American Hospital Association Recommends Revisions to Medicare ACO Models

As we enter the sixth year of the Medicare and Medicaid Electronic Health Records Incentive Programs (commonly referred to as the “Meaningful Use Programs”), the Centers for Medicare & Medicaid Services (CMS) continues to make adjustments to the Meaningful Use Programs to better accommodate providers and suppliers. Two recent updates are described below.

CMS Streamlines Hardship Exception Process

CMS recently announced important changes to the hardship exception application process for the Medicare Meaningful Use Program. Under the Medicare Meaningful Use Program, eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) that do not qualify for meaningful use are subject to Medicare payment penalties. The Patient Access and Medicare Protection Act (PAMPA), Pub. L. No. 114-115, which President Obama signed into law on December 28, 2015, now requires CMS to consider hardship exceptions for certain categories of EPs, eligible hospitals, and CAHs that were identified on CMS’s website as of December 15, 2015. These include categories such as insufficient internet connectivity, extreme and uncontrollable circumstances (e.g., natural disasters), lack of control over EHR technology (EPs only), and lack of face-to-face interactions (EPs only). Under prior law, CMS considered all hardship waivers on a “case-by-case” basis.

With these changes, CMS has adopted a more streamlined process for applying for a hardship exception. As in the past, EPs, eligible hospitals, and CAHS must be mindful of the applicable deadlines for applying for hardship exception. For EPs, that deadline is March 15, 2016; for eligible hospitals and CAHs, the deadline is April 1, 2016. As an additional accommodation, CMS indicates that EPs who practice in a medical group may use one hardship exception application for all EPs in the group, and eligible hospitals and CAHs that include inpatient and outpatient settings may include both the individual Nation Provider Identifiers (NPIs) for any EPs and the CMS certification number (CCN) for the eligible hospitals and CAHs on a single submission for their organization.

These changes should help qualifying EPs, eligible hospitals, and CAHs avoid the sting of Medicare payment penalties. CMS has posted the updated hardship exception materials on its website.

CMS Extends Meaningful Use Program Attestation Deadline

To allow EPs, eligible hospitals, and CAHs additional time to attest to meaningful use for 2015, CMS has extended the attestation deadline for the Medicare Meaningful Use Program from February 29, 2016 to March 11, 2016. EPs, eligible hospitals, and CAHs can access the Meaningful Use Program attestation website here.