CMS Issues Guidance on Applying For Meaningful Use Hardship Exceptions

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By Kendra Casey Plank  

March 11 --The Centers for Medicare & Medicaid Services released details March 10 about how Medicare-participating providers and hospitals can apply for meaningful use hardship exemptions because of technology vendor issues.

The guidance is meant to help eligible professionals and hospitals who participated in Stage 1 of the meaningful use program but aren't able to update their electronic health record systems this year to meet the 2014 Edition EHR certification criteria from the Office of the National Coordinator for Health IT.

Payment penalties based on the 2014 reporting period will be effective in 2016. The CMS noted that payment penalties only apply to the Medicare program. Providers and hospitals eligible to participate only in the Medicaid program aren't subject to payment penalties for failing to meet meaningful use criteria.

In separate one-page guidance documents for eligible professionals and eligible hospitals, the CMS explained that providers and hospitals should indicate on the hardship application that they are seeking an exception for the 2014 reporting period based on “2014 Vendor Issues.”

For eligible professionals, the hardship application for the 2014 reporting period will be available after July 1, 2014, and will be due by July 1, 2015. For eligible hospitals, hardship applications for the 2014 reporting period will be available after April 1, 2014, and will be due by April 1, 2015.

New Participants

However, the CMS said providers and hospitals new to the program in 2014 but unable to implement 2014 certified EHRs should apply for a hardship exemption earlier to avoid payment penalties in 2015. Those applications are available now and are due April 1, 2014, for hospitals and July 1, 2014, for providers. The CMS said it currently is only accepting hardship applications from providers and hospitals seeking to avoid the 2015 payment penalty.

According to separate guidance updated in March for eligible professionals and for hospitals, exceptions also could be granted for reasons other than technology issues, including newly practicing professionals and “unforeseen circumstances.”

Participants in the program that already have attested to meeting Stage 1 requirements won't be subject to payment adjustments in 2015, the CMS said.

Providers and hospitals have complained that their EHR products implemented for Stage 1 of the meaningful use program aren't being updated by technology vendors in time to meet Stage 2 requirements and avoid the reduced Medicare reimbursements.

In February, CMS Administrator Marilyn Tavenner said the agency would make it easier for providers and hospitals to obtain hardship exemptions in 2014 if they faced technology problems (see previous article). Participation in Stage 2 of the meaningful use program requires that providers and hospitals be using EHRs certified under the updated 2014 Edition certification criteria.

To contact the reporter on this story: Kendra Casey Plank in Washington at

To contact the editor responsible for this story: Patty Logan at

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