Because of a delay in the publication of regulations governing the Medicare meaningful use program, physicians are being urged to preemptively file for a 2015 hardship exemption to avoid penalties in 2016.

Physicians should apply for an exemption under the “extreme and uncontrollable circumstances” category, even if they are uncertain whether they will meet the program requirements this year. Doing so will not preclude physicians from receiving an incentive if they do meet meaningful use requirements, but applying can serve as a safety net in staving off a penalty.

In order to avoid a penalty under the meaningful use program, eligible professionals must attest that they met the requirements for meaningful use stage 2 for a period of 90 consecutive days during calendar year 2015. Unfortunately, however, the Centers for Medicare and Medicaid Services (CMS) did not publish the updated regulations for stage 2 meaningful use until October 16, 2015. As a result, eligible professionals were not informed of the revised program requirements until fewer than the 90 required days remained in the calendar year.

CMS has stated that it will grant hardship exemptions for 2015 if eligible providers are unable to attest due to the late publishing of the rule. However, under current law, CMS can only grant such exemptions on a case-by-case basis. This means that many eligible professions will be required to apply for exemptions and that CMS will have to act on each application individually. CMS has approved over 85 percent of hardship exemptions in the past.

Hardship applications will be available in early 2016 at

The California Medical Association (CMA) and the American Medical Association are also supporting new legislation in Congress to streamline the hardship exemption process. The legislation, H.R. 3940 – the Meaningful Use Hardship Relief Act of 2015 – would grant CMS the authority to grant blanket hardship exceptions to physicians, hospitals and other affected providers for 2015, alleviating burdensome administrative issues for both providers and the agency.

The ACCMA and CMA will continue to monitor this situation.

For more information on the electronic health record (EHR) incentive program, see the CMS tipsheet, "EHR Incentive Programs for Eligible Professionals: What You Need to Know for 2015."

For questions or assistance, contact the ACCMA at 510-654-5383 or