Revenue Cycle Management Blog | GroupOne Health Source

Meaningful Use Update: Keeping Your Practice on Track for 2016

Written by Jeff Jones, CPHP | September 6, 2016

We welcomed the news earlier this year that the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) released a Notice of Proposed Rulemaking (NPRM) to allow for flexibility in meeting Meaningful Use this year. However, the 90-day reporting period for 2016 still has not been finalized and the final 90-day reporting period in calendar year 2016 is rapidly approaching.

Healthcare organizations are pressuring the Centers for Medicare and Medicaid Services to set a 90-day reporting period for 2016, reports HealthData Management

As September nears and with only four months remaining in 2016, providers need to know with certainty the length of the reporting period for meaningful use, says the letter, submitted on August 22, 2016 to Andy Slavitt, CMS’ acting administrator.

The letter was signed by 21 professional organizations, including the American Medical Association, the American Medical Informatics Association, the College of Healthcare Information Management Executives, the Federation of American Hospitals and the Medical Group Management Association.

Reporting Period for 2016 Meaningful Use

Under existing rules, EPs reporting for the first time must report for a 90-day period, while those beyond their first year are subject to a reporting period of a full calendar year. That represents a significant challenge in collecting data, and it’s also more difficult for providers to demonstrate that they’ve hit target levels over the course of an entire year.

If the CMS proposal is approved, any continuous 90-day period in calendar year 2016, would qualify. EPs beyond their first year should prepare for the full-year reporting period while awaiting a ruling on the proposed changes. For more information, click here.

First-Time Providers Beginning Meaningful Use

Those beginning Meaningful Use for the first time in 2016 report to a continuous 90-day period in the calendar year. To avoid a negative payment adjustment in CY 2017, the 90-day period must occur within the first three quarters of CY 2016, and the EP must attest by October 1, 2016, (i.e. be on 2014 CEHRT by July 2, 2016).

Are You On Track to Meet Meaningful Use in 2016?

Certain Meaningful Use measures are time sensitive, including

  • Electronic Prescribing 
  • Health Information Exchange 
  • Patient Electronic Access 

For these measures, even while CMS is proposing a 90-day reporting period, it is important that you continue to follow the necessary workflow throughout the year, so that you meet the measures at the end of the reporting period.

Medicaid Meaningful Use 2016

The last year that an eligible professional can begin participation in the Medicaid EHR incentive program is 2016. Incentive payments for eligible professionals are higher under the Medicaid EHR incentive program – up to $63,750 over six years.

Medicaid- eligible professionals who also treat Medicare patients will see a payment adjustment to Medicare reimbursements if they do not successfully demonstrate Meaningful Use. For more information on reporting requirements and deadlines, click here.

Quality Payment Program Proposed Rule (MACRA, MIPS and APMs)

On April 27, 2016, CMS released a notice of proposed rulemaking (NPRM) to implement key provisions of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). 

At close to 1,000 pages of legislation, MACRA is the biggest face lift of the medicare system in decades, which promises to change the way physicians are paid. Instead of the current fee-per-service model, it will be practice-driven, focused on connecting with patients, and rewards high quality care.

The 962 pages detail how CMS will manage the two programs stemming from MACRA: The Merit-Based Incentive Payments Systems (MIPS) and Alternative Payment Models (APMs).

The proposed final rule would streamline existing programs – MU, PQRS, and VBM – into a program called the Merit Based Incentive Payment System (MIPS)Changes begin to roll out in 2017, so physicians need to begin now to understand the new structure.

[Also: Are You Exempt from MIPS? How Advanced APMs Differ from APMs]

Where can I find more information?

Check out these resources from CMS for more information on MACRA.