Electronic Health Records

Adoption & Implementation News

257K Meaningful Use EPs to Get Medicare Payment Adjustments

By Kyle Murphy, PhD

Close to 260K meaningful use eligible professionals will receive notice of upcoming Medicare payment adjustments for failing to meet the requirements of the Medicare EHR Incentive Program.

Over the next few weeks, more than 257,000 providers eligible for the Medicare EHR Incentive Program will receive notice that they will be subject to Medicare payment adjustments beginning in 2015.

Earlier today, the Centers for Medicare & Medicaid Services (CMS) revealed the number of eligible professionals who would reductions in their Medicare payments in 2015 for failing to demonstrate meaningful use in previous years.

“As part of the American Recovery and Reinvestment Act of 2009, Congress mandated that payment adjustments be applied to Medicare-eligible professionals who are not meaningful users of certified EHR technology under the Medicare Electronic Health Record Incentive Program,” the federal agency told reporters.

“We are getting ready to start mailing the letters to the eligible professionals who will be getting this payment adjustment and it is a number that is over 257,000,” CMS officials continued, “and these people will be paid one percent less of the Medicare Physician Fee Schedule amount that would otherwise apply for all their Medicare-covered professional services that they provide.”

More than 28,000 EPs will see a two-percent reduction in their 2015 Medicare payments for failure to comply with both the Electronic Prescribing (eRx) Incentive Program as well as the Medicare EHR Incentive Program.

The Medicare payment adjustments for EPs will begin next month, going into effect on January 5 after CMS completes system changes. As part of the notification, these providers will receive instructions for challenging CMS’s decision. “When they receive the letter, they will receive instructions for how they can apply for reconsideration and we will be taking those applications through the end of February,” the federal agency explained.

The application for reconsideration should appear on the CMS website later today. “They just answer the questions on the form and fill in the information. It’s possible that we could’ve made a mistake and we want to make sure that people have the opportunity to point that out to us,” added CMS officials.

The number of Medicare EPs receiving notices pales in comparison to the number of hospitals subject to payment adjustments, which according to CMS is slightly for than 200 eligible hospitals. CMS is not yet able to say what percentage of the total number of EPs is subject to Medicare payment adjustments. “We don’t have that information available at this time. We’re working on developing that,” CMS revealed.

What is known is the effectiveness of the two meaningful use hardship exception application periods. The first period ending July 1, 2014, saw 43,000 applications submitted and little than 1,000 denials. The second period ending Nov. 30, 2014, saw another 13,000 applications and less than 1,000 denials.

The final 2014 meaningful use reporting period is coming to end this month after which time EPs must complete their meaningful use attestation to avoid 2016 Medicare payment adjustments. Currently, EHs are coming closer to the deadline for meaningful use attestation extended to Dec. 31, 2014, to avoid similar penalties.

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