CMS offers EHR hardship exceptions to avoid penalties

Penalties could cost ODs thousands of dollars if they don’t act.

Optometrists who face barriers to achieving meaningful use of electronic health records (EHRs) can apply for certain exceptions this summer to avoid penalties in 2015.

Federal regulators recently granted more time for providers to attest to meaningful use of certified EHR technology in 2014. However, those who don't meet the requirements of the EHR incentives program face penalties under the Medicare program beginning in 2015.

EHRs, for example, need to be certified for the Medicare incentives program. Penalties could cost ODs thousands of dollars if they don't act, says Rodney Peele, the AOA's assistant director for regulatory policy and outreach. The AOA continues to educate members about these requirements and what they can do to possibly avoid penalties, he says. One way to do so is to request a so-called "hardship exception" from the Centers for Medicare and Medicaid Services.

CMS criteria for hardship exceptions

The AOA urges members to be aware of the deadlines to request such exceptions—and the limitations Medicare places on granting them.

In a recent guidance document, CMS lists a number of circumstances in which an eligible provider can apply for a hardship exception and avoid a penalty:

  • The provider can't get sufficient access to the Internet or faces other infrastructure barriers.
  • They're newly practicing but eligible and haven't had enough time to establish meaningful use of EHRs. In this instance, providers could apply for a two-year exception.
  • They're practicing at multiple locations and can't control the availability of certified EHR technology for half of their patient encounters.
  • Natural disasters or other unforeseen circumstances occur.
  • The provider faces patient interaction barriers.
  • The provider is struggling with vendor certification issues for 2014.

CMS recently added the exemption related to vendor issues. Take note of this new exemption if you have faced issues with vendor certification.

In its guidance, CMS specifies that eligible providers must prove that they're facing "a significant barrier to achieving meaningful use" under any of these circumstances. 

How to apply for exceptions

For physicians who are not participating in meaningful use, applications for a hardship exception are due July 1 to avoid the 2015 penalty.

The exceptions are valid for one year. A new application will have to be submitted in future years if the barriers to achieving meaningful use persist. As an example, those wanting to avoid 2016 penalties must apply by July 1, 2015, for an exception.

Providers can't be granted an exception for more than five years. Also, any CMS determination regarding a hardship exemption is final and can't be appealed.

The hardship exception application is available online. ODs should take note that submitting a handwritten application can delay processing. They should also be aware that various types of supporting documentation must be submitted with the application.

Not everyone has to worry about the hardship exception deadline; for example, ODs who demonstrated meaningful use last year and will avoid the 2015 penalties.

March 26, 2014

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