Physicians who are not participating in the Medicare electronic health record (EHR) incentive program, also known as meaningful use, will be penalized by Medicare beginning Jan. 1, 2015. To prevent the penalty, physicians must either attest to meaningful use by Oct. 1, 2014, or apply for a hardship exemption by July 1, 2014.
Physicians who meet the following criteria are automatically exempt from the program and do not need to file an exemption application:
Specialties: If you're classified in the Medicare Provider Enrollment, Chain and Ownership System (PECOS) as one of these five specialties, you don't need to file an exemption and will be exempt for payment year 2015:
- Diagnostic radiology,
- Nuclear medicine,
- Interventional radiology,
- Anesthesiology, and
New to practice: If you are in your first year of practice, you do not need to claim an exemption. Based on Medicare data in PECOS, the Centers for Medicare & Medicaid Services (CMS) says it will know you are new to practice and will automatically exempt you.
Hospital-based: If you perform more than 90 percent of services using place of service codes 21 or 23 (hospital), then you will automatically be exempt from the Medicare penalty.
Other exemptions are available, but you must take the time to fill out the 14-page application and submit it to CMS by July 1, 2014. If multiple physicians at one practice are applying, be sure to include the multiple NPI addendum.
You can apply for a hardship exemption if your circumstances fall under one of the following categories:
- Infrastructure: You must demonstrate that your practice is in an area without sufficient Internet access to comply with meaningful use and that you face insurmountable barriers to obtain such connectivity.
- Unforeseen circumstances: This exemption can be claimed in the case of a natural disaster, closing of a practice, bankruptcy, or if the EHR vendor goes out of business.
- Lack of face-to-face patient interactions: If your specialty isn't listed above as exempt and you lack face-to-face interactions with your patients, you can claim an exemption.
- 2014 EHR vendor issues: If your EHR vendor was unable to obtain a 2014 certification by July 1, 2014, you should file an application for exemption.
Exemptions must be renewed annually, and you may not claim an exemption for more than five years.
For more information on penalties and exemptions, please refer to TMA's one-pager. Contact TMA's Health Information Technology Department with questions by email or by calling (800) 880-5370.
Action, June 16, 2014