The Centers for Medicare & Medicaid Services (CMS) enacted the Patient Access and Medicare Protection Act on December 28, 2015, which considered hardship exceptions for certain eligible healthcare professionals when it comes to the EHR incentive program.
As a result, certain eligible professionals (EP) are exempt from filling out a hardship form to exempt themselves from the EHR incentive program.
Background: the EHR Penalty
The Electronic Health Record (EHR) incentive program was established in Fiscal Year 2011. The goal is to increase adoption of EHR guidelines and standards across all institutions and practices that are involved with Medicare/Medicaid.
To encourage use of this new program, CMS enacted a penalty of 1% of the total Medicare reimbursement. This penalty is assessed to a provider if they do not make “meaningful use” of EHR for that year. Note that 1% was just for CY 2015; in 2016, the penalty increased to 2%, and will go up to 3% in CY 2017.
Exploring the Exemption
CMS allows providers to apply for hardship exemptions under the PAMPA established in 2015. But there are certain types of providers who are exempt from filling out the application.
According to official guidance:
“If an EP is classified in the Medicare Provider Enrollment, Chain and Ownership System (PECOS) as having one of the following 5 specialty codes as the primary area of practice, the EP does not need to submit this form. The EP is automatically granted a hardship exception from the 2017 payment adjustment based on the designation in PECOS.”
One of the codes is Anesthesiology (05), meaning CRNAs and other providers are automatically exempt and do not need to worry about filling out hardship exemption forms for 2017.
Adhering to EHR
It is still important to adhere to EHR regulations. Hiring an outsourced provider of anesthesia billing and coding can assist with making sure you are meeting all requirements, keeping your practice in concordance with all regulations, and avoiding incentive penalties from CMS.