Associations Ask CMS to Establish “Administrative Burden” Hardship Exemption for MU

March 30, 2017
The AMA and numerous other healthcare groups have written a letter to CMS Administrator Seema Verma asking to minimize the penalties assessed for physicians who have tried to participate in meaningful use and other federal reporting programs.

The American Medical Association (AMA) and numerous other healthcare groups have written a letter to Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma asking to minimize the penalties assessed for physicians who have tried to participate in meaningful use and other federal reporting programs.

The letter states that the 21st Century Cures Act directs CMS to establish a strategy to relieve the electronic health record (EHR) documentation burden on physicians today. “To fulfill this legislative directive, we urge CMS to establish a new ‘Administrative Burden’ category of hardship exemption for the 2016 MU performance year.  Eligible providers should not be penalized for focusing on providing quality patient care rather than the arbitrary ‘check the box’ requirements of MU.  Creating an administrative burden hardship exemption would provide immediate relief for those impacted by the programs that predate MACRA.”

Indeed, MACRA’s (the Medicare Access and CHIP Reauthorization Act of 2015) Quality Payment Program streamlines existing Medicare value-based purchasing programs—meaningful use, the physician quality reporting system (PQRS), and value-based payment modifier (VM). But as the letter states, “We urge the Administration to take a series of steps to address these same challenges in MU, PQRS, and VM prior to their replacement by MACRA and minimize the penalties assessed for physicians who tried to participate in these programs.  Clearly this would send a strong message to the physician community about the extensive regulations with which physicians have been dealing and the Administration’s commitment to reduce the burden.”

The organizations also want CMS to create a hardship exemption for physicians who attempted to report to PQRS in 2016 but were unsuccessful due to the “complexity of the reporting requirements and the significant number of measures that were required.” The AMA said that it has heard from physicians who tried to successfully report PQRS 2016, but were unable to find nine measures that were applicable and meaningful for their specialty. “We recommend that CMS create a hardship exemption that would allow physicians who successfully reported on any number of PQRS measures in 2016 to avoid the two percent penalty in 2018,” they wrote.

The organizations give credit to federal officials for recognizing in the MACRA final rule that “fair and accurate measurement of physicians’ performance will not be possible until better tools become available.” There are shortcomings in the value-based purchasing programs mentioned above, the letter states, and they conclude by writing, “We also believe the steps we have outlined are in keeping with President Trump’s efforts to reduce regulatory burden.”

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