MU Hardship Exception Application Process, Round Two

AAFP Promises Followup Questions

January 26, 2016 02:13 pm Sheri Porter
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As promised, CMS recently announced a new "streamlined" process( physicians, hospitals and critical-access hospitals can use to apply for a hardship exception that could exempt them from financial penalties for failing to meet meaningful use stage two requirements for 2015.

The announcement came on the heels of the December 2015 passage of the Patient Access and Medicare Protection Act that included a provision giving CMS the authority to expedite these applications by allowing the HHS secretary to consider hardship exceptions for "categories" of health care professionals.

Previously, applications were reviewed only on a case-by-case basis.

Importantly, the latest CMS announcement included a determination that the agency had the authority to allow groups of providers to request a hardship exception using a single application form.

Story Highlights
  • CMS recently approved a simplified application process for physicians to apply for hardship exceptions related to meaningful use stage two requirements for 2015.
  • As reported in December, new legislation gives CMS the authority to expedite applications by considering "categories" of health care professions. The just-announced process also allows groups of providers to apply using a single application form.
  • The AAFP will continue to work with CMS to ensure that family physicians are insulated from unfair penalties.

The hardship categories are the same for individual and group application requests. For instance, circumstances of significant hardship include

  • insufficient Internet access or insurmountable barriers to obtaining infrastructure such as lack of broadband technology,
  • extreme and uncontrollable circumstances in the form of a natural disaster that destroyed an electronic health records (EHR) system,
  • closure of a practice or hospital,
  • severe financial distress such as bankruptcy or debt restructuring, and
  • lack of control over the availability of certified EHR technology.

Although supportive of CMS' efforts overall, the AAFP continues to have some reservations about how the agency is tackling specific issues.

In an interview with AAFP News, Steve Waldren, M.D., director of the AAFP's Alliance for eHealth Innovation, questioned whether CMS had done enough to insulate physicians from unfair penalties.

"Certain things were not addressed in today's announcement from CMS, and so the process moving forward is still far from crystal clear," said Waldren.

For instance, although Waldren welcomed the introduction of a simplified application form, he said the AAFP needed assurance that the abbreviated process would not put family physicians at additional risk in the event of a meaningful use audit.

Reconsideration Application Deadline Also Approaches

Some family physicians who received letters from Medicare stating they were subject to the 2016 meaningful use penalty may want to contest that determination.

Such physicians have until Feb. 29 to submit a payment adjustment reconsideration application.( Follow CMS' instructions( on how to complete the form.

Electronic submission of the application is strongly recommended; in the event that is not possible, fax the application to (814) 464-0147.

"The AAFP intends to follow up with CMS on this hardship exemption issue and get all of our questions answered. As we learn more, we'll pass that information on to family physicians," said Waldren.

The AAFP strongly supported the legislation that gave CMS the nod to, in the short term, expedite the hardship application process via categorical authority. In a Dec. 21 statement, AAFP President Wanda Filer, M.D., M.B.A., called the bill's passage a "reprieve" for physicians who were not able to attest to meaningful use "through no fault of their own."

Deadlines for the submission remain the same as previously reported: Physicians have until March 15 to submit hardship exception applications; eligible hospitals and critical-access hospitals must submit by April 1.

Hardship applications( are available online. Follow CMS' instructions( for completing the forms.

Remember, CMS' categorical authority expires April 1; after that date, CMS must revert back to considering case-by-case hardship exemptions until July 1.

Related AAFP News Coverage
Meaningful Use Program Officially Shelved
AAFP Cautiously Optimistic About CMS Announcement


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