS data are currently unable as they manage new and evolving processes to avoid patient delays by conserving limited IV fluid supplies, managing existing supplies and investigating alternative supply chains,” the AMA’s Madara wrote.
The AMA requested that applications for the exemption be opened quickly, as MIPS data submissions for the 2024 performance year are due by March 31.
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