EP Meaningful Use Payment Adjustments and Hardship Exception

As the reporting period start date deadlines are drawing near for Eligible Professionals (EP), and vendors are still working to get their EHR’s certified and rolled out to their customers, a big question on everyone’s mind is ‘what happens if I can’t attest in 2014?’. Eligible Professionals must begin their 90-day reporting period by October 1, 2014 in order to attest in 2014. So what options do EP’s have if they can’t meet these deadlines?

First, let’s look at who Payment Adjustments affect and when these adjustments begin. The adjustments will affect Medicare EP’s as well as EP’s that bill Medicare and can participate in either the Medicare or Medicaid EHR Incentive Programs. The only individuals who are not affected are Medicaid EP’s who can only participate in the Medicaid EHR Incentive Program and do not bill Medicare. If you are eligible for both the Medicare and Medicaid programs, you must demonstrate meaningful use in order to avoid the payment adjustment – receiving a payment for adopt/implement/upgrade (AIU) under the Medicaid EHR program does not make you exempt from payment adjustments.

Adjustments will be applied at the beginning of the 2015 calendar year for EP’s (January 1, 2015). For EP’s, the Adjustment starts at 1% and increases by 1% for every year that an EP is not meaningful user with a maximum adjustment of 5%. EP’s must continue to demonstrate meaningful use every year to avoid payment adjustments in subsequent years.

So, how does CMS determine who the 2015 adjustments apply to? In order to avoid the adjustments, EP’s must demonstrate MU prior to 2015 calendar year. This means they have either attested to MU successfully in the 2013 reporting year or the 2014 reporting year.

What if your vendor does not deliver software to you in time to attest in 2014? In this case you can apply for a Hardship Exception based on the reason of ‘2014 Vendor Issues’.

If you are an EP planning to attest for the first time in 2014 (new participant) and your vendor will not meet the deadline for you to attest in 2014, you can apply for a hardship exception for the 2015 payment adjustment.  You must attest by October 1, 2014 to receive incentives and avoid 2015 penalties. If you cannot attest by October 1, 2014, EP’s should apply for the hardship to avoid 2015 penalties.  To apply, use the eligible professional hardship exception form for 2015. These forms must be submitted to CMS by July 1, 2014.

EP Hardship Exception Form

If you are an EP who attested to MU in the 2013 reporting year, you will not be subjected to the 2015 payment adjustment. But if your vendor is not able to deliver a 2014 certified solution before the attestation deadline, you can apply for a hardship exception for the 2016 payment adjustment. To apply, use the eligible professional hardship exception for 2016 which will be available after July 1, 2014. These forms must be submitted to CMS by July 1, 2015.

Contact Dynamic Health IT if you have questions about Meaningful Use or if you need assistance with your 2014 Edition Certification at 504-309-9103.