Home > EHR, meaningful use, Medicare > How to Avoid Meaningful Use Penalties

How to Avoid Meaningful Use Penalties

*This article was updated with new information from CMS on March 20, 2014.

The payment adjustments (penalties) for nonparticipation in the EHR Incentive Program (“meaningful use” or MU) are scheduled to begin in calendar year (CY) 2015. Eligible radiologists have two ways to avoid the penalties:

Option 1: Comply on time

  • Prior MU participants must comply in the year that is two years before the penalty year.
  • First time MU participants must complete attestation by October 1 of the year before the penalty year. To complete attestation in time, the reporting period must begin by July 1.

Option 2: Obtain a significant hardship exception
CMS can grant a temporary “significant hardship exception” to a physician on an annual basis for up to 5 years maximum. Exceptions that require manual applications have an application submission deadline of July 1 of the year before the penalty year. The various significant hardship exceptions are as follows:

  • Lacking broadband/infrastructure: The physician was located in an area without sufficient Internet access to comply for any 90-day period of time from the beginning of the year that is 2 years before the penalty year to July 1 of the year before the penalty year. Moreover, the physician must have faced insurmountable barriers to obtaining the internet connectivity.
  • Newly practicing: The physician has been practicing for less than 2 years.  This will be automatically given (no manual application required).
  • Extreme and uncontrollable circumstances: a) A previous MU participant faced extreme and uncontrollable circumstances in the year 2 years before the penalty year. Or, b) a physician who has never participated in MU faced extreme and uncontrollable circumstances in the year before the penalty year.
  • Inability to influence availability of certified EHR technology (CEHRT): The physician practiced at multiple locations, and lacked control over the availability of CEHRT at one or more locations where he/she had more than 50% of his/her patient encounters.
  • Lack of face-to-face/telemedicine interaction with patients AND lack of need for follow-up: The physician can demonstrate difficulty in meeting MU on the basis of lack of face-to-face or telemedicine interaction with patients and lack of need for follow up with patients.
  • Primary specialty listing in PECOS: The physician has a primary specialty listed in PECOS as radiology, anesthesiology, or pathology 6 months before the penalty year. For radiology, the primary specialty listing would need to be “diagnostic radiology” (30), “nuclear medicine” (36), or “interventional radiology” (94). This will be automatically given (no manual application required). Note, CMS has not released information about how to “opt out” if the radiologist was MU compliant in time and does not need to obtain an exception in 2015.
  • 2014 EHR Vendor Issues: The physician’s HIT vendor was unable to obtain 2014 Edition certification in time for a reporting period in 2014.

For more information about the significant hardship exceptions, please see CMS’ website.

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Categories: EHR, meaningful use, Medicare

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