Republican Senators are asking the Centers for Medicare and Medicaid Services for details on its new plan to grant hardship exemptions to health care providers who are struggling to comply with Stage 2 EHR meaningful use requirements. Last week, CMS announced at HIMSS14 the availability of the hardship exemptions during 2014, but GOP lawmakers are seeking clarification on the qualification criteria.  

“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. How will these categories be expanded? Will the applications be due April 1? What documentation or standard of proof must be met to obtain an exception? What is the timing for review, and will there be an appeals process?,” wrote six senators in a letter to CMS Administrator Marilyn Tavenner.

Senators Lamar Alexander (R-Tenn.), John Thune (R-S.D.), Richard Burr (R-N.C.), Tom Coburn (R-Okla.), Mike Enzi (R-Wyo.) and Pat Roberts (R-Kan.) also expressed their disappointment with CMS' decision. “Despite the overwhelming outpouring of concern about the Stage 2 regulations, you announced in a speech last week that the timing of Stage 2 will not change," wrote the senators. "Instead, you said that hardship exceptions will be available. We were disappointed to hear this announcement, even more so because of the lack of clarity about how the exceptions will be administered."

In September, the senators sent a letter to Health and Human Services Secretary Kathleen Sebelius requesting additional time for health care providers to meet Stage 2 EHR requirements. However, as the letter to Tavenner points out, the Obama administration has "refused that request, and instead announced it will grant hardship exemptions, but provided no details on the criteria providers will have to meet, or explained how a plan to grant narrow exceptions will address widespread challenges in meeting the deadline."

The senators stated in their letter that last week "close to 50 provider groups representing nearly every hospital, doctor, and vendor organization in America warned CMS that the program is at risk of failure due to the many providers and vendors who may be unable to upgrade their systems in time." If these providers are unable to meet the requirements in 2014, they will have to pay "steep penalties" that are "unfair to providers who are making good faith efforts to upgrade their electronic health record systems, but do not have enough time or the financial resources to accomplish this upgrade in the timeframe CMS allowed."

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