July 1 is the deadline for eligible professionals within the Medicare EHR Incentive Program who did not successfully meet meaningful use in 2013 to submit a hardship exception application for payment year 2015. However, the American Medical Association and Medical Group Management Association have sent a letter to the Centers for Medicare and Medicaid Services requesting an extension of the deadline to help EPs avoid MU financial penalties.

According to the trade associations, a Notice of Proposed Rulemaking published May 20 that proposes permitting EPs who are unable to fully implement 2014 certified EHR technology to report for the 2014 reporting year using 2011 CEHRT and using 2013 criteria is complicating matters. While this “much-needed modification to the program should facilitate continued program participation for many EPs,” AMA and MGMA argue in their letter to CMS that the timing of the proposed rule--with its July 21 closing date for public comments and publication of the final rule not expected until late summer--comes well after the July 1 date for EPs to submit a hardship exception to avoid the 2015 Medicare payment adjustment.

“With the expected delay in finalization of the rule, many EPs are unclear as to the MU requirements for 2014 and whether they need to apply for a hardship now before the rule is finalized,” states the June 27 letter to CMS Administrator Marilyn Tavenner. “Should an EP be unable to meet the modified MU requirements they will have missed the hardship exception deadline and will be unfairly penalized in 2015. To date, 50 percent of Medicare EPs have participated in the MU program, placing another 50 percent at risk for these penalties.”

AMA and MGMA recommend to Tavenner that CMS extend the deadline for EPs to submit the hardship exception to a minimum of 30 days following publication of the final rule. “This additional time would allow EPs to fully understand the new rule’s requirements and would provide further encouragement for EPs to continue their participation in this important program,” asserts the letter, which emphasizes that many EPs are “working diligently toward successfully meeting the 2014 requirements, but expect to do so later this year well after the July 1 deadline” for 2013 reporting year–2015 payment adjustment year hardship exceptions.

Last month, a CMS official reported during the Health IT Policy Committee's monthly meeting that 600 EPs have applied for hardship exceptions. In addition to EHR vendor issues, lack of infrastructure and unforeseen/uncontrollable circumstances, eligible professionals can also use "lack of control over the availability of Certified EHR Technology" and "lack of Face-to-Face Interaction" as reasons for applying for hardship exemptions.

Hardship exceptions are valid for one payment year only. If an EP claims a hardship exception for the following payment year, a new application must be submitted.

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