EHR Hardship Exemption

The following information is from the Centers for Medicare & Medicaid Services (CMS) regarding the Electronic Health Records (EHR) payment reduction hardship exemption:

    Hardship Exceptions for Medicare EPs

    EPs may apply for hardship exceptions to avoid the payment adjustments described above. Hardship exceptions will be granted only under specific circumstances and only if CMS determines that providers have demonstrated that those circumstances pose a significant barrier to their achieving meaningful use. Information on how to apply for a hardship exception will be posted on the CMS EHR Incentive Programs website ( in the future.

    EPs can apply for hardship exceptions in the following categories:

    • Infrastructure — EPs must demonstrate that they are in an area without sufficient internet access or face insurmountable barriers to obtaining infrastructure (e.g., lack of broadband).
    • New EPs — Newly practicing EPs who would not have had time to become meaningful users can apply for a 2-year limited exception to payment adjustments. Thus EPs who begin practice in calendar year 2015 would receive an exception to the penalties in 2015 and 2016, but would have to begin demonstrating meaningful use in calendar year 2016 to avoid payment adjustments in 2017.
    • Unforeseen Circumstances — Examples may include a natural disaster or other unforeseeable barrier.
    • Patient Interaction:
      1. Lack of face-to-face or telemedicine interaction with patients
      2. Lack of follow-up need with patients
    • Practice at Multiple Locations: Lack of control over availability of CEHRT for more than 50% of patient encounters

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