Don’t Miss the Deadline to Submit a Hardship Exception Application

On May 1, 2023, the Centers for Medicare & Medicaid Services (CMS) (@CMSGov) opened the Hardship Exception application period for eligible hospitals and critical access hospitals (CAHs) that participated in the Medicare Promoting Interoperability Program in calendar year (CY) 2022.

The deadline for eligible hospitals to submit a Hardship Exception application for the CY 2022 reporting period was Monday, July 31, 2023. Please note that the deadline for CAHs to submit a Hardship Exception application is September 1, 2023.

Application Submission Details

Medicare eligible hospitals may submit their Hardship Exception application using the Hospital Quality Reporting (HQR) system. Previously registered users should already have account access, and new users can sign up by selecting “Register” to create a new account.

If an electronic submission is not possible, you may verbally submit your application over the phone by calling the Center for Clinical Standards and Quality (CCSQ) Service Center at (866) 288-8912.

About Hardship Exception for Eligible Hospitals

For the CY 2022 electronic health record (EHR) reporting period, CMS required that all eligible hospitals use (1) existing 2015 Edition certification criteria, (2) the 2015 Edition Cures Update criteria, or (3) a combination of the two in order to successfully meet the program requirements, as finalized in the CY 2021 Physician Fee Schedule final rule (85 FR 84818 through 84828). CMS mandates that downward payment adjustments be applied to eligible hospitals that were not meaningful users of certified electronic health record technology (CEHRT) and score below the 60-point minimum requirement and failed to report three self-selected calendar quarters of electronic clinical quality measures (eCQMs) data on four self-selected eCQMs.

Medicare eligible hospitals may be exempt from Medicare penalties and avoid a downward payment adjustment if they can show that compliance with the requirement for being a meaningful CEHRT user would result in a significant hardship. To be considered for an exemption, participants must complete a Hardship Exception application and provide proof of hardship (e.g., natural disaster, lack of internet access, etc.).

If approved, the Hardship Exception is valid for only one payment adjustment year. Eligible hospitals would need to submit a new application for subsequent years and no eligible hospital can be granted more than five exceptions.

Reminder: CAHs have until September 30, 2023 to submit their Hardship Exception applications.

For More Information

More information on the Medicare Hardship Exception application can be found here (PDF). For more information on the Medicare Promoting Interoperability Program, visit the Promoting Interoperability Program website.