CMS must act now on guidance for 'unforeseen' MU hardship exceptions

There appears to be a big disconnect between desire and reality when it comes to Stage 2 of the Meaningful Use Incentive Program. On one hand, you've got the Office of the National Coordinator for Health IT, which earnestly wants to forge on with Stage 2 on time in January 2014. Stage 2, as you may recall, has already been delayed once.

On the other hand, you've got the reality that a lot of electronic health record products are not yet certified for the 2014 edition software that supports Stage 2 of the program. Some vendors are scrambling, but haven't attained certification yet. Others are opting to drop out of the market entirely. More than 3,500 ambulatory EHR products or modules were certified for 2011; only 174 have attained 2014 certification.

"If a vendor changes course, it may be reasonable for the vendor but the little guy is left out in the cold," Frank Ruelas, a consultant and compliance officer with Gila River Health Care, located on the Gila River Indian Reservation in Arizona, recently told FierceEMR.

The upshot? A lot of a lot of hapless providers--many of them the smaller physician offices that already are struggling with EHR adoption and Meaningful Use--will take a financial hit in terms of both lost incentive payments and penalties for not attesting.

So what are these providers supposed to do? If a vendor can't or won't be 2014 certification-ready, many eligible professionals will simply have to switch EHR systems to stay in the program. Although studies have shown that many physicians, unhappy with their first EHR purchase, already plan to change vendors, at least they have the luxury of choosing how and when to do so. It's quite different when you're forced into such action.

The answer lies in the hardship exception for unforeseen circumstances.

This is one of the five hardship exceptions for which eligible professionals can apply. Providers that meet a hardship exception are exempt from EHR penalties, at least temporarily.

CMS has been dropping hints that lack of a 2014-certified EHR product may, in certain circumstances, qualify as an "unforeseen circumstance." In a provider call in August, CMS official Travis Broome noted that loss of a certified EHR or other unforeseen health IT event out of the control of the provider may fall within this exception, and encouraged providers in this boat to apply.  

Broome also indicated that CMS may publish guidance on this issue.

That guidance would be very welcome relief to the many providers finding themselves in this very predicament.

But that dangling carrot was mentioned back in August. If any guidance is forthcoming, CMS must act quickly. Switching EHRs vendors takes time, and 2014 is right around the corner. - Marla (@MarlaHirsch @FierceHealthIT)

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