In an attempt to add more flexibility to the EHR Incentive Programs, the Centers for Medicare & Medicaid Services included "extreme and uncontrollable circumstances" as a new meaningful use hardship exemption. This new exemption is for eligible providers who want to avoid penalties as a consequence of failing to meet the meaningful use standards as a part of the Medicare EHR Incentive Program, according to Modern Healthcare.
Why another exemption?
The CMS announced that the reason for the new hardship exemption were the results of the recent rule changes that were meant to give providers increased flexibility in accomplishing a successful meaningful use reporting period in 2014. This only led to a significant amount of confusion. Therefore, this "extreme and uncontrollable" exemption is meant to make up for this confusion.
According to EHR Intelligence, the final rule states, "Providers were extremely concerned that their inability to use the flexible options specified in the 2014 CEHRT Flexibility rule would subject them to a payment adjustment in 2015 under Medicare for failing to demonstrate meaningful use of CEHRT."
These concerns were worsened by the fact that the CMS Registration and Attestation System did not make it possible for physicians to attest so they could benefit from flexible options prior to Oct. 1, 2014, in order to successfully avoid 2015 payment adjustments.
According to EHR Intelligence, providers and hospitals can qualify for the extreme and uncontrollable circumstances hardship exemption only if they meet two criteria:
1. 2014 Edition CEHRT
Full implementation of the 2014 Edition certified electronic health record technology would immediately disqualify providers hoping to apply for the new meaningful use exemption. This adoption of the 2014 Edition CEHRT should not have taken place because of the delays in the system's availability.
2. 2014 attestation deadline
All providers applying for the meaningful use exemption must have missed the 2014 attestation deadline. Eligible professionals should not have been able to attest on Oct. 1, 2014, with help from the flexibility options as a part of the 2014 CEHRT Flexibility rule. Meanwhile, eligible hospitals must have missed their attestation date of July 1, 2014. However, the final rule states that critical access hospitals do not qualify for this particular hardship exemption. This is because the deadlines for the 2015 meaningful use payment adjustment are over a year away on Nov. 30, 2015.
In the final rule, the CMS explains, "Accordingly, to ensure that we do not face similar timing constraints in the future and to reduce administrative burden on providers who wish to request a hardship exception, we are amending the regulation text for the other hardship exception categories to enable CMS to specify a later deadline for submission of hardship exception applications," as quoted by EHR Intelligence.
According to Modern Healthcare, both providers and hospitals have until Nov. 30, 2014, to apply for the new hardship exemption. This final exemption is meant to address and alleviate the hardships that providers and hospitals currently face as they attempt to adhere to meaningful use requirements, while also preparing rulemaking regarding the emerging hardships for the coming year.