Scott Mace | December 18, 2014
“More than 50% of eligible professionals will face penalties under the Meaningful Use program in 2015, a number that is even worse than we anticipated,” says the AMA’s president-elect.
More than 257,000 eligible providers this week will start getting letters from the Centers for Medicare & Medicaid Services stating they will be paid 1% less by Medicare and Medicaid in 2015, as a result of failing to demonstrate Meaningful Use of electronic health records in 2013.
The payment adjustments, CMS-speak for penalties, were prescribed by the American Recovery and Reinvestment Act of 2009, which also established the EHR incentive payment program which has since paidout more than $25 billion to eligible providers and hospitals.
To be levied starting January 5, the adjustments have only been in effect since October 2014, and so far have only applied to about 200 eligible hospitals. The new adjustments are the first to hit eligible professionals.
In addition, about 28,000 eligible providers will receive adjustments of 2%, because they had enrolled in both the incentive program and in CMS’s ePrescribing incentive program.
CMS provided the statistics during a press briefing Wednesday. Eligible providers will also be able to apply to have their status reconsidered by CMS. It said an online application form to do so would be available Thursday.
Eligible professionals also had been able to apply for hardship exemptions from the payment adjustments by July 1, 2014. At that time, CMS received nearly 44,000 applications. The vast majority were approved, and just over 1000 were denied. Some were dismissed because the hardship exemption application had already met Meaningful Use criteria and were “confused,” a CMS official said.
The hardship exemption application period was extended into a second round, during which CMS received more than 13,000 applications, fewer than 1,000 of which were denied.
AMA ‘Appalled’
In a statement Wednesday, the American Medical Association said it was “appalled” by the impending payment adjustments.
“More than 50% of eligible professionals will face penalties under the Meaningful Use program in 2015, a number that is even worse than we anticipated,” said Steven J. Stack, MD, AMA president-elect:
“The Meaningful Use program was intended to increase physician use of technology to help improve care and efficiency. Unfortunately, the strict set of one-size-fits-all requirements is failing physicians and their patients. They are hindering participation in the program, forcing physicians to purchase expensive electronic health records with poor usability that disrupts workflow, creates significant frustrations and interferes with patient care, and imposes an administrative burden.”
Stack noted that the AMA supported the original HITECH legislation and had provided extensive and constructive feedback to the Administration to help fix the Meaningful Use program, “but few changes have been made.
“In light of the dismal number of eligible professionals meeting Meaningful Use, we hope that the Administration will now move forward with the solutions we put forth in our Blueprint to make the program more successful and better enable physicians to provide quality care for their patients.
Stack also said the penalties physicians are facing under the Meaningful Use program “are part of a regulatory tsunami facing physicians, apart from the flawed Sustainable Growth Rate formula, that could include cuts from the Physician Quality Reporting System (PQRS), the Value-based Modifier Program (VBM) and the sequester, further destabilizing physician practices and creating a disincentive to see Medicare patients.”
Additional Penalties
According to the Administration, only half of eligible physicians participated in PQRS in 2013, meaning that many will incur penalties from both the Meaningful Use and PQRS programs, Stack said.
“The overlapping and often conflicting patchwork of laws and regulations must be fixed and aligned to ensure physicians are able to move to innovative payment and delivery models that could improve the quality of care.”
A CMS official also noted that under ARRA, those eligible providers who never opted into the Meaningful Use incentive payment program nevertheless begin facing their own payment adjustments if they are not attesting as of January 1, 2015.
When asked what reasons such providers were giving for not participating, the official said “There are certainly some people who are close to retirement who believe that they want to stay on paper records and don’t want to switch, but now that we know who they are, we can do more analysis and delve into that, and I think that will be coming out in the next couple months.”
CMS will be taking applications for reconsideration of the payment adjustments through the end of February 2015, the official said.
Source: Health Leaders Media
http://www.healthleadersmedia.com/print/TEC-311416/Meaningful-Use-Payment-Adjustments-Begin