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Payment Adjustments & Hardship Information

Hardship Information

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 as an Eligible Professional (EP), Eligible Hospital, or Critical Access Hospital (CAH) you may be exempt from Medicare penalties if you can show that demonstrating Meaningful Use would result in a significant hardship. To be considered for an exemption (to avoid a payment adjustment) you must complete a Hardship Exception application along with the proof of the hardship. If approved, the hardship exemption is valid for only one payment year and you would need to submit a new application for subsequent years. In no case may a provider be granted an exemption for more than 5 years.

2018 Eligible Professional (EP) Hardship Form

The deadline for Eligible Professionals (EPs) to submit Hardship forms for the 2018 payment adjustment, based on the 2016 EHR reporting period is July 01, 2017.

2018 EP Hardship Instructions

2018 EP Hardship Application

2018 Eligible Hospital Hardship Form

The deadline for Eligible Hospitals to submit Hardship forms for the 2018 payment adjustment, based on the 2016 EHR reporting period is July 01, 2017.

2018 Eligible Hospital Hardship Instructions

2018 Eligible Hospital Hardship Application

2016 Critical Access Hospitals (CAHs) Hardship Form

The deadline for Critical Access Hospitals (CAHs) to submit Hardship forms for the 2016 payment adjustment, based on the 2014 EHR reporting period is July 01, 2017.

2016 CAH Hardship Instructions

2016 CAH Hardship Application

2017 Eligible Professionals Transitioning to MIPS Hardship Form

The deadline for Eligible Professionals (EPs) to submit Hardship forms for the 2018 payment adjustment, based on the 2016 EHR reporting period is October 01, 2017.

EP Hardship Instructions (Transitioning to MIPS)

EP Hardship Application (Transitioning to MIPS)

  • An Eligible Professional (EP) may submit this Hardship Exception Application if the EP has never before successfully attested to meaningful use under the EHR Incentive Program and is transitioning to MIPS in Program Year 2017.
  • If an EP meets the criteria for this one time exception to the 2018 EHR Incentive Program payment adjustment, the EP must submit this application no later than October 1, 2017.
  • If an EP has successfully attested to meaningful use under the EHR Incentive Program in the past, but was unable to attest for a reason beyond their control in Program Year 2016, the EP can submit the standard Hardship Exception Application. Do not submit this application. (See above.)
      

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 (EP) Payment Adjustment information can be found here.

Critical Access Hospital (CAH) Payment Adjustment information can be found here.

Eligible Hospital Payment Adjustment information can be found here.

Eligible Professional (EP) Reconsideration Form

The deadline for Eligible Professionals to submit Reconsideration forms for the 2017 payment adjustment, based on the 2015 EHR reporting period was February 28th, 2017. No applications will be accepted after the deadline. For inquiries about the Reconsideration Application, please email pareconsideration@provider-resources.com.

Critical Access Hospitals (CAHs) Reconsideration Form

The deadline for Critical Access Hospitals (CAHs) to submit Reconsideration forms for the 2015 payment adjustment, based on the 2015 EHR reporting period was November 30th, 2016. No applications will be accepted after the deadline. For inquiries about the Reconsideration Application, please email pareconsideration@provider-resources.com.

Eligible Hospital Reconsideration Form

The deadline for Eligible Hospitals to submit Reconsideration forms for the 2017 payment adjustment, based on the 2015 EHR reporting period was November 30th, 2016. No applications will be accepted after the deadline. For inquiries about the Reconsideration Application, please email pareconsideration@provider-resources.com.