Healthcare News & Insights

Who’s eligible for meaningful use hardship exceptions?

Is your hospital ready to meet the Meaningful Use Stage 2 reporting deadline? After all, Jan. 1, 2015 is less than a year away, and the payment adjustment is 1% per year and is cumulative for every year that an eligible professional (EP) is not a meaningful user. Luckily, if you qualify, you may be able to get an exception from the mandated payment adjustments. 

85500911EPs may apply for hardship exceptions only under specific circumstances, and only if the Centers for Medicare & Medicaid Services (CMS) determines that providers have demonstrated that specific circumstances pose a significant barrier to achieving meaningful use.

Exception categories

So who can apply for these exceptions?

According to CMS, EPs can apply for hardship exceptions in the following categories:

  • Infrastructure: EPs must demonstrate they’re in an area without sufficient internet access or face insurmountable barriers to obtaining infrastructure (e.g., lack of broadband).
  • New EPs: Newly practicing EPs who wouldn’t have had time to become meaningful users can apply for a two-year limited exception to payment adjustments. So EPs who begin practice in calendar year 2015 would receive an exception to the penalties in 2015 and 2016, but would have to begin demonstrating meaningful use in calendar year 2016 to avoid payment adjustments in 2017.
  • Unforeseen circumstances: Examples may include a natural disaster or other unforeseeable barrier.
  • Patient interaction: Includes such things as a lack of face-to-face or telemedicine interaction with patient or a lack of follow-up need with patients.
  • Practice at multiple locations: Lack of control over availability of CEHRT for more than 50% of patient encounters.
  • 2014 EHR vendor issues: The EP’s electronic health records (EHR) vendor was unable to obtain 2014 certification or the EP was unable to implement meaningful use due to 2014 EHR certification delays.

Other issues addressed by CMS

EPs have to demonstrate meaningful use each year to avoid Medicare payment adjustments. It’s not a one-and-done thing.

As for hospital-based Medicare EPs, they aren’t subject to the payment adjustments. If an EP performs 90% or more of their covered professional services in either the inpatient or emergency department of a hospital, then they’re classified as hospital based, aren’t eligible to receive an EHR incentive and won’t be subject  to the payment adjustments.

However, hospital-based status can change from year to year. So if at any point the hospital-based status changes, EPs can be subject to the payment adjustment. So it’s important to check the status at the beginning of the year by going to the Medicare EHR Incentive Programs Registration System.

 

 

 

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