Thousands of providers seek exemption from 2015 meaningful use principles

The U.S. Centers for Medicare & Medicaid Services has recently announced that it has received thousands of requests from eligible providers for exemption from penalties starting next year. Many providers feel that they will not meet the new meaningful use principles for EHR technology certified to the 2014 edition, according to EHR Intelligence. 

The CMS hinted that it would release a new meaningful use hardship exemption more than six months ago. The new exemption is aimed at helping eligible professionals and hospitals that fear they will not be able to properly implement their EHR technology in time.

Lack of preparedness to cause issues
In an email earlier this week, the federal agency said, "CMS received approximately 44,000 hardship exemption applications. This is the first time we're announcing this number as we have been working through the applications and notifying each individual provider of their status. The vast majority are of first-timers in 2014 experiencing issues with their CEHRT," according to EHR Intelligence.

The significant number of providers and hospitals that are not prepared for the new meaningful use criteria is likely to affect new patients due to the amount of requests that have been sent from first-timers. This lack of preparedness will probably impact customers even more than EHR vendors that have adopted a more recent system. 

Earlier this year, Elizabeth Holland, director of the HIT Initiative Group in the Office of E-Health Standards and Services, told EHR Intelligence, "One of the things we were worried about is the deployment of the 2014 products. We've looked to see if people are attesting for 2014 yet, and we've had some hospitals that have attested for 2014 but for stage 1 – so new hospitals coming on. We haven't had people come in for stage 2 yet."

Any early hints of provider performance in 2014 meaningful use are not yet available, even as the closing of the final quarterly reporting period for hospitals on Sept. 30 and the attestation deadline in two months are swiftly approaching.

Criteria for automatic exemption
A few months ago, at the start of April, hospitals saw their deadline for submitting an application for a 2015 meaningful use hardship exemption pass. Meanwhile, providers could apply up until July 1, 2014. However, some providers were able to skip the application process altogether, as they would automatically get an exemption from the CMS if they were meeting specific criteria, including:

  • Hospital-based eligible professionals receive automatic exemption. However, in order to be consider hospital-based, they must provide over 90 percent of their covered professional services in either an inpatient or emergency department of a hospital.
  • New hospitals and providers must be in their first year of service. 
  • Eligible professionals with certain Provider Enrollment, Chain and Ownership System specialties, such as pathology, anesthesiology, interventional radiology, diagnostic radiology and nuclear medicine, are automatically exempt during the six months before the first day of the payment adjustments. In order for this to count toward their exemption, eligible professionals should verify that they have their PECOS specialty up to date.
  • Eligible professionals in which Place of Service 21, Place of Service 23 and specific observation services using Place of Service 22 account for 90 percent of their claims will receive exemption.

The federal agency has been aware of the lack of readiness since the early meaningful use attestation numbers in 2014 were not optimistic. However, the applications that will receive exemption have not been specified by the CMS yet.

Participation in the program is likely to grow after the finalization of a rule meant to provide flexibility for providers in meaningful use reporting year 2014. This would have been impossible if it were not for the easing of requirements for EHR technology certification.