Rule writers at the CMS once again are making adjustments to the timeline of the federal electronic health-record incentive payment program. The change this time effectively corrects an earlier provision that would have forced some providers to suffer Medicare payment cuts next year through no fault of their own.
The changes appear under the heading of “Extreme Uncontrollable Circumstances Hardship Exemption” on seven pages near the back of the massive, 1,185-page final rule on the physician fee schedule.
They will allow certain groups of hospitals, critical-access hospitals, physicians and other professionals eligible to participate in the incentive program more time to file hardship requests to avoid Medicare payment reduction penalties.
Hospitals and physicians and other professionals now have a Nov. 30, 2014 deadline to file those specific hardship exemptions. The previous filing deadlines had been July 1 for hospitals and Oct. 1 for physicians and other EPs.
The Catch 22 was that the effective date of a prior-related CMS rule didn't go into effect until Oct. 1, well after hospitals' deadline for filing hardship exemptions, and on the very day of a similar deadline for physicians and other EPs.
The CMS expanded the hardship exemption in response to industry complaints that health IT systems vendors were behind in their deliveries of updated EHRs and other IT systems and, therefore, providers couldn't use them to meet the program's meaningful-use criteria.
Critical-access hospitals previously had until Nov. 30 to file their hardship exemptions for these “extreme and uncontrollable circumstances,” so they should have had “ample time to attest” under the flexibility options offered on the prior CMS rule, the most recent rule said.
However, “to maximize flexibility” to all providers in the hardship exception application process, and “so that we avoid similar situations in the future,” the CMS gave itself going forward “the flexibility to specify an alternative hardship exemption application submission deadline (other than Nov. 30) for certain hardship categories.”
The problem—which surfaced in September—in part involved logic built into a CMS website that was unable to handle attestations of compliance from a narrow subset of program participants.
The same new fee schedule rule, issued on Halloween, also contained a provision that increased flexibility over the types of software required by providers seeking to qualify for the new chronic-care management programs under Medicare.
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