MU	
  Hardship	
  Excep0ons	
  
Wednesday,	
  April	
  2,	
  2014	
  
Disclaimer:	
  Nothing	
  that	
  we	
  are	
  shari...
Agenda	
  
•  Introduc-ons	
  	
  
•  Background	
  
•  Payment	
  Adjustments	
  
•  What	
  is	
  Hardship	
  Excep-on?	...
Background	
  
•  Part	
  of	
  ARRA	
  (American	
  Recovery	
  and	
  
Reinvestment	
  Act)	
  congress	
  mandates	
  
...
•  EP’s	
  who	
  did	
  not	
  meet	
  MU	
  in	
  beginning	
  of	
  
2014	
  
•  Payment	
  adjustment	
  is	
  applied...
Adjustment	
  Impact	
  
•  If	
  75%	
  of	
  EP’s	
  meet	
  MU	
  by	
  2018	
  the	
  
adjustment	
  caps	
  at	
  3%	...
Adjustment	
  Impact	
  Table	
  
>	
  75%	
  EP’s	
  MU	
   <	
  75	
  EP’s	
  MU	
  
2015	
   99%	
   99%	
  
2016	
   9...
EP’s	
  A[ested	
  Prior	
  to	
  2015	
  	
  
•  EP’s	
  that	
  first	
  a[ested	
  in	
  2011	
  and	
  2012	
  must	
  ...
What	
  is	
  the	
  Hardship	
  Excep-on	
  
•  An	
  excep-on	
  that	
  allows	
  EP’s	
  to	
  avoid	
  the	
  payment...
Do	
  I	
  Qualify?	
  
•  EP’s	
  a[es-ng	
  for	
  first	
  -me	
  in	
  2014	
  but	
  unable	
  
to	
  implement	
  CEH...
Eligible	
  Providers	
  
– Infrastructure	
  
– New	
  eligible	
  
professionals	
  
– Unforeseen	
  
circumstances	
  
...
Infrastructure	
  
•  EP’s	
  must	
  demonstrate	
  they	
  are	
  without	
  
sufficient	
  internet	
  access	
  
•  EP’s...
New	
  Eligible	
  Professionals	
  
•  New	
  EP’s	
  granted	
  a	
  2	
  year	
  limited	
  excep-on	
  
•  New	
  EP’s...
Unforeseen	
  Circumstances	
  
•  Natural	
  disaster	
  
•  Other	
  unforeseen	
  circumstances	
  
Prac-ce	
  at	
  Mul-ple	
  Loca-ons	
  
– Lack	
  of	
  control	
  over	
  availability	
  of	
  CEHRT	
  of	
  
more	
  ...
Pa-ent	
  Interac-on	
  
•  Lack	
  of	
  face	
  to	
  face	
  interac-on	
  with	
  pa-ents	
  
•  Lack	
  of	
  follow	...
EHR	
  Vendor	
  Issues	
  
•  Vendor	
  unable	
  to	
  obtain	
  CEHRT	
  cer-fica-on	
  
2014	
  
•  EP	
  unable	
  to	...
Exemp-on	
  
•  Special-es	
  classified	
  in	
  the	
  Medicare	
  Provider	
  
enrollment	
  Chain	
  and	
  Ownership	
...
Exemp-on	
  
•  EP’s	
  enrolling	
  in	
  a	
  new	
  Medicare	
  program	
  
•  Hospital	
  based	
  EP’s	
  for	
  2012...
Applica-on	
  
•  Applica-ons	
  must	
  be	
  completed	
  and	
  signed	
  electronically	
  
by	
  July	
  1,	
  2014	
...
Mul-ple	
  NPI’s	
  Applica-on	
  
•  A	
  physician	
  that	
  has	
  mul-ple	
  NPI’s	
  will	
  need	
  to	
  
complete...
Q&A	
  
dan.holleran@quirkhealthcare.com	
  
aaron.rucker@quirkhealthcare.com	
  	
  
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MU Hardship Exceptions

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In this webinar, we explore the topic of Meaningful Use (MU) hardship exceptions. This should be of great interest to practices who are unable to attest for MU Stage 2 through no fault of their own. Here you'll find background on the exceptions, the categories CMS uses to determine valid hardships, and basic instructions on how to apply.

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MU Hardship Exceptions

  1. 1. MU  Hardship  Excep0ons   Wednesday,  April  2,  2014   Disclaimer:  Nothing  that  we  are  sharing  is  intended  as  legally  binding  or  prescrip7ve  advice.  This  presenta7on  is  a   synthesis  of  publically  available  informa7on  and  best  prac7ces.  
  2. 2. Agenda   •  Introduc-ons     •  Background   •  Payment  Adjustments   •  What  is  Hardship  Excep-on?   •  Impact  of  Excep-on   •  MU  Hardship  Deadline   •  Who  Qualifies?   •  What’s  next?     •  Q&A  
  3. 3. Background   •  Part  of  ARRA  (American  Recovery  and   Reinvestment  Act)  congress  mandates   adjustments  applied  to  EP’s  (eligible   professionals)  who  did  not  meet  MU   •  Payment  adjustments  applied  star-ng  Jan  1,   2015   •  Medicaid  only  providers  are  not  included  in   adjustments  
  4. 4. •  EP’s  who  did  not  meet  MU  in  beginning  of   2014   •  Payment  adjustment  is  applied  to  the   Medicare  physician  fee  schedule   •  Payment  adjustment  is  1%  per  year     •  Payment  adjustment  is  cumula-ve  for  every   year  the  provider  does  not  meet  MU   •  Payment  adjustments  begin  January  1,  2015   Payment  Adjustments  
  5. 5. Adjustment  Impact   •  If  75%  of  EP’s  meet  MU  by  2018  the   adjustment  caps  at  3%   •  If  less  than  75%  of  EP’s  meet  MU  by  2018  the   adjustment  can  reach  as  high  as  5%  
  6. 6. Adjustment  Impact  Table   >  75%  EP’s  MU   <  75  EP’s  MU   2015   99%   99%   2016   98%   98%   2017   97%   97%   2018   97%   96%   2019   97%   95%   2020   97%   95%  
  7. 7. EP’s  A[ested  Prior  to  2015     •  EP’s  that  first  a[ested  in  2011  and  2012  must   demonstrate  MU  for  a  full  calendar  year  in   2013   •  Aer  a[es-ng  EP’s  must  maintain  MU   compliance  every  calendar  year  thereaer  to   avoid  adjustments   •  October  1,  2014  last  day  to  a[est  to  avoid   adjustment  in  2015  
  8. 8. What  is  the  Hardship  Excep-on   •  An  excep-on  that  allows  EP’s  to  avoid  the  payment   adjustments  star-ng  in  2015   •  Only  given  under  circumstances  outlined  by  CMS   •  CMS  determines  if  circumstances  pose  barrier  to   achieving  MU   •  Provider  must  show  that  demonstra-ng  MU  would  result   in  significant  hardship   •  Applica-on  must  be  submi[ed  in  addi-on  to  proof  of  the   hardship   •  Hardship  will  last  for  one  year   •  Hardship  excep-on  can  be  u-lized  a  maximum  of  5  years  
  9. 9. Do  I  Qualify?   •  EP’s  a[es-ng  for  first  -me  in  2014  but  unable   to  implement  CEHRT   •  Payment  adjustments  only  apply  to  Medicare   Incen-ve  program   •  Adjustments  do  not  apply  for  Medicaid  
  10. 10. Eligible  Providers   – Infrastructure   – New  eligible   professionals   – Unforeseen   circumstances   – 2014  EHR  vendor   issues   – Pa-ent  interac-on   – Prac-ce  at  mul-ple   loca-ons   Eligible  Hospitals   – Infrastructure   – New  eligible   professionals   – Unforeseen   circumstances   – 2014  EHR  vendor   issues   Reasons  for  Excep-on  
  11. 11. Infrastructure   •  EP’s  must  demonstrate  they  are  without   sufficient  internet  access   •  EP’s  must  demonstrate  barriers  faced  to   obtaining  infrastructure   – Lack  of  broadband  
  12. 12. New  Eligible  Professionals   •  New  EP’s  granted  a  2  year  limited  excep-on   •  New  EP’s  that  start  prac-cing  in  2015  would   be  granted  excep-on  un-l  2017  
  13. 13. Unforeseen  Circumstances   •  Natural  disaster   •  Other  unforeseen  circumstances  
  14. 14. Prac-ce  at  Mul-ple  Loca-ons   – Lack  of  control  over  availability  of  CEHRT  of   more  than  50%  pa-ent  encounters  
  15. 15. Pa-ent  Interac-on   •  Lack  of  face  to  face  interac-on  with  pa-ents   •  Lack  of  follow  up  needs  with  pa-ents  
  16. 16. EHR  Vendor  Issues   •  Vendor  unable  to  obtain  CEHRT  cer-fica-on   2014   •  EP  unable  to  implement  MU  due  to   cer-fica-on  delays  from  vendor  
  17. 17. Exemp-on   •  Special-es  classified  in  the  Medicare  Provider   enrollment  Chain  and  Ownership  System   (PECOS)  with  specialty  codes   – Diagnos-c  Radiology   – Nuclear  Medicine   – Interven-onal  Radiology   – Anesthesiology   – Pathology  
  18. 18. Exemp-on   •  EP’s  enrolling  in  a  new  Medicare  program   •  Hospital  based  EP’s  for  2012  or  2013   – If  90%  or  more  of  covered  professional  services  in   and  inpa-ent  facility  or  emergency  department  
  19. 19. Applica-on   •  Applica-ons  must  be  completed  and  signed  electronically   by  July  1,  2014   •  Along  with  applica-on  proof  of  hardship  is  also  required   •  If  applica-on  is  approved  it  is  valid  for  1  payment  year  only   •  If  EP  is  claiming  excep-on  for  the  following  year  a  new   applica-ons  must  be  submi[ed   •  Access  the  applica-on  on  the  CMS  website  for  addi-onal   informa-on  at:     h[p://www.cms.gov/Regula-ons-­‐and-­‐Guidance/ Legisla-on/EHRIncen-vePrograms/Downloads/ HardshipExcep-on_EP_Applica-on.pdf    
  20. 20. Mul-ple  NPI’s  Applica-on   •  A  physician  that  has  mul-ple  NPI’s  will  need  to   complete  a  separate  applica-on   •  Mul-ple  NPI’s  applica-on  can  be  accessed  at:   h[p://www.cms.gov/Regula-ons-­‐and-­‐Guidance/ Legisla-on/EHRIncen-vePrograms/Downloads/ HardshipExcep-on_EP_Applica-on_Mul-pleNPIs.pdf    
  21. 21. Q&A   dan.holleran@quirkhealthcare.com   aaron.rucker@quirkhealthcare.com    

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