American Society of Plastic Surgeons
For Consumers

ASPS Strongly Supported MU Hardship Exemption Signed by President Obama

President Obama signed the Patient Access and Medicare Protection Act into law on December 28, 2015. This legislation incorporates the much needed, ASPS supported Meaningful Use hardship exemption, which will authorize a blanket meaningful use hardship exception for 2015 reporting due to the delay in publication of the Stage 2 rules. ASPS actively supported this measure, originally introduced by Rep. Tom Price, MD, and continued pressure throughout the fall. CMS is currently drafting the hardship application, which is expected to be released shortly. ASPS is proud to have joined with its partners in organized medicine to push this legislation through and to see Congress support physicians through this much needed exemption.


Following deep frustration with the Centers for Medicare & Medicaid Services' (CMS) handling of Stage 2 and 3 of Meaningful Use, Congress passed a measure that will provide expedited applications for hardship exemptions. This was the result of numerous complaints from the medical community and continued pressure by Rep. Tom Price, MD, Chair of the House Budget Committee, and Senator Lamar Alexander, Chair of the Senate Committee on Health, Education, Labor and Pensions, who have been vocal advocates on this issue. Both Price and Alexander have continuously pushed congressional leadership and the Centers for Medicare & Medicaid Services (CMS) to delay Stage 3 of Meaningful Use (MU). Even after Alexander and Price explicitly outlined the ramifications of continued implementation of Stage 3 to Secretary of Health and Human Services, Sylvia Burwell, CMS did not adjust its plan to execute the final stage of the program.

On December 8, ASPS wrote to every member of the House and Senate appropriations committees and requested that they take advantage of negotiations surrounding the omnibus spending bill, crafted in the wake of the November budget agreement, as a vehicle for blocking funding for CMS implementation of Stage 3 of MU. Because of CMS's clear opposition to acting of its own accord to pause MU so that the program can be fixed, ASPS argued that Congress must intervene. Unfortunately, this provision was not incorporated into the final omnibus package.

While unable to stop Stage 3 from advancing, ASPS also worked to advance Rep. Price's Meaningful Use Hardship Relief Act (H.R.3940), which will soften the blow that physicians will face from failing to comply with Stage 2. ASPS expressed our strong support for the bill directly to Republican and Democratic leadership in both houses, as well as to the House Ways & Means Committee. When the bill was later merged with S.2425, crafted by Senators Portman and Casey, ASPS again wrote to members of Congress and expressed our support for the Meaningful Use hardship exemption within the bill. Both houses passed the hardship exemption language on December 18.

Frequent delays in the release of rules for MU have resulted in persistently low levels of successful physician participation. This problem surfaced again in October, when CMS released a modification to the rules for Stage 2 stating that in order to avoid a penalty under the program, providers must attest that they met the requirements for MU Stage 2 for a period of 90 consecutive days during calendar year 2015. Unfortunately, the aforementioned delay meant that providers were notified of this change with fewer than the 90 required days. Taken in concert with the additional requirements imposed by the rule, this timeframe will be enormously difficult for MU participants.

While CMS has acknowledged that eligible entities may apply for a hardship exception if they are unable to attest due to the timeframe of the rule, statute requires that these exceptions be granted only on a case-by-case basis. CMS rightly anticipates a significant number of applications, and ASPS believes this will inevitably lead to unacceptably long timeframes for the disposition of individual applications. The Meaningful Use hardship exemption will authorize a blanket hardship exception for the 2015 reporting period and, in doing so, would allow for applications to be processed in a more acceptable manner.