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CMS Issues Guidance on MU Hardship Exemption Process, Extends Comment Period on Quality Reporting

February 2, 2016
by Heather Landi
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The Centers for Medicare & Medicaid Services (CMS) has issued further guidance to the Medicare Electronic Health Record (EHR) Incentive Program Hardship Exemption process on its website, specifically clarifying that providers are not required to submit documentation with the new hardship application form for the 2017 payment adjustment.

On its website, CMS posted guidance stating that it does not require eligible providers, eligible hospitals or critical access hospitals to submit documentation for the hardship category selected and it will not be reviewing documentation supporting the application on a case-by-case basis. CMS said it would review applications to record the hardship category selected and use the identifying information provided to approve hardship exemptions for each provider listed on the application.

As reported by Healthcare Informatics Managing Editor Rajiv Leventhal, last month CMS announced it had launched a new, streamlined hardship application process. CMS said the new hardship exception process will reduce burden on clinicians, hospitals, and critical access hospitals (CAHs). These changes are a result of recent Medicare legislation—the Patient Access and Medicare Protection Act (PAMPA)—and the agency’s ongoing efforts to improve the program, CMS said

CMS also released another guidance this week clarifying that providers can apply for a hardship exemption from the meaningful use program 2017 payment adjustment because they are unable to meet the requirements of MU for an EHR reporting period in 2015 for reasons related to the timing of the publication of the 2015 through 2017 modifications final rule,. CMS released the meaningful use Stage 2 modifications and Stage 3 final rules in October.

When completing the hardship exemption application, CMS states that providers applying for reasons related to the 2015 rulemaking timing can use sub-category 22.d – EHR Certification/Vendor Issues (CEHRT issues), which is under the existing category 2.2 - Extreme and Uncontrollable Circumstances.

“Providers who experienced an issue with their CEHRT related to the rule timing – and any other provider for whom the timing of the rule caused a significant hardship – should select sub-category 2.2d on the 2017 hardship exception application. No additional documentation is required for this selection,” CMS stated.

In late December, President Obama signed the new hardship exemption bill into law, designed to make it easier for healthcare providers to receive hardship exemption from financial penalties for failing to meet Stage 2 meaningful use EHR requirements. The legislation enables CMS to grant hardships not just on a case-by-case basis, but also to 'categories' with the deadline of March 15, 2016 for eligible professionals (EPs) and April 1, 2016 for eligible hospitals (EHs), after which time CMS would still have the case-by-case authority to grant hardship exemptions until July 1, 2016.

The new applications and instructions for a hardship exception from the meaningful use program 2017 payment adjustment are now available here.

Also this week, CMS and the Office of the National Coordinator for Health Information Technology (ONC) announced that CMS extended the deadline for commenting on quality reporting programs and certification of EHR products to Feb. 16.

CMS posted the extension notice on the Federal Register.

Back in December, CMS and ONC issued a request for information (RFI) entitled “Certification Frequency and Requirements for the Reporting of Quality Measures under CMS Programs,” seeking public comment on several items related to the certification of health information technology.

As reported by HCI’s Leventhal, the RFI provides CMS and ONC with an opportunity to assess policy options that could improve the effectiveness of the certification of health IT and specifically the certification and testing of electronic health record (EHR) products used for the reporting of quality measures. Specifically, the RFI is for CMS quality reporting programs such as, but not limited to, the EHR Incentive Programs, the Hospital Inpatient Quality Reporting (IQR) Program and the Physician Quality Reporting System (PQRS). In addition, CMS is requesting feedback on how often to require recertification, the number of clinical quality measures (CQMs) a certified Health IT Module should be required to certify to, and testing of certified Health IT Module(s).



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