Blanket MU hardship exemption a relief to providers, CMS alike

The news that eligible hospitals and providers participating in the meaningful use program can apply for a blanket hardship exemption to avoid reimbursement penalties certainly is welcomed relief, but CMS stands to gain from the rule as well.

Last Friday, Congress passed bill S. 2425, which allows any eligible hospital or professional to apply for an exemption from meaningful use penalties in 2017. Previously, hospitals and professionals had to meet certain criteria and qualifications to apply for the exemption.

Dan Golder, DDS, principal at Impact Advisors, says relief is likely felt by providers and CMS alike.

For providers, the hardship exemption offers an obvious respite in their journey to meaningful use attestation. Not only does it stave off penalties, but it softens the burden of meeting the newly released stage 3 requirements, which CMS released in early October. 

Dr. Golder said the release of the stage 3 final rules was late in the year, meaning a series of events had to coincide and sequence for an eligible professional or eligible hospital to meet meaningful use. "The rule has to come out, your EHR developer has to look at the rule and interpret it, and they have to write code," he said. "That code has to be tested, then it has to be rolled out for implementation. Providers have to get in the implementation queue, get software updated, then change their workflow before they can even start measuring for the attestation period. There's no time to do all those things."

EHR developers and vendors may also be reassured with the change, as they now have a little more breathing room so the timeline for development isn't so crunched. When working under deadlines, vendors may expedite their development and move through processes quicker than normal, which can heighten the likelihood of errors or the possibility of a software bug. "Accelerating timelines is never really a good idea in software development," Dr. Golder says.

When the stage 3 rules were released, the first week of the final attestation period had already passed. Dr. Golder says since CMS "ran up against the calendar" with the final stage 3 rule, the provided relief is arguably warranted. 

What's more, CMS eases the burden on itself with this blanket exception. Since the agency no longer has to review hardship exemptions on a case-by-case basis, that eliminates thousands of applications it needed to individually review, says Dr. Golder, who adds CMS has faced growing pressure and complexities throughout the program.

"If you look at how long it took [CMS] to come out with the final rule, some of that may just be the complexity of meaningful use and layers of review," Dr. Golder says. "That might be the biggest thing that, maybe, was overlooked when they started meaningful use: the amount of complexity and administrative burden for both providers and CMS to administer the program."

More articles on meaningful use:

25 things to know about the state of health IT 
AMA, CHIME want to fix meaningful use based on these 11 recommendations 
Geisinger, Kaiser applaud unique device identifier requirements in MU 

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