D'Arcy Gue

Understanding the Meaningful Use / MIPS Hardship Exemption

October 14, 2014

Healthcare Industry, Meaningful Use / MIPS 3 Minute Read

The Centers for Medicare and Medicaid Services (CMS) received approximately 44,000 hardship exemption applications before July 1 from doctors and other providers who said they wouldn’t be able to attest to Meaningful Use / MIPS in time to avoid payment reductions in 2015. This news, first announced by Politico comes amidst a flurry of criticism directed at CMS for how they have handled the Meaningful Use / MIPS program to date.Simultaneously, there is a lot of activity as physicians approach the final opportunity to attest for 2014 and as hospitals are beginning their 365-day measurement period for 2015.

CMS noted that the majority of hardship applications were submitted by first-time attesters having difficulty with their 2014 certified EHR system.

It is with this group of first time attesters in mind that CMS has announced that it will re-open the submission period through November 30, 2014 for hardship exception applications for those who have been unable to demonstrate Meaningful Use / MIPS in time to avoid the 2015 Medicare payment adjustments. This extension is specific to eligible hospitals that were unable to attest by July 1, 2014 (and eligible professionals who were unable to attest by October 1, 2014) using the flexibility options provided in the CMS 2014 CEHRT Flexibility Rule. It is only available to providers who attest that they were unable to fully implement 2014 Edition CEHRT due to delays in 2014 Edition CEHRT availability.

Meaningful Use / MIPS extensionCMS has repeatedly pointed to the hardship exemption as the ideal response to the industry’s calls for more flexibility. By applying for (and receiving) a hardship exemption, a provider can avoid the Medicare penalty for not meeting the standards, but the provider also doesn’t receive the incentive money that they would have received for meeting the standard.

What this extension of the hardship application period does not do, however, is provide any flexibility to the large group of hospitals who are currently in the 365-day measurement period for FY2015. These hospitals are struggling with significant new requirements for Stage 2, including the use of patient portals and implementation of electronic quality measures. As CMS noted in their responses to comments on the CMS 2014 CEHRT Flexibility Rule, there have been numerous requests for this kind of flexibility and Congress is threatening to get involved and legislate a 90-day measurement period for MU in 2015. 

What does this mean?

If you are among the group of healthcare providers who haven’t yet attested to Meaningful Use / MIPS because you are having issues obtaining and implementing 2014 certified software, and your challenges weren’t eased by the 2014 CEHRT Flexibility Rule, this brief extension offers you an opportunity to request an exemption. If you are currently participating, and struggling to meet phase 2 goals for the first time this year, this extension won’t help. If that’s your situation, don’t give up hope. CMS or Congress could still shorten the measurement period for this year. Contact your representatives to support the Flex-IT Act, House Bill 5481.

If you are struggling, talk to one of our Meaningful Use / MIPS experts >>



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