The Meaningful Use attestation hardship exemption deadline passed on July 1 without any moves by the Centers for Medicare and Medicaid Services (CMS) to extend the date for when eligible providers can file for an exemption, despite the pleas of the American Medical Association (AMA) and the Medical Group Management Association (MGMA).

Recognizing that many providers were in the unfortunate situation of having adopted an electronic health record system certified as compliant with Stage 1 Meaningful Use criteria that then did not become certified as Stage 2 compliant in time for the provider to meet the next CMS reporting deadline, CMS had created rules for a broad set of hardship exceptions to needing to meet Meaningful Use Stage 2 criteria. However, because CMS is still working to finalize rules about what criteria providers who were unable to fully implement 2014 certified electronic health record technology (CEHRT) should meet instead, there is confusion among providers, and many who perhaps should have gotten an exception did not apply, say the AMA and the MGMA.

According to the letter the AMA and MGMA sent CMS Administrator Marilyn Tavenner, to be fair, the deadline to apply for a hardship exemption should have been extended until at least 30 days after finalization of a rule that would permit eligible providers who are unable to fully implement 2014 CEHRT to report for the 2014 reporting year using 2011 CEHRT and using 2013 criteria. That proposed rule was not published until May 20 and its comment period will not close until July 21. The final rule itself is not expected until late this summer, well after the July 1 date for providers to submit a hardship exception to avoid the 2015 Medicare payment adjustment.

“With the expected delay in finalization of the rule, many [eligible providers] are unclear as to the [Meaningful Use] requirements for 2014 and whether they need to apply for a hardship now before the rule is finalized. Should [eligible providers] be unable to meet the modified [Meaningful Use] requirements, they will have missed the hardship exception deadline and will be unfairly penalized in 2015,” the AMA and MGMA wrote.