CMS issues guidance on Stage 2 hardship exceptions

Answering pressure to provide more details about hardship exception from Stage 2 meaningful-use requirements, the CMS issued guidance that gives hospitals and eligible professionals more time if their EHR vendor is to blame for their failure to meet the deadline.

Until now, CMS Administrator Marilyn Tavenner said only that Stage 2 compliance dates under the federal electronic health record incentive payment program would not be pushed back and that hardship exception applications would be evaluated on a case-by-case basis. Few details about the requirements, deadlines and process for winning an exception had emerged, prompting six Republican senators—Sens. 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.)—to prod Tavenner for clarification.

New language in applications for the exception for hospitals (PDF) and for eligible professionals (PDF) allows them to apply for a one-year exemption in the event of “2014 EHR vendor issues.”

Specifically, providers can apply for hardship exceptions if the “EHR vendor was unable to obtain 2014 certification” or the eligible professional or hospital “was unable to implement meaningful use due to 2014 EHR certification delays.”

It isn't the solution proposed last month when nearly 50 U.S. healthcare groups, including the College of Healthcare Information Management Executives, petitioned HHS Secretary Kathleen Sebelius for meaningful-use extensions. But it is a step in the right direction, according to Jeff Smith, CHIME's senior director of federal affairs.

“What was released is absolutely going to be helpful to a certain cross section of providers facing challenges relating to availability and implementation of 2014 EHRs,” Smith said. “While they didn't take our exact policy prescription, it is clear they have heard us.”

The deadline for hospitals to apply is midnight, April 1, while the deadline for eligible professionals is midnight, July 1. If approved, a hardship exception will be valid for one payment year, while denials of such an exception will be final and not subject to an appeals process.

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