CMS Issues Meaningful Use Hardship Exemption Guidance

The Centers for Medicare and Medicaid Services (CMS) on Tuesday issued guidance for eligible professionals, eligible hospitals and critical access hospitals that need a temporary hardship exemption to implementation of stage 2 meaningful use certified electronic health record (EHR) technology.

Representatives of CMS and the Office of the National Coordinator for Health Information Technology indicated at the 2014 HIMSS conference that the agency had little appetite for delaying the mandatory implementation of improvements in EHR technologies that will get the U.S. health care system to a point where electronic records can easily travel with patients across care settings and between providers. The hope is that this type of interoperability will justify the money spent on meaningful use incentives by reducing the types of waste that currently come from duplicative testing and missed diagnoses. CMS and the ONC have faced criticism from conservative lawmakers over the lack of progress on interoperability of EHR systems despite millions in meaningful use incentives having been handed out.

However, while a delay in the required implementation of the 2014 Edition of Certified Electronic Health Record technology (aka, meaningful use stage 2) is unlikely, a fair number of organizations will qualify for the hardship exemptions to demonstrating meaningful use for the 2014 and 2015 reporting years.

According to CMS’s guidance, eligible professionals who intended to demonstrate meaningful use for the first time in 2014, but are unable to implement 2014 certified EHR technology for the 2014 reporting year, may apply for a hardship exception for the 2015 payment adjustment by submitting a “eligible professional hardship exception form for 2015” by July 1 and indicating “2014 Vendor Issues” as the reason.

Meanwhile, eligible professionals who successfully demonstrated meaningful use for the 2013 reporting period should do the same, but for the following year. They should use the “professional hardship exception form for 2016” — which will be available after July 1 of this year — and submit it by July 1 of next year.

The system is similar for hospitals and critical access hospitals. The Medicare EHR Incentive Program payment adjustment is applied in 2016 for the 2014 reporting year for hospitals that demonstrated meaningful use in a previous year. Hospitals applying for the first time in 2014 can also apply for an exception to the 2015 payment adjustment.

Just as for the individual eligible professionals, the reason hospitals should select when applying for the hardship exemption is “2014 Vendor Issues.”

View the hospital guidance here and the eligible professional guidance here.