Securing a MIPS Waiver for a Long-Time Client Amid Complex Circumstances

In 2024, one of our long-time clients, a physician working in a hospital setting, faced a challenging situation involving the Merit-based Incentive Payment System (MIPS). The doctor, like many hospitalists, was concerned about the time-consuming nature of MIPS reporting. With limited applicable measures and a heavy workload, he sought to avoid the process altogether by applying for a waiver under the Extreme and Uncontrollable Circumstances Application, citing the ongoing impact of COVID-19. 

Initial Attempt: Application Denied 

At the start of the year, the doctor submitted his waiver application, hoping for relief from the MIPS reporting requirements. However, the application was declined, which left him with no choice but to prepare for full MIPS reporting. The physician gathered the necessary documentation, despite his initial reluctance, and started working on meeting the reporting requirements. 

New Opportunity: Cybersecurity Waiver 

In the midst of this, Julie Abdyllatypova, WCH account representative, received crucial information that changed the course of the case. Due to a cyberattack, the MIPS waiver for Extreme and Uncontrollable Circumstances was now available for the physician. This presented an opportunity to resubmit the waiver under this new justification. 

The Challenge: Duplicate Application 

Julie promptly notified the doctor about this update and submitted the waiver application under the new criteria. However, to our surprise, the application was declined as a “duplicate.” This setback required immediate intervention. Julie took the initiative to reach out to Quality Payment Program (QPP) representatives on behalf of the doctor, only to learn that she couldn’t resolve the issue herself. The doctor had to personally communicate with QPP for this type of case. 

Persistence and Collaboration: Securing the Waiver 

Together, we prepared a detailed letter for the physician to submit directly. He spoke with the appropriate representatives, and after multiple communications, we finally received approval for the MIPS waiver due to the cybersecurity circumstances. 

The Takeaway: Client Success Through Continuous Support 

This case demonstrates our commitment to keeping clients informed about relevant updates and supporting them through every step of the process. Despite the initial denial, we continued to work diligently to find a solution, ensuring that our client received the outcome he needed. 

The lesson learned? Always stay in touch with your billing team and be proactive in addressing any changes or new opportunities in healthcare regulations.