In November, the Centers for Medicare and Medicaid Services (CMS) released regulatory guidance for clinicians participating in the Merit-Based Incentive Payment System (MIPS) who had been adversely impacted by recent natural disasters. This week, CMS updated its list of California counties that will be given automatic MIPS exceptions under the "Extreme and Uncontrollable Circumstances" policy. In addition to the Northern California counties announced in the fall , physicians in a number of Southern California counties affected by recent wildfires are now eligible. The affected areas in California now include Butte, Lake, Mendocino, Napa, Nevada, Orange, Santa Barbara, Solano, Sonoma, Ventura and Yuba counties. The "Extreme and Uncontrollable Circumstances" policy grants MIPS-eligible clinicians exceptions without having to submit an exception request. This automatic exception only applies to you if you're an individual MIPS-eligible clinician in an affected area [determined by zip code and based on information in the Provider Enrollment, Chain and Ownership System (PECOS)]. Under this policy, physicians affected by the Northern and Southern California wildfires will automatically receive a neutral MIPS payment adjustment, unless they submit data for any of the MIPS performance categories by the 2017 submission deadline. If you do submit MIPS performance data, you will be scored in each performance category for which you submit data, according to existing MIPS scoring policies. This policy does not apply to MIPS-eligible clinicians in alternative payment models in 2017, such as the Medicare Shared Savings Program.