Revenue Cycle Management Blog | GroupOne Health Source

EHR Incentive Programs: Important Payment Adjustment Information

Written by Kaitlyn Houseman | November 1, 2013

Medicare EPs participating in the EHR Incentive Program may be subject to payment adjustments beginning on January 1, 2015. 

CMS will determine the payment adjustment based on meaningful use data submitted prior to the 2015 calendar year. EPs must demonstrate meaningful use prior to 2015 to avoid payment adjustments. Determine how your EHR Incentive Program participation start year will affect the 2015 payment adjustments:

If you began in 2011 or 2012
If you first demonstrated meaningful use in 2011 or 2012, you must demonstrate meaningful use for a full year in 2013 to avoid the payment adjustment in 2015. 

If you began in 2013
If you first demonstrate meaningful use in 2013, you must demonstrate meaningful use for a 90-day reporting period in 2013 to avoid the payment adjustment in 2015. 

If you plan to begin in 2014
If you first demonstrate meaningful use in 2014, you must demonstrate meaningful use for a 90-day reporting period in 2014 to avoid the payment adjustment in 2015. This reporting period must occur in the first 9 months of calendar year 2014, and EPs must attest to meaningful use no later than October 1, 2014, to avoid the payment adjustment. 

Avoiding Payment Adjustments in the Future
You must continue to demonstrate meaningful use every year to avoid payment adjustments in subsequent years.

If you are eligible to participate in both the Medicare and Medicaid EHR Incentive Programs, you must demonstrate meaningful use to avoid the payment adjustments. You may demonstrate meaningful use under either Medicare or Medicaid. 

If you are only eligible to participate in the Medicaid EHR Incentive Program, you are not subject to these payment adjustments.

Helpful Resources
For more information on EP payment adjustments, view the 
Payment Adjustments and Hardship Exceptions Tipsheet for EPs. 

Want more information about the EHR Incentive Programs?
Make sure to visit the 
EHR Incentive Programs website for the latest news and updates on the EHR Incentive Programs.