CMS issues tips, guidance for MU hardship exceptions

The Centers for Medicare & Medicaid Services (CMS) has issued guidance regarding the recently announced hardship exceptions they will consider for those eligible professionals (EPs) and hospitals (EHs) struggling to meet Meaningful Use (MU) Stage 2.

Speaking during today’s Health IT Policy Committee meeting, Elisabeth Myers of the CMS Office of eHealth Standards and Services, said, “hardship exceptions will be available for providers who cannot get certified software.”

Participants new to the incentive program in 2014 intending to demonstrate MU for the first time this year but not able to implement 2014 certified EHR technology (CEHRT) for the 2014 reporting year, may apply for a hardship exception for the 2015 payment adjustment. These EPs should use the EP hardship exception form for 2015 and select “2014 vendor issue” as the reason for the hardship exception, according to the guidance. Applications are due by July 1.

EPs who successfully demonstrated MU for the 2013 reporting year will not be subject to the 2015 payment adjustment. EPs not able to implement 2014 CEHRT for a 2014 reporting period may apply for a hardship exception for the 2016 payment adjustment. They should use the EP hardship exception form for 2016 which will be available after July 1, according to the guidance. Again, the reason for the hardship application is “2014 vendor issues” and applications are due by July 1, 2015.

EHs should follow the same procedure, according to the guidance. New participants in the 2014 reporting year can apply for an exception to the 2015 payment adjustment and CMS is currently accepting hardship applications for the 2015 payment adjustment only.

New EHs in 2014 must submit their hardship application by April 1 and returning EHs may apply for an exception to the 2016 payment adjustment. That application will be available after April 1.

Payment adjustments are only applicable to the Medicare EHR Incentive Program, so those eligible for the Medicaid program do not need to apply for a hardship exception. Those eligible for both programs, however, must demonstrate MU in either Medicare or Medicaid in order to avoid the payment adjustment or apply for a hardship exception. Receiving a payment for adopt/implement/upgrade under the Medicaid incentive program will not exempt any provider or hospital from the Medicare payment adjustment.

More guidance is forthcoming, Myers said. She did clarify that the exceptions are for those who cannot “obtain or implement” certified EHR technology. “Just because a technology is certified doesn’t mean it is implemented that same day.”

Applications and tip sheets are available on the EHR Incentive Program website. The tip sheet for EHs lists infrastructure, new eligibility, unforeseen circumstances and 2014 EHR vendor issues as possible reasons for a hardship exception. For EPs, the listed reasons include the same four reasons for EHs plus patient interaction and practice at multiple locations. The guidance directs both EPs and EHs to use only the “2014 vendor issues” reason at this time.

“Hardship exceptions will be granted only under specific circumstances and only if CMS determines that providers have demonstrated that those circumstances pose a significant barrier to their achieving Meaningful Use,” according to the tip sheet. “Information on how to apply for a hardship exception will be posted on the CMS EHR Incentive Programs website (www.cms.gov/EHRIncentivePrograms) in the future.”