Act Now to Avoid 2015 Payment Reduction
On Jan. 1, 2015, the Centers for Medicare & Medicaid Services (CMS) will begin penalizing healthcare providers who did not successfully attest to meaningful use criteria of electronic health record (EHR) technology in 2013. If you act quickly, though, you may be able to avoid the 1 percent Medicare payment reduction.
Only eligible professionals (EP) who are enrolled in Medicare must attest to meaningful use, so the first thing you should do is determine whether you are an EP. In general, the following types of professionals are eligible to participate in the Medicare EHR Incentive Program:
- Doctor of medicine or osteopathy
- Doctor of optometry
- Doctor of dental surgery or dental medicine
- Doctor of podiatry
Use CMS’s eHealth Eligibility Assessment Tool to confirm your eligibility.
If you find that you are in fact an EP and you did not successfully attest to meaningful use of an EHR in 2013, you might avoid the 2015 payment adjustment:
- If you’ve participated in the EHR incentive program before, you have until July 1, 2014 to apply for a hardship exception.
- If you’ve never participated in the EHR incentive program, you have until Oct. 1, 2014 to successfully attest to meaningful use for 2014, or until July 1, 2014 to apply for a hardship exception.
To be considered for an exception to the payment adjustment, you must complete a Hardship Exception application, along with proof of the hardship, by July 1, 2014.
A few legitimate hardship exceptions are:
- Lack of infrastructure (unable to obtain Internet access)
- Unforeseen/uncontrollable circumstances, such as a natural disaster, bankruptcy, or EHR vendor issues
- Lack of control over availability of certified EHR technology
See CMS’s Payment Adjustments & Hardship Exceptions Tipsheet for Eligible Professionals for a complete list of hardship exceptions.
You cannot appeal an unfavorable decision. If approved, the exception is valid for one payment year only. You may only apply for an exception up to five years, so this is a temporary fix, not a permanent solution.
Exceptions to the Rule
If you are a new EP enrolling in the Medicare program this year, you are automatically exempt from the 2015 payment adjustment and do not need to submit a form. The following specialties are also automatically exempt: diagnostic radiology (30), nuclear medicine (36), interventional radiology (94), anesthesiology (05), and pathology (22). Also exempt are EPS who had a hospital-based designation in PECOS during 2012 and 2013.