Lack of infrastructure and unforeseen or uncontrollable circumstances are not the only criteria the Centers for Medicare and Medicaid Services will consider in granting hardship exemptions to health care providers who are struggling to comply with Stage 2 EHR meaningful use requirements. CMS has also added "2014 EHR vendor issues" as an acceptable reason.

In order to qualify, CMS' hardship exemption application form for eligible hospitals states: "During the fiscal year (2014) preceding the payment adjustment year (2015), the Hospital's EHR vendor was unable to obtain 2014 certification or the Hospital was unable to implement meaningful use due to 2014 EHR certification delays." The form emphasizes that "circumstance must be beyond the Hospital’s control and the Hospital must explicitly outline how the circumstance significantly impaired the Hospital’s ability to meet Meaningful Use."

Hospitals applying for a hardship exemption must submit the application electronically by April 1 or in writing postmarked by Midnight EDT. Eligible professionals must submit their application no later than midnight EDT on July 1.

Eligible professionals, in addition to EHR vendor issues, lack of infrastructure and unforeseen/uncontrollable circumstances, also can 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, according to the CMS application form.

At HIMSS14, CMS announced the availability of the hardship exemptions during 2014. Last week, six Republican senators sent a letter to CMS Administrator demanding clarification of the qualification criteria for the program. The lawmakers complained that the CMS website "currently says hardship exceptions are available only in certain narrow circumstances—such as a lack of broadband internet or an unforeseen natural disaster" and asked how these categories might be expanded.

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