Bill Allows Mass Exemptions From EHR Meaningful Use Penalty

December 22, 2015

The House and Senate last week passed a bipartisan bill that would help spare physicians a 3% Medicare pay cut in 2017 by rectifying extreme and uncontrollable circumstances created by none other than the Centers for Medicare & Medicaid Services (CMS).

On October 6, CMS released its final rules for how physicians could comply with Medicare's incentive program for meaningful use of electronic health record systems in 2015. Physicians needed to satisfy meaningful use requirements for only a 90-day period of their choosing, as opposed to the entire year, according to CMS. Failure to do so would mean a 3% reduction in Medicare reimbursement 2 years later.

The trouble was, there were fewer than 90 days left in 2015 when the regs came out, making it impossible for physicians to comply and avoid the penalty.

CMS recognized this absurd situation right away and said physicians could apply for a hardship exemption from the 2017 penalty under the category of "extreme and uncontrollable" circumstances. The agency would review the applications on a case-by-case basis, as required by law.

Get ready for a million hardship applications, organized medicine warned CMS.

Sen. Rob Portman (R-OH) aimed to head off this looming bureaucratic logjam by introducing a bill called the Patient Access and Medicare Protection Act. One provision allows CMS to grant meaningful hardship exemptions for the 2017 penalty not only to individual physicians on a case-by-case basis but also to entire categories of physicians, as in all physicians beset by extreme and uncontrollable circumstances. Physicians will have until March 15 to apply for this mass escape hatch.

The bill, quickly passed by the House and Senate on December 18, now awaits the signature of President Barack Obama.

Assuming the president inks the legislation, the next likely step is for CMS to tell physicians how to apply for this blanket exemption from the 2017 meaningful use penalty, a spokesperson for the American Academy of Family Physicians told Medscape Medical News. A CMS spokesperson said the agency was unable to comment because "this is still legislation in progress."

American Academy of Family Physicians President Wanda Filer, MD, said in a news release that the passage of the act "heralds a reprieve to physician practices that are unable to successfully attest to meaningful use for 2015, through no fault of their own."

"This legislative solution will more easily allow CMS to make physicians whole," Dr Filer said.

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