The California Medical Association (CMA) has joined the American Medical Association and other medical associations to urge the Centers for Medicare and Medicaid Services (CMS) to establish a new "administrative burden" category of hardship exemption for the 2016 meaningful use and physician quality reporting system (PQRS) performance year.

When the Medicare Access and CHIP Reauthorization Act (MACRA) was passed, Congress recognized that existing Medicare reporting programs like meaningful use and PQRS needed to be streamlined. Indeed, MACRA's Merit-Based Incentive Payment System will consolidate and streamline these programs when it is implemented next year. Because of this, CMA and AMA are urging the administration to take a series of steps to address these same challenges for meaningful use and PQRS prior to their replacement by MACRA to minimize penalties for physicians who tried to participate in these programs.

Physicians should not be penalized for focusing on providing quality patient care rather than the arbitrary “check the box” requirements of meaningful use. Creating an "administrative burden" hardship exemption would provide immediate relief for those impacted by the programs that predate MACRA.

CMA and AMA are also urging CMS to create a hardship exemption for physicians who attempted to report PQRS in 2016 but were unsuccessful due to the complexity of the reporting requirements and the significant number of measures that were required. Many physicians tried and were unsuccessful in their efforts to report on the 2016 PQRS measure because they were unable to find nine measures that were applicable and meaningful for their specialty. CMA and AMA are recommending that CMS create a hardship exemption that would allow physicians who successfully reported on any number of PQRS measures in 2016 to avoid the 2 percent penalty in 2018.

With the passage of MACRA and its final regulations, policymakers in Congress clearly understand that fair and accurate measurement of physicians’ performance will not be possible until better tools become available.