Avoiding the 2017 Meaningful Use Penalty

UPDATE (3/29/16):

  • CMS announced last Friday an extension to the deadline for hardship exemptions from the Medicare EHR Incentive Program's meaningful-use requirements.
  • The new deadline is July 1 adding several months from the former deadline of March 15 for eligible professionals, and April 1 for eligible hospitals and CAHs.
  • CMS says it is granting the extension to give providers "sufficient time to submit their applications to avoid adjustments to their Medicare payments in 2017."

In late December 2015, Congress passed the Patient Access and Medicare Protection Act (PAMPA), which directed the Centers for Medicare and Medicaid Services (CMS) to make changes to the Medicare EHR Incentive Program hardship exception process that allows physicians to avoid a Meaningful Use (MU) penalty in 2017. The new, streamlined process allows individuals and groups to apply for a hardship exception on a single application.

If you or your organization did not successfully meet meaningful use for an EHR reporting period in 2015 and would like to apply for a hardship exception, the deadlines are as followed:

  • An application including only eligible professionals (EPs) must meet the EP deadline on July 1, 2016.
  • An application including EPs and eligible hospitals must meet the EP deadline on July 1, 2016.
  • An application including only eligible hospitals must meet the deadline of July 1, 2016.

Please note, that applying for the hardship will not prevent a physician from earning an incentive. It simply protects a physician from receiving an MU penalty.

How to apply for the hardship?

CMS provides step-by-step instructions for completing the hardship exception application on their website. But here are the highlights:

Step 1: Download the Application

  • Electronic submission of your application is strongly recommended by CMS. This will be the fastest, easiest method for you to apply. Completed applications should be emailed to ehrhardship@provider-resources.com.
  • If you are not able to submit the application electronically, please TYPE or PRINT all information using BLUE or BLACK ink. Pencil is not accepted. Fax the completed application to 814-456-7132.

Step Two: Applicant Information

  • Provide information for the person working on behalf of the physicians to apply for the hardship exception.
  • An individual may apply on behalf of a group of physicians. This individual may be the physician applicant him/herself or the individual filling out the information on behalf of a physician group (for example, a member of the group’s administrative staff).
  • CMS will provide notice of its hardship exception decisions – which are final and cannot be appealed – via the email address provided on the application.

Step Three: Circumstances of Hardship

  • Check the box beside the hardship exception reason that best applies to your circumstances.
  • A physician who qualifies for more than one hardship exception category may select all of the options applicable to his or her practice; however, one category will suffice.
  • All providers listed on the application must select the same category for consideration.

In a recent statements from the AMA, the organization is encouraging physicians to apply for a hardship exemption under the “EHR Certification/Vendor Issues (CEHRT Issues)” category (Option 2.2.d in the application), even if they are uncertain whether they will meet the program requirements this year. The AMA states, because of the delay in publication of the regulation, this category will apply to all physicians. CMS has also stated that they will refrain from auditing physicians who file under this option.

Step Four: Provider Identification Information

  • List the NPI, first name, and last name for each physician applicant.
  • Failure to provide each physician’s NPI will result in a delayed hardship exception decision by CMS.
  • In addition to listing each physician’s information on the application itself, CMS will accept physician identification contained in the following formats: Microsoft Excel (.xls or .xlsx), comma delimited (.csv), or text file (.txt).

Step Five: Certification Statement

  • Read the certification statement and check the box marked “Confirm” and enter the date of application and the name of the individual completing the form.

Step Six: Submit the Application

  • Submit the application to CMS.
  • Remember, if you are submitting the application electronically, email ehrhardship@provider-resources.com.
  • If submitting a hardcopy, fax the application to 814-456-7132.
  • If you have a separate file for physician NPIs, don’t forget to attach it to your email or include it with your fax.
  • Keep a copy of your application and any documentation supporting hardship exceptions on file.

If an exemption is granted, CMS will notify the applicant listed. All decisions are final. CMS has not said when applicants will be notified of CMS’ decision.

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