CMS extends meaningful use hardship exemption to 2015

The stages of meaningful use have placed enormous strains on health care organizations across the U.S., but recent developments may afford them some extra time to attest. The end of May marks two months since the official delay of the ICD-10 billing codes, which were postponed one year by a Congressional bill. As medical professionals scrambled to reassess preparations, meaningful use stage 1 was almost written off as an afterthought.

However, the Centers for Medicare and Medicaid Services appears to be in-touch with the concerns of the health care industry and the workload it faces. According to a joint proposal between the CMS and the Office of the National Coordinator for Health Information Technology, the hardship exemption for stage 1 of meaningful use, which governs the CMS's response to verified third-party electronic health record systems, may be extended one year. The CMS and ONC hope this will give the industry the time it needs to adequately prepare health IT departments for all that lies ahead.

CMS gives industry more time
Stage 1 of meaningful use and the opportunity to attest to the CMS's requirements and receive reimbursement payments were scheduled to come to a close in 2014. However, health care professionals and provider groups rallied against the agency for months asking for more time, and the CMS responded.

The proposal to extend the hardship exemption for stage 1 only applies to physicians and groups that can reasonably prove that their inability to attest is caused by factors outside of their control. The most widely cited reason for attestation delays is the unavailability of 2014-certified EHR software. Vendors must coordinate with the CMS and other federal agencies to ensure that their products are compliant with all regulations. If this does not happen, health care organizations cannot use those unverified pieces of software to attest to meaningful use.

In the joint proposal, the CMS and ONC noted that there is an extensive backlog of several months across the industry for organizations to receive, install and comprehensively implement 2014-verified EHR systems. With this in mind, the proposal suggested that physicians and hospitals currently scheduled to move up to stage 2 or drop out of the program should be allowed to stay in stage 1 if they can prove external, vendor-related delays to their EHR systems.

Karen DeSalvo, national coordinator for health information technology, hoped that the proposed extension would be enough for struggling health care organizations.

"[The extension] will give new options to those who, through no fault of their own, have been unable to get the new 2014 Edition technology, including those at high risk, such as smaller providers and rural hospitals," DeSalvo said.

Proposal may be too little, too late
Richard Schreiber, chief medical informatics officer at Pennsylvania-based Holy Spirit Health System, told Modern Healthcare that while the proposed hardship exemption is sure to help a small group of struggling hospitals, the timeline of its implementation could pose massive problems for hospital systems, such as Holy Spirit, that have a lot on their plates.

The proposal will stay open for a 60-day public comment period, which will end in mid-July. After that, it may be several more months before the CMS and ONC release official regulations. Schreiber explained that because many health care professionals like himself are under pressure to keep moving forward with dozens of other projects, they may choose to ignore meaningful use entirely if the CMS and ONC take too long with their proposal.