Eligible professionals who have been frustrated by the requirements of the Electronic Health Record (EHR) Incentive Program (the "Program" or "Meaningful Use") were offered some (potential) relief in CMS's new proposed rule for Stage 2 of the Program. Providers interested in the new potential exceptions (which could help them avoid penalties, or ease reporting burdens) should review these important provisions and comment as appropriate.

Since the Program's inception, certain professionals (especially those in specialties or situations that offer minimal patient contact, such as radiology, pathology; or employed physicians who have little control over their patient contact or the records system they must use) have been frustrated by the Program's "all or nothing" standards. An eligible professional must meet each and every Program requirement (which may be impossible for some types of otherwise eligible professionals) or the professional will both lose the ability to collect the Program's substantial incentive payments and face penalties (which could be triggered as early as 2013) for failing to meaningfully use certified EHR technology as required. Hospital-based professionals are not eligible and, accordingly, are exempt from both Program incentives and penalties. Hospital-based professionals are those who provide 90 percent or more of their covered services in a hospital setting (inpatient hospital or emergency room). For professionals, all of this is decided on a calendar-year bycalendar- year basis. The Stage 2 proposed rule offers at least the potential for some exceptions for professionals in these difficult positions.