CMS Aligns Extreme and Uncontrollable Circumstances Policies with Medicare Shared Savings Program
2017 was a rough year. Hurricanes Harvey, Irma, and Maria battered parts of Florida and devastated Puerto Rico. Wildfires destroyed hundreds of thousands of acres in Northern California. And the Centers for Medicare & Medicaid Services (CMS) implemented a new payment system tied to improved health outcomes and reduced spending — two things that are impossible to control in the midst of extreme and uncontrollable circumstances.
On Dec. 21, 2017, CMS made it official: Medicare would align its automatic Extreme and Uncontrollable Circumstances Policies for Performance Year 2017, recently finalized for the Quality Payment Program, with Medicare Shared Savings Program accountable care organizations (ACOs).
CMS states in an interim final rule with comment period, scheduled for the Dec. 26, 2017, Federal Register, “We believe it is also appropriate to establish automatic extreme and uncontrollable circumstances policies under the Shared Savings Program for performance year 2017 due to the urgency of providing relief to Shared Savings Program ACOs impacted by Hurricanes Harvey, Irma, and Maria, and the California wildfires, because their quality scores could be adversely affected by these disasters and some ACOs could be at risk for additional shared losses due to the costs associated with these extreme and uncontrollable events.”
The Shared Savings Program extreme and uncontrollable circumstances policies will apply when CMS determines that an event qualifies as an automatic triggering event under the Quality Payment Program.
CMS amends in the interim final rule 42 CFR part 425 to allow the retroactive application of this policy in 2017. This policy will remain in place and applied as warranted in the even of future extreme and uncontrollable circumstances.
Please see the interim final rule with comment period for complete details.
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