Congress Simplifies MU Hardship Exemption Process

AAFP Strongly Supported New Legislation

December 22, 2015 03:42 pm News Staff

Congress provided a bit of end-of-the year cheer to America's physicians on Dec. 18 when the U.S. House and Senate passed the Patient Access and Medicare Protection Act( with the AAFP's strong support.

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The bill includes a provision that gives CMS the authority -- for the next few months -- to expedite applications from physicians for a hardship exemption related to meaningful use stage two requirements for the 2015 calendar year.

The expedited "categorical authority" applies only to hardship exemption applications filed before March 15, 2016. Stay tuned for more information on the application process as it becomes available from CMS.

The bill was sponsored by Sen. Rob Portman, R-Ohio, and is widely expected to be signed by the President.

"This heralds a reprieve to physician practices that are unable to successfully attest to meaningful use for 2015, through no fault of their own," said AAFP President Wanda Filer, M.D., M.B.A., in a Dec. 21 statement about the legislation.

Passage of the bill is important to many family physicians because under current law, physicians participating in the Medicare and Medicaid electronic health record (EHR) incentive programs( must attest to meeting meaningful use stage two requirements for 90 consecutive days in 2015.

Physicians who don't participate or who do not attest successfully face financial penalties.

CMS accepted some responsibility for physicians' inability to successfully attest this year since the agency didn't publish an additional and necessary rule modifying stage two until Oct. 16.

The Academy told Congress that the late publication left some physicians without sufficient time to comply. Filer welcomed the solution that the new bill offers physicians who are trying to use EHRs to their highest potential.

"EHRs that communicate with all of a patient's physicians and providers can improve the effectiveness and efficiency of health care. The AAFP is committed to helping make that happen," said Filer in the statement. "Although this legislation will not resolve more global troubles with the meaningful use program, it does allow CMS to more easily hold physicians harmless for the problematic timing of the stage two modifications rule."

CMS already had announced it would grant hardship exemptions for 2015 for physicians and other eligible professionals who were adversely affected by the late modification language.

However, since 2009, CMS has had the authority to grant exemptions only on a case-by-case basis. This year, given CMS' tardiness in rule making, an already slow exemption process likely would have left hundreds of physicians on the hook for a 3 percent penalty adjustment on their 2017 Medicare payments.

Physicians who procure the hardship waiver for 2015 will avoid that penalty.

Specifically, the recently passed bill gives CMS the authority to process requests for hardship exemptions through a yet-to-be-determined streamlined process.

The current case-by-case hardship authority is part of the meaningful use framework that's been in place since passage of the American Recovery and Reinvestment Act of 2009. CMS will continue to accept physicians' hardship applications after March 15, but such applications will revert back to the original case-by-case review process.

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