How do I apply for a Meaningful Use Hardship Exception?

As an Eligible Professional (EP), you may be exempt from Medicare penalties if you can show that demonstrating Meaningful Use would result in a significant hardship. To be considered for an exemption, you must complete a Hardship Exception application along with the proof of the hardship. If approved, the hardship exemption is valid for only one payment year and you would need to submit a new application for subsequent years. In no case may a provider be granted an exemption for more than 5 years.


Update: per CMS, the deadline to submit an EHR Incentive Program Hardship Exception application to avoid the 2017 Medicare EHR payment adjustment has passed. For inquiries about Hardship Exception Applications, please email ehrhardship@provider-resources.com.


Payment adjustments for eligible professionals who did not successfully participate in the Medicare EHR Incentive Program in 2015 will begin on January 1, 2017. Medicare eligible professionals could avoid the 2017 payment adjustment by taking action in 2016 and applying for a 2017 hardship exception.  The deadline to apply for a 2017 hardship exception is July 1, 2016.


The Hardship Exception Applications and instructions for an individual and for multiple Medicare eligible professionals will become  available on the EHR Incentive Programs website, and outline the specific types of circumstances that CMS considers to be barriers to achieving Meaningful Use and how to apply. To file a hardship exception, you must:

  • Show proof of circumstances beyond your control

  • Explicitly outline how the circumstances significantly impaired your ability to meet Meaningful Use


Please note that the hardship exemption applications to avoid a penalty in 2016 were due in July of 2015. If you did not complete Meaningful Use successfully in 2014, and did not apply for the 2016 hardship exemption by July of 2015, you will receive penalties on your Medicare reimburse.


Supporting documentation must also be provided for certain hardship exception categories. CMS will review applications to determine whether or not a hardship exception should be granted.


*While Practice Fusion can provide the CMS specifications for hardship exceptions and CMS specifications, we cannot advise or recommend that a provider apply for a hardship exception.*


Your Hardship Exception Application must be submitted electronically or postmarked by the CMS deadline that they post on their website to be considered. You can email the completed documentation to ehrhardship@provider-resources.com. If approved, the exception is valid for the 2017 payment adjustment only. If you intend to claim a hardship exception for a subsequent payment adjustment year, a new application must be submitted for the appropriate year. In addition, providers who are not considered eligible professionals under the Medicare program are not subject to payment adjustments and do not need to submit an application. Those types of providers include:

  • Medicaid only

  • No claim to Medicare

  • Hospital-based


EPs can apply for a hardship exemption in the following categories:

  • Infrastructure: Provider must demonstrate that they are in an area without sufficient internet access or face insurmountable barrier to obtaining infrastructure (e.g. lack of broadband).

  • New professionals (see below): Newly practicing professions can apply for a 2 year limited exception to penalties. Those who begin practice in 2015 would receive an exception to the penalties in 2015 and 2016, but would need to demonstrate Meaningful Use in 2016 to avoid penalties in 2017.

  • Unforeseen circumstances: Examples include a natural disaster or other unpredictable barrier.

  • Patient Interaction: Lack of face to face or telemedicine interaction with patient or lack of follow-up need with patients.

  • Practice at multiple locations: Lack of control over availability over certified EHR for more than 50% of patient encounters.

  • Extreme and Uncontrollable circumstances: If a provider is unable to meet the requirements of Meaningful Use for an EHR reporting period in 2015 for reasons related to the timing of the publication of the 2015-2017 Modifications final rule, a provider may apply for a hardship exception under the “extreme and uncontrollable” circumstances category.

Some providers will automatically be granted a hardship exemption for 2015. The following providers do not need to submit a hardship application:

  • New providers enrolling in Medicare for the first year

  • EPs who are hospital-based: a provider is considered hospital-based if he or she provides more than 90% of their covered professional services in either an inpatient or emergency department of a hospital. Please register in the CMS Registration & Attestation System to determine hospital-based status.

  • EPs with certain specialties (Anesthesiology, Pathology, Diagnostic Radiology, Nuclear Medicine, or Interventional Radiology). Make sure to verify that your PECOS specialty is up to date.

More information

For more information about the EHR Incentive Program, you should visit the Meaningful Use Center.

Meaningful Use

  1. What is Meaningful Use?
  2. How do I attest for Meaningful Use?
  3. How does the Meaningful Use Dashboard work?
  4. 2018 Medicaid Meaningful Use Stage 2 Objective 1: Protect Patient Health Information
  5. 2018 Medicaid Meaningful Use Stage 2 Objective 2: Clinical Decision Support
  6. 2018 Medicaid Meaningful Use Stage 2 Objective 3: CPOE for Medication, Lab, and Radiology Orders
  7. 2018 Medicaid Meaningful Use Stage 2 Objective 4: Electronic Prescribing (eRx)
  8. 2018 Medicaid Meaningful Use Stage 2 Objective 5: Health Information Exchange
  9. 2018 Medicaid Meaningful Use Stage 2 Objective 6: Patient-Specific Education
  10. 2018 Medicaid Meaningful Use Stage 2 Objective 7: Medication Reconciliation
  11. 2018 Medicaid Meaningful Use Stage 2 Objective 8: Patient Electronic Access
  12. 2018 Medicaid Meaningful Use Stage 2 Objective 9: Secure Electronic Messaging
  13. 2018 Medicaid Meaningful Use Stage 2 Objective 10: Public Health Reporting
  14. 2017 Medicaid Meaningful Use Stage 2 Objective 1: Protect Patient Health Information
  15. 2017 Medicaid Meaningful Use Stage 2 Objective 2: Clinical Decision Support
  16. 2017 Medicaid Meaningful Use Stage 2 Objective 3: CPOE for Medication, Lab, and Radiology Orders
  17. 2017 Medicaid Meaningful Use Stage 2 Objective 4: Electronic Prescribing (eRx)
  18. 2017 Medicaid Meaningful Use Stage 2 Objective 5: Health Information Exchange
  19. 2017 Medicaid Meaningful Use Stage 2 Objective 6: Patient-Specific Education
  20. 2017 Medicaid Meaningful Use Stage 2 Objective 7: Medication Reconciliation
  21. 2017 Medicaid Meaningful Use Stage 2 Objective 8: Patient Electronic Access
  22. 2017 Medicaid Meaningful Use Stage 2 Objective 9: Secure Electronic Messaging
  23. 2017 Medicaid Meaningful Use Stage 2 Objective 10: Public Health Reporting
  24. 2017 Medicaid Meaningful Use Stage 2 Objective 10: Public Health - Immunization Registry Data Submission
  25. 2017 Medicaid Meaningful Use Stage 2 Objective 10: Public Health - Syndromic Surveillance Data Submission
  26. 2017 Medicaid Meaningful Use Stage 2 Objective 10: Public Health - Specialized Registry Reporting
  27. What are the Modified Stage 2 Meaningful Use requirements for 2017?
  28. What are the exclusions for Meaningful Use?
  29. What patients are counted for Meaningful Use?
  30. How do the components of a chart note relate to Meaningful Use?
  31. How do I print the Meaningful Use Dashboard?
  32. How do I minimize or refresh CDS notifications?
  33. How can I send a referral using Direct Messaging?
  34. How does patient portal access and auto-invite relate to Meaningful Use?
  35. What constitutes a "unique" patient?
  36. Meaningful Use attestation for previous years
  37. How do Meaningful Use payment adjustments work?
  38. How do I apply for a Meaningful Use Hardship Exception?
  39. How do I find Practice Fusion's CMS EHR Certification ID?
  40. How do I register for the Medicaid Meaningful Use Program?
  41. Can I change, modify, or cancel my attestation?
  42. How do I choose my reporting period duration for Medicaid Meaningful Use?
  43. Is Practice Fusion a certified EHR?
  44. Patient records maintained in the EHR for Meaningful Use attestation
  45. How do I get my AIU letter from Practice Fusion?
  46. How do I report eCQMs for Medicaid Meaningful Use?
  47. Do I have to meet all 10 objectives to achieve Meaningful Use?
  48. Can I participate in both MIPS (Medicare) and Meaningful Use (Medicaid)?
  49. Are there patient education materials available in Spanish?
  50. How do I select or change my reporting period start date?
  51. When do I need to sign chart notes for Meaningful Use? Can I sign a chart after the reporting period?
  52. How do I contact my state about the Medicaid EHR Incentive Program?
  53. How do I qualify for Meaningful Use if I see patients in multiple locations?
  54. How many exclusions can each provider claim for meaningful use?
  55. How do I use multiple EHR's to qualify for Medicaid Meaningful Use?
  56. What stage of Medicaid Meaningful Use am I in?
  57. How do I prepare for the PQRS Penalty Informal Review?
  58. How do I prepare for a Meaningful Use audit?
  59. How do I batch export patient data from the EHR?
  60. How can I report CQMs for PQRS?
  61. Diabetes: Low Density Lipoprotein (LDL) Management (CMS 163v4)
  62. Ischemic Vascular Disease (IVD): Complete Lipid Panel and LDL Control (CMS 182v5)
  63. Use of Appropriate Medications for Asthma (CMS 126v4)

Feedback and Knowledge Base