Let's get this out of the way: Yes, there is a very strong likelihood that the Senate will vote this week on a bill to repeal and replace the Affordable Care Act. The so-called Graham-Cassidy legislation picked up considerable steam late last week.
In the meantime, life goes on. For physicians transitioning to a new payment model, this is also a big week. First-time participants in the Medicare EHR Incentive Program need to act now to avoid a payment penalty. The deadline for filing a hardship exemption is Oct. 1.
The exemptions give providers who are transitioning to the new Merit-based Incentive Payment System a way to avoid 2018 payment penalties for not demonstrating meaningful use in the 2016 reporting year because they would have experienced "significant hardship" in meeting the requirements. "Hardship exemptions are one way that CMS can help protect physicians from penalties when it is nearly impossible for them to participate successfully in federal programs," said Dr. David Barbe, president of the American Medical Association.
In addition to being first-time participants this year, eligible providers who want to be exempt must also be moving into the MIPS track of MACRA for the 2017 performance period and be reporting data for the MIPS advancing care information performance category in 2017.
These providers, who can be exempted only once, might apply for exceptions if they lack internet access or suitable infrastructure, or if they've been hit by a natural disaster. But the most common reason will likely be that they didn't yet have an EHR during the reporting period, said Robert Tennant, director of health information technology policy for the Medical Group Management Association. For the subset of those providers who have many Medicare patients, meeting the exemption application deadline is crucial, Tennant said, since "the penalty will be significant and could potentially impact their financial ability to buy technology going forward." The CMS will also accept hardship exemption applications from eligible professionals whose previously certified EHRs were decertified in the year before or during the reporting period for 2018 payments.
This year, about 171,000 Medicare eligible professionals could be penalized for not meeting meaningful use, according to the CMS.
