CMS Payment Adjustments Set to Begin January 1, 2015

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The Centers for Medicare and Medicaid Services (CMS.gov) recently updated their ‘Payment Adjustments & Hardship Exceptions Tipsheet for Eligible Professionals’.  The information pertains to Medicare Eligible Professionals who are not meaningful users of Certified Electronic Health Record (EHR) and the payment adjustments that will be applied beginning January 1, 2015.  Meaningful use is using certified electronic health record (EHR) technology to: improve quality, safety, efficiency, and reduce health disparities; engage patients and family; improve care coordination, population and public health; and maintain privacy and security of patient health information.

Payment adjustments will be made to the Medicare physician fee schedule (PFS) and are tied to the year they did not demonstrate meaningful use.  These adjustments also depend on the total number of Medicare eligible professionals who are meaningful users under the EHR incentive programs after 2018, with the maximum cumulative payment adjustment able to reach 5%.  In order to avoid the adjustments, eligible professionals just demonstrate meaningful use before 2015.

Meaningful use must be attested to through the online portal at CMS.gov or through each provider’s state attestation system. Meaningful use timeline charts are available from CMS.gov.  Continued demonstration of meaningful use is required to avoid payment adjustments.  Eligible professionals who first establish meaningful use in 2014 must do so for a 90 day reporting period within the first 9 months in order to avoid 2015 adjustments.  This table shows the timeline to avoid payment adjustments.

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There are provisions for hardship and exceptions will be granted by CMS.  Hardship exceptions can be applied for due to infrastructure barriers (not having access to internet), newly practicing eligible professionals who have not had time to become a meaningful user, unforeseen circumstances such as natural disaster, multi location practice issues such as lack of control of CEHRT for more than 50% of patient encounters, PECOS specialties such as radiology or pathology.

Certified EHR systems such as Lytec MDMedisoft Clinical, and Greenway PrimeSuite are available from Microwize Technology and can help your practice stay compliant and avoid payment adjustments. Contact a healthcare technology consultant today for more information.