Insurance News:

CMS Payment Adjustments & Hardship Information

by CMS.gov | 3/24/2016 1:12:28 PM

Hardship Information

The streamlined hardship applications reduce the amount of information that eligible professionals (EPs), eligible hospitals, and CAHs must submit to apply for an exception. The new applications and instructions for a hardship exception from the Medicare Electronic Health Records Incentive Program 2017 payment adjustment are available below.

This new, streamlined application process is the result of PAMPA, which established that the Secretary may consider hardship exceptions for “categories” of EPs, eligible hospitals, and CAHs that were identified on CMS’ website as of December 15, 2015. Prior to this law, CMS was required to review all applications on a “case-by-case” basis.

Importantly, EPs, eligible hospitals, and CAHs that wish to use the streamlined application must submit their application according to the timeline established in PAMPA:

  • Eligible Professionals: July 1, 2016
  • Eligible Hospitals & CAHs: July 1, 2016

Please note: CAHs should use the form specific for the CAH hardship exceptions related to an EHR reporting period in 2015. CAHs that have already submitted a form for 2015 are not required to resubmit.

Medicare EHR Hardship Exception Instructions

Medicare EHR Hardship Exception Application

Medicare EHR Hardship Exception Application (CAH)

 

Payment Adjustments

In the American Recovery and Reinvestment Act of 2009 (ARRA), Congress mandated that payment adjustments should be applied to Medicare eligible professionals, eligible hospitals, and critical access hospitals (CAH) that are not meaningful users of Certified Electronic Health Record (EHR) Technology under the Medicare EHR Incentive Program.

If a provider is eligible to participate in the Medicare EHR Incentive Program, they must demonstrate meaningful use in either the Medicare EHR Incentive Program or in the Medicaid EHR Incentive Program, to avoid a payment adjustment. Medicaid providers who are only eligible to participate in the Medicaid EHR Incentive Program are not subject to these payment adjustments.

Eligible Professional Reconsideration Form

 

The deadline for Eligible Professionals to submit Reconsideration forms for the 2016 payment adjustment, based on the 2014 EHR reporting period, was February 29th, 2016. No applications will be accepted after the deadline. For inquiries about the Reconsideration Application, please email pareconsideration@provider-resources.com.

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