CMS proposes stage 2 hardship exemption extension

CMS proposes stage 2 hardship exemption extension

So far, 2014 has been a year of delays and postponements for the health care industry. It began with an ICD-10 bill from Congress that moved so quickly through both legislative bodies that provider groups and the Centers for Medicare and Medicaid Services barely had time to rally support in favor of the original ICD-10 deadline. Now, it appears that meaningful use will receive its own moratorium. However, unlike the ICD-10 delay, health care professionals are likely to welcome this one.

According to a joint proposal issued by the CMS and the Office of the National Coordinator for Health Information Technology, the agencies would like to extend the hardship exemption for physicians and hospitals currently participating in stage 1 of meaningful use. While the health care industry was initially granted a shorter exemption earlier this year, the current proposal would give those eligible another full year to coordinate with third-party vendors, who the CMS and ONC fingered as the root cause of the extension.

Physicians and hospitals get more time
Stage 1 of meaningful use was originally scheduled to come to an end in 2014. Participants would either have to successfully attest and move on to stage 2 or drop out of the program entirely. However, ongoing issues with certified software and third-party vendors have caused the CMS and ONC to rethink the meaningful use timeline.

In the joint proposal, the agencies cite the fact that concerted and continuous feedback from the health care industry about the lack of 2014-certified electronic medical record technology caused them to propose the extension. The CMS requires all participating health care organizations to use EMR software certified up to the current year, but vendors have been slow to develop EMR systems that comply with federal regulations. In turn, this has caused health care companies to keep using old software that ostensibly would not allow them to successfully attest to stage 1.

Under the proposed one-year extension, physicians and hospitals still need to prove that delays in acquiring certified EMR software were caused by third-party vendors and not internal issues. If they can do so, the CMS and ONC hope that this will allow more organizations to successfully move on to stage 2 when the time is right.

Karen DeSalvo, national coordinator for health information technology, said in a statement that the hardship exemption extension "will give new options to those who, through no fault of their own, have been unable to get the new 2014 Edition technology, including those at high risk, such as smaller providers and rural hospitals."

Timeline extension may come too late
Health care organizations have been under strain due to ICD-10 and meaningful use through the last several years that it is unlikely professionals will criticize the CMS and ONC for allowing them more time. However, some experts believe that such a proposal may be too little, too late.

Richard Schreiber, chief medical informatics officer at Pennsylania-based Holy Spirit Health System, told Modern Healthcare that had this hardship exemption extension come months ago, he would have rallied behind it. The proposal will stay open for a 60-day open comment period that will end mid-July. After that, the fate of the proposal is unclear, and Schreiber explained that he may not be willing to hold his entire organization up if he has to wait to find out.

"If it's going to be four to six months to final [regulations], three months brings us into the next quarter, and I've already had to make my decision," Schreiber told the news source.


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