New Process Announced to Avoid EHR Penalties in 2017; Apply Now

The government has issued an update to previous rules governing the Electronic Health Records Incentive Program and is now allowing blanket “hardship” exemptions to the program so that clinicians, hospitals, and critical access hospitals can avoid penalties that would have been incurred in 2017 had they not complied with “meaningful use” requirements in 2015.

The deadline to apply for the exemption is July 1 for eligible professionals, hospitals, and critical access hospitals.

The update, which also reduces the amount of information that eligible professionals, hospitals, and critical access hospitals must submit for an exemption, is the result of the Patient Access and Medicare Protection Act (PAMPA). This law established that the secretary of Health and Human Services may consider hardship exemptions for “categories” of eligible professionals, hospitals, and critical access hospitals. Prior to this law, the Centers for Medicare and Medicaid Services (CMS) was required to review applications on a case-by-case basis. Under the group application, multiple providers and provider types may apply together using a single submission.

This is the first time that an individual may apply for the hardship exemption on behalf of a group of physicians. This individual may be the physician applicant or the individual filling out the information on behalf of a physician group (for example, a member of the group’s administrative staff). CMS will provide notice of its hardship-exception decisions—which are final and cannot be appealed—via the email address provided on the application.

Applying for the hardship will not prevent a physician from earning an incentive; it simply protects a physician from receiving a meaningful-use penalty. Therefore, physicians who believe that they met the requirements for the 2015 reporting period should still apply for the hardship protection.

The update rectifies problems related to CMS’s delayed notification of the meaningful-use rule regarding exemptions; that delay would have adversely impacted many physician practices. The final rule was released last October, which left less than 90 days for physicians to submit data for what should have been a 90-day reporting period before the end of 2015. Because of this delay, the hardship category applies to all physicians.

The new applications and instructions for a hardship exception from the Medicare Electronic Health Records Incentive Program 2017 payment adjustment are posted at the CMS website. For more information, contact APA’s Department of Practice Management and Delivery Systems at practicemanagement@psych.org.

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Government Proposes New Timeline for Implementing 'Meaningful Use' Criteria

The Centers for Medicare and Medicaid Services (CMS) has proposed a modification of its timeline for physician adoption and meaningful use of electronic health records (EHRs). This program, designed to encourage physicians and hospitals to use EHR programs, pays an incentive that is added to Medicare reimbursements for physicians who adopt EHRs, but will impose deductions on the reimbursements of those who fail to do so. Under the revised timeline, Stage 2 of EHR adoption will be extended through 2016, and Stage 3 will begin in 2017 for providers who have completed at least two years in Stage 2. The program is currently in Stage 1. Among the goals of the proposal to shift the timeline is to give CMS more time to use data from Stage 2 participation to inform policy decisions for Stage 2, the agency explained in a press release. According to CMS, "The proposed timeline for meaningful use would have a number of benefits, such as:

• More analysis of feedback from stakeholders on Stage 2 progress and outcomes;

• More available data on Stage 2 adoption and measure calculations—especially on new patient engagement measures and health information exchange objectives;

• More consideration of potential Stage 3 requirements;

• Additional time for preparation for enhanced Stage 3 requirements;

• Ample time for developers to create and distribute certified EHR technology before Stage 3 begins, and incorporate lessons learned about usability and customization."

In 2015, Medicare providers who have not started using a certified EHR will begin seeing a claims penalty. However, as the meaningful use program is voluntary for Medicaid providers, they will not be subject to penalties if they do not participate.

To read more about the meaningful use EHR program, see the Psychiatric News article, "Is 'Meaningful Use' for Me?"

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