CMS Extends Hardship Exemption
By Megan Williams, contributing writer
The Centers For Medicare & Medicaid Services (CMS) have decided to add “extreme and uncontrollable circumstances” to its list of Meaningful Use hardship exemptions. As with the existing exemptions, they will allow providers and healthcare entities that qualify to avoid penalties for failing to meet Meaningful Use standards.
The agency has admitted that the reason for the hardship exemption was confusion that arose around rule changes that were originally intended to give providers more flexibility in attesting for reporting year 2014. As the final rule stated, “Providers were extremely concerned that their inability to use the flexible options specified in the 2014 CEHRT [Certified Electronic Health Record Technology] Flexibility rule would subject them to a payment adjustment in 2015 under Medicare for failing to demonstrate meaningful use of CEHRT.”
Worsening Problems
The situation was made worse by limitations on the CMS Registration and Attestation System that kept physicians attesting for the first time, from choosing flexibility options before the October 1, 2014, deadline. This meant they could not avoid 2015 MU Payment adjustments, according to EHR Intelligence.
Qualifications
Providers, professionals, and hospitals who want to meet the uncontrollable circumstances hardship exception, must meet two criteria by November 30, 2014: “First, the provider must not have been able to fully implement the 2014 Edition CEHRT due to delays in 2014 Edition CEHRT availability. Second, the provider must not have been able to attest by their attestation deadline in 2014. For example, for eligible professionals, the eligible professional must not have been able to attest by October 1, 2014 using the flexibility options under the 2014 CEHRT Flexibility rule. For eligible hospitals, the eligible hospital must not have been able to attest by July 1, 2014 using the flexibility options under the 2014 CEHRT Flexibility rule.”
The AMA’s Objections
The American Medical Association has weighed in with its belief that Meaningful Use challenges aren’t best met with increased flexibility. The association believes that penalties (including payment adjustment) should be removed from the EHR incentive programs. President-elect Steven J. Stack, M.D., stated, “The whole point of the Meaningful Use incentive program was to allow for the secure exchange of information across settings and providers and right now that type of sharing and coordination is not happening on a wide scale for reasons outside physicians’ control. Physicians want to improve the quality of care and usable, interoperable electronic health records are a pathway to achieving that goal.”