Avoiding Meaningful Use Penalties

January 27, 2015
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meaningful use penalties

meaningful use penalties

If you are a Medicare eligible provider, you are undoubtedly aware of the requirements for attesting to meaningful use (MU) of electronic health records (EHR) in your medical practice or hospital.  There are consequences for failing to attest to Stage 1, and problems facing those who are now entering Stage 2 of MU.

Failure to attest to Stage 1 MU results in payment adjustments

Healthcare providers were required to attest to 90 days of Stage 1 MU by October 1, 2014.  Attesting required you to provide documentation that you had met the requirements of Stage 1 MU, which focuses primarily on data entry and conversion of paper files to EHRs.  If you did not meet the MU standards by the October 2014 deadline, Medicare will impose a “payment adjustment” on your part B Medicare claims beginning January 1, 2015.

“Payment adjustment” is a euphemism for “penalty.”  Any claim you submit for services rendered to Medicare part B recipients after January 1, 2015, will be reduced by 1%.  The adjustment, or 1 percent reduction, is based on the Medicare physician fee schedule (PFS).  The penalties increase every year that you are unable to attest that you are engaging in Stage 1 MU until the maximum of a 5 percent claims reduction is reached.

It is too late to avoid the 2015 penalties?  Although rules change frequently, and the AMA is encouraging postponement of penalties, the only exception currently available to you is if you live in an area that has some type of insurmountable technological issue that prevents you from engaging in MU.  At the Centers for Medicare and Medicaid Services (CMS), you can find details on Stage 1 attesting requirements and other pertinent information that may assist you in avoiding penalties in the future.

Problems facing providers who need to attest to MU Stage 2

While Stage 1 focused primarily on the collection and conversion of data to an electronic format, Stage 2 requires providers to “engage” patients online by giving them secure access to the provider’s website where patients can obtain their health information.  Healthcare providers are also charged with the duty of exchanging patient health information online.  This includes e-prescribing, and exchange of information between specialists. There are actually 17 criteria providers must meet in order to avoid payment adjustments.  According to Physicians Practice, there are some major obstacles providers are facing.

  • A large percentage of Medicare patients are not comfortable using online services.  In order to attest to Stage 2 MU, providers must prove that a certain percentage of their patients have actually used the online services to access their health information.  At least 5 percent must have viewed, downloaded or transmitted their health information to a third party.  At least 5 percent must also communicate with the provider via a secured online messaging system.

    These requirements present real obstacles since many Medicare patients are in an age group that does not use the Internet for any reason.  They are not interested in using technology to access their medical records or to communicate with their physicians.  Those that do use the Internet are still reluctant to have their health information transmitted online.
     

  • Rural practices are disadvantaged.  Physicians in primarily rural practices do not generally have extensive communication with other providers.  It will be difficult them to meet the requirement of transferring their summary of care EHR records to another provider.

Orthopedists, radiologists and other practitioners may benefit from consultation with a professional revenue cycle and management company like Healthcare Information Services as they strive to attest to the MU standards and avoid payment adjustments.   

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