Health Law Blog - Healthcare Legal Issues

Vendor Delays Hardship EHR Meaningful Use Implementation Standards

CMS Recognizes Hardship Exemption From Meaningful Use Standards

meaningful use,vendor delays,cms hardshipThe American Recovery and Reinvestment Act of 2009 mandates a reduction in payments to eligible Medicare providers who have not met meaningful use standards for electronic health record technology.  Payment adjustments begin October 1, 2014, for hospitals and January 1, 2015, for Medicare eligible professionals.

CMS has created a hardship exception that permits providers to request an exemption from the payment adjustments in certain circumstances.  The hardship exemption lasts for one payment year.  A provider can be granted up to five years worth of hardship exceptions but must reapply on a yearly basis.

In order to be granted a hardship exception, providers must prove that special circumstances pose a significant barrier to their achieving meaningful use.  A few of the circumstances where hardship may be considered include the following:

  • Being located in an area without sufficient internet access or with other insurmountable infrastructure barriers.
  • Professionals who are new to the practice and who have not had time to become meaningful users can apply for a two-year limited exception to the payment adjustment rules.
  • Certain other unforeseen circumstances such as natural disasters or other unforeseeable impediments to meeting standards.

Recently, CMS added a new potential hardship for providers who are faced with EHR vendor issues.  In order to be eligible for the vendor exemption, a provider must demonstrate that circumstances are beyond its control and must explicitly outline these circumstances and indicate how they significantly impaired the ability to meet meaningful use standards.

The standards applied to receive a hardship exemption are fairly narrow and can be difficult to meet.  However, providers who see potential significant impediments to their implementation of meaningful use should begin to consider the possibility of applying for hardship exemption.  If the hardship exemption is going to be based upon EHR vendor difficulties, the implementation difficulty should be clearly documented.  At the time of application for a hardship exemption, the complete circumstances involved in the vendor relationship will need to be described to CMS.

If you have any further questions regarding electronic health record information or other health law questions, please contact John Fisher, II of our health law practice.

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John H. Fisher

Health Care Counsel
Ruder Ware, L.L.S.C.
500 First Street, Suite 8000
P.O. Box 8050
Wausau, WI 54402-8050

Tel 715.845.4336
Fax 715.845.2718

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