Q&A: CMS Clarifies Meaningful Use Hardship Application Process
You have until March 15 to submit your application for a hardship exemption from Medicare’s EHR meaningful use payment penalties, and it’s important to understand the recently revised application process.
Many practices were confused about having no obvious option on the hardship application form to choose if they were unable to attest in 2015 due to CMS actions. Others were confused about the numerous deadline dates for the hardship exemption, especially after Congress passed a bill that required CMS to expedite hardship applications.
Below is a list of clarifications obtained by The Business of Medicine from conversations with CMS officials. The hardship application form is in PDF format and available here.
Remember: The hardship application pertains to the 2015 meaningful use (MU) reporting period, which CMS will use to determine payment adjustments for 2017. If you are facing MU payment penalties for this year (you’ll know because CMS will send you a letter), those penalties are based on the 2014 reporting period, and you can still try to appeal them by using a “reconsideration” form available here. All reconsiderations must be submitted to CMS by Feb. 29.
The Business of Medicine: What’s the final deadline date for eligible providers (EPs)? Previously CMS had indicated a deadline of July 1, 2016, for its case-by-case process of reviewing EP hardship applications. However in the law recently passed by Congress, CMS is given wider authority to grant exemptions, and to do so more quickly than “case-by-case,” but with a deadline of March 15. Can you explain whether the July 1 date has any relevance now?
CMS: Applications for eligible professionals will be due on March 15, 2016 and April 1, 2016 for eligible hospitals and critical access hospitals.
The Business of Medicine: Which hardship option should EPs choose if they were impacted by CMS rulemaking? If an EP was affected by late CMS rulemaking that altered measures and reverted the reporting period from 365 days to a 90-day period for 2015, which hardship option should be chosen? Can CMS confirm that “2.2.d” is the correct option in these cases?
CMS: Yes, that is correct.
The Business of Medicine: How will CMS determine eligibility? For EPs who choose 2.2.d, how will CMS decide whether to grant the hardship? Will the EP be required to produce information to support this?
CMS: We will review each application submitted and determine whether the provider has demonstrated that their circumstances poses a significant barrier to achieve meaningful use. CMS is not requiring an EP to provide any documentation.
The Business of Medicine: How long will it take for CMS to make a decision? With a March 15 deadline, how long will CMS take to grant or deny an application, approximately? Is it a matter of days, weeks, or months?
CMS: We plan on reviewing and approving each application on a rolling basis. Determinations will be sent out within the next 30 to 90 days.
Hardship exemption won’t be ‘blanket’
Previously, the hardship exemption was being referred to as a “blanket” exemption because the Congressional action was intended to give CMS wider authority to grant exemptions, but the actual application form doesn’t mention any such broad scope, says Bradley Coffey, government affairs manager for AAOE in Indianapolis, Ind. “CMS has made it clear to us that this is not a blanket exemption, it is not intended to give any provider the chance to get out of a year of meaningful use,” he says. “It was written to give providers an exemption for specific hardships.”
The form also contains an ominous legal disclaimer that reads “NOTICE: Anyone who misrepresents or falsifies essential information to receive payment from Federal funds requested by this application may upon conviction be subject to fine and imprisonment under applicable Federal laws.”
If you didn’t intend to attest to meaningful use in 2015, but try to claim an exemption, it’s lying to a federal agency which comes with hefty penalties, Coffey says. “To be safe, you should claim the exemption only if you really do have an EHR system, and did intend to meet meaningful use.”
— Grant Huang, CPC, CPMA (email@example.com). The author is Director of Content at DoctorsManagement.