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Washington Debrief: More Details Emerge on MU Hardship Exemptions

March 17, 2014
by Jeff Smith, Senior Director of Federal Affairs
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Jeff Smith, Senior Director of Federal Affairs

Details Emerge on Meaningful Use Hardship Exceptions; More Details Needed, CHIME Says

Key Takeaway: The Centers for Medicare and Medicaid Services (CMS) updated guidance and applications for Electronic Health Record (EHR) Incentive Payment hardship exceptions this week to include “2014 Vendor Issues,” related to meaningful use (MU) in 2014.

Why it Matters: CIOs who are on the brink of being “Meaningful Use-ready” by July 1 should examine the new EHR hardship exception application to see if they qualify. However, CIOs should know that if they do not meet MU requirements in 2014, but are successful in obtaining a hardship exception, they will lose all incentives due to their organization for program year 2014.

What’s Next: Another round of hardship exception revisions is expected later this year. It is unclear if those revisions will enable providers to avoid reimbursement penalties.

The dominos have been slow to drop, but they are dropping nonetheless. It began with a sign-on letter to the Department of Health and Human Services (HHS) from nearly 50 provider stakeholder groups asking for relief on Meaningful Use timelines and program requirements. Then came the announcement made by CMS Administrator Marilyn Tavenner, assuring HIMSS14 audiences that policymakers “are listening” and that “relief is coming.” Last week, that relief materialized in the form of a new EHR hardship exception category, called “2014 Vendor Issues.” According to updated guidance, EHs, EPs and CAHs who are “unable to implement EHR Technology certified to the 2014 edition certification criteria in time to successfully demonstrate meaningful use for the 2014 reporting year…may be eligible for a hardship exception from the applicable Medicare payment adjustments.” Specifically, the hardship exception application contains two options for providers to check:

  1. Vendor unable to obtain 2014 certification
  2. Provider unable to implement meaningful use due to 2014 EHR certification delays

In media interviews, CHIME officials said the expanded category was a “step in the right direction,” but that more information is needed to ensure that good-faith efforts are not penalized. Upon receiving word that CMS intends to publish more revisions for providers looking for relief during the 2014 program year, CHIME said, “Should CMS choose to define the new hardship exceptions in a way that does not address the core concerns of our industry we will continue to seek the kind of flexibility that nearly 50 national healthcare organizations communicated to HHS Secretary Kathleen Sebelius on February 21, 2014.”

Stage 3 MU Milestone Reached, Recommendations Approved by HIT Policy Committee

Key Takeaway: The Health IT Policy Committee last week voted to approve recommendations for Stage 3 Meaningful Use.

Why it Matters: While somewhat pared down from draft recommendations, Stage 3 will largely build off Stage 2 measures and objectives. It remains to be seen what alterations CMS will make based off experience with Stage 2.


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