Crosswalk - Hardship Exception Application Form

Appendix K2 2020 Hardship Exception Application Form Crosswalk.pdf

Quality Payment Program/Merit-Based Incentive Payment System (MIPS) (CMS-10621)

Crosswalk - Hardship Exception Application Form

OMB: 0938-1314

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2020 Promoting Interoperablity Hardship Exceptions Application Crosswalk
Burden Impact: The changes to this application do not reflect proposals in the CY2021
Physician Fee Schedule (PFS) Proposed Rule for the Quality Payment Program. There are no
impacts to burden as a result of these changes.

Change # 1: Exceptions Application Access
Summary of Change: Authenticated Experience- Still accessed through the QPP Website – the
end user will now sign into access and submit Exceptions Applications.
Reason for Change: An Authenticated Login ensures the submitter has the proper credentials
to submit the application on behalf of the Clinician(s) or Group and provides an efficient way for
to track and document submitted applications including: Status changes – Pending Review,
Approved, Denied, Withdrawn or Information Requests.
Corresponding Figures:
PY2019 Application: 1
PY2020 Application: 1 & 2
*****
Change # 2: Application Selection
Summary of Change: Exception application selection has been condensed into one area that
allows the end user to select either the Promoting Interoperability (PI) Hardship or the Extreme
and Uncontrollable Circumstances (EUC) Exceptions Application from the same screen
depending on their circumstances.
Reason for Change: Reduces the number of places that the end user must go to submit their
request.
Corresponding Figures:
PY2019 Application: N/A
PY2020 Application: 3
*****
Change # 3: Application Filing Level (Individual, Group or Virtual Group
Summary of Change: The addition of radio buttons clearly shows the level under which an
application can be submitted. Based on the selection the application additional prompts have
been added to request the NPI,TIN, or VG ID, the entry of one of these requirements will
initiates a data pull identifying the clinician or group by name as well as their practicing
credentials (MD,DO,PA, ect).
Reason for Change: Allows parts of the application to be pre-populated with information
regarding the Clinician or Group connected to the exception application.

2020 Promoting Interoperablity Hardship Exceptions Application Crosswalk

Corresponding Figures:
CY2019 Application: 1, 2, 3, 4 & 5
CY2020 Application: 4, 4a, 4b, & 4c
*****
Change # 4: Submitter Information
Summary of Change: The submitter is NO LONGER required to enter their First Name, Last
Name or Company/Organization Name- it is now tied automatically to the information provided
in association with their Authenticated QPP Login.
Reason for Change: The use of the Authenticated login allows portions of the application to be
pre-populated reducing the amount of information the submitter needs to provide during the
application process.
Corresponding Figures:
CY2019 Application: 6
CY2020 Application: 5 & 6
*****
Change # 5: Additional Access
Summary of Change: The new “Additional Access” section allows the submitter to designate
additional staff who can help to manage the form and receive program announcements.
Reason for Change: Helps to ensure that status update can be managed by more than one
person within the organization – preventing errors in the event of staff changes or un-expected
absences on the part of the submitter.
Corresponding Figures:
CY2019 Application: N/A
CY2020 Application: 7
*****
Change # 6: Selection of an applicable Hardship Reason
Summary of Change: Radio buttons have been added which enables all acceptable PI Hardship
Exception reasons to be displayed on one screen.
Reason for Change: Streamlining the PI Hardship Exception scenarios into one place, rather
than strolling through an entire application the submitter can click on the radio button most
applicable to their situation and it will automatically open the corresponding attestation,
including the fields for all the required supporting information as well as the Optional Event
description text box.

2020 Promoting Interoperablity Hardship Exceptions Application Crosswalk

Corresponding Figures:
CY2019 Application: 7, 7a, 7b, 7c, 7d, 7e, 7f
CY2020 Application: 8, 8a, 8b,8b.1, 8b.2, 8b.3, 8b.4, 8c, 8d, 8e
*****
Change # 7: Submission and Certification of Application
Summary of Change: Upon completion of all of the required portions of the Exceptions application the
submitter will click a “Submit for Review” button and be presented with a final Certification and Review
screen providing them the opportunity to review each section of the application for accuracy prior to
submission, this section includes all Notices and Disclosures required

Reason for Change: Adding the Final Review along with the Certification and Attestation Statements at
the end of the application ensures that any errors within the application have had the opportunity to be
corrected by the submitter prior to going into the review process.

Corresponding Figures:
CY2019 Application: 14
CY2020 Application: 9 & 9a
*****
Change # 8: Submission Confirmation and Application Status Tracking
Summary of Change: After the submitter has clicked “Certify & Submit” they will be provided
with an immediate application status: Submitted for Review, Approved or Denied. the
submitter can also track applications from submission to final disposition through the
Authenticated QPP Login
Reason for Change: Implementing the application process through the Authenticated QPP
Login reduces the burden on submitters trying to track the submission and status of multiple
exceptions applications.
Corresponding Figures:
CY2019 Application: N/A
CY2020 Application:10, 11 & 11a


File Typeapplication/pdf
File Title2020 Promoting Interoperablity Hardship Exceptions Application Crosswalk
AuthorCMS
File Modified2020-07-30
File Created2020-07-30

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