The week after Christmas is always a hard one. There’s a reason why the term “post-holiday blues” is now a recognized phenomenon. One day you are unwrapping gifts and sipping on egg nog without a care in the world. The next there’s despair as you realize all those items you promised yourself would be dealt with ‘after the holiday’ are eagerly awaiting your return.
For those who are still hanging onto the rollercoaster ride called Meaningful Use, it’s also a time of sheer panic, wondering if each task has been completed with the end of the year fast approaching.
I know Meaningful Use is probably the last thing you want to read about right now, but hopefully the following news will ease those blues and keep you in the holiday spirit.
A Blanket Hardship Exemption
It may have been the unusually warm weather or the upcoming holiday that had the Senate and Congress in good cheer, because on Dec 18, both groups quickly passed Bill S.2425, also known as the “Patient Access and Medicare Protection Act.”
The Patient Access and Medicare Protection Act, sponsored by U.S. Senator Rob Portman (R-Ohio), included a number of health-related provisions, from wheelchair accessories to radiation therapy services to flexibility in applying for Meaningful Use hardship exemptions for the 2015 reporting period.
The bill (which Portman called “common sense”) will make it easier for providers to get approved for a hardship exemption for the 2015 reporting period due to CMS’s tardiness in releasing the modified stage 2 final ruling.
Just to give you a quick refresher, the modified stage 2 final rule aligned the objectives for both stage 1 and 2 by removing the core and menu framework, reducing the number of required objectives. It also lessened the reporting period from a full calendar year to any 90-day reporting period in 2015. The problem was there were fewer than 90 days left in the year when the rule was released in October. This made it nearly impossible for providers to understand the changes and attempt to course correct.
CMS understood that their late ruling could put some providers in an unsuccessful position to attest. Therefore, they announced that providers who were adversely affected by the late modifications could apply for a hardship exemption (under the “extreme and uncontrollable circumstances” category).
Cue the flood of applications!
The vague nature of the new hardship option will most likely overwhelm CMS with more applications than they can handle.
Under current law, CMS can only grant hardship exemptions on a case-by-case basis. The existing process is tedious and slow – and, if not streamlined, could leave thousands of providers on the hook for a 3% penalty in 2017.
CMS could either sift through thousands upon thousands of hardship applications due to the late ruling, or just throw its hands up and grant a “blanket” exception for all those who filed: thus introducing the Patient Access and Medicare Protection Act. The Act only contains three short paragraphs on MU that focus on giving CMS the authority to streamline the hardship exemption process for applications received through March 15, 2016.
“This much needed relief will make the hardship application process much easier for doctors to avoid penalties stemming from the Administration’s mistake, and thereby provide more time to care for patients,” said Rep. Tom Price, M.D. (R-Ga.).
Any hardship application received after March 15, 2016, would revert back to the old case-by-case process.
This is a little different from what the American Medical Association requested. They requested that an automatic hardship be given to all providers who did not successfully attest in 2015. The Patient Access and Medicare Protection Act would require that providers still file a hardship application.
To file or not to file?
After the October ruling was released, my inbox began to fill up with emails from providers and practice managers wondering if they should just take the new 2015 hardship exception and throw in the towel. Although it sounded like the easy thing to do, nothing with Meaningful Use has proven to be easy thus far.
Under the current “case-by-case” hardship application process, filing for the new hardship option seemed to be too risky. What if CMS didn’t approve their application in time? By then it would be too late to try to attest. On the flipside, could they even meet the Meaningful Use objectives this late in the game? It’s a bureaucratic logjam.
However, if the Patient Access and Medicare Protection Act does become law, filing for the new hardship would provide a huge reprieve. It would allow providers to procure a hardship waiver a lot quicker and thereby return their focus back to the patient.
Hopefully President Obama returns from holiday break with relaxed, nimble fingers to quickly sign the bill into law!
Diana Strubler, Senior Product Analyst, Health IT Standards, joined Acumen in 2010 as an EHR trainer then quickly moved into the role of certification and health IT standards subject matter expert. She has successfully led Acumen through three certifications while also guiding our company and customers through the world of Meaningful Use, ICD-10 and PQRS.