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Critical access hospitals that did not achieve meaningful use in the Medicare Electronic Health Record Incentive Program for the 2016 reporting period can apply through Nov. 30 for a hardship exception to avoid a 2018 payment adjustment. Inpatient prospective payment system hospitals that did not achieve meaningful use or receive a hardship exception for the 2016 reporting period can apply through Nov. 30 for reconsideration of their 2018 payment adjustment. For instructions and applications, click .