Topics: Revenue Cycle Management
The Sustainable Growth Rate (SGR) formula has been eliminated. The Senate voted 92-8 to pass the Medicare Access and CHIP Reauthorization Act of 2015, which will replace the Sustainable Growth Rate. It was passed on the eve of a 21 percent cut to physicians' Medicare payments which was set to take place. Instead, the new legislation removes much of the instability and uncertainty that long has plagued the Medicare payment system so practices can focus on patient care. A huge step in the right direction, the bill also includes several other important improvements for physician practices.
Topics: Revenue Cycle Management
CMS issued a new proposed rule for the Medicare and Medicaid EHR Incentive Programs to align Stage 1 and Stage 2 objectives and measures with the long-term proposals for Stage 3.
CHICAGO--(BUSINESS WIRE)--eClinicalWorks® and Epic, two of the most widely used electronic health record systems (EHR) in the U.S., today jointly announce interoperability between the companies’ EHR systems using the Carequality framework. This real-time data transfer between the systems facilitates coordination of care between providers in various care settings and ensures they have more complete and accurate patient information at the time of care. Together, the two companies’ patient record exchange networks represent over 1,000 hospitals and 40,000 clinics that are ready to connect.
The negative 21% payment rate adjustment under current law for the Medicare Physician FeeSchedule is scheduled to take effect on April 1, 2015. CMS is taking steps to limit the impact on Medicare providers and beneficiaries by holding claims for a short period of time beginning on April 1st. Holding claims for a short period of time allows CMS to implement any subsequent Congressional action while minimizing claims reprocessing and disruption of physician cash flow in the event of legislation addressing the 21% payment reduction. Under current law, electronic claims are not paid sooner than 14 calendar days (29 days for paper claims) after the date of receipt. CMS will provide more information about next steps by April 11, 2015.
Did you know that CMS provided Quality and Resource Use Reports (QRURs) to physicians in groups of all sizes and physician solo practitioners in September of 2014? The 2013 QRURs provide clinically meaningful and actionable information that can be used to improve the quality and efficiency of care provided to Medicare beneficiaries and also to understand and improve performance on quality and cost measures. If you are a physician subject to the Value-Based Payment Modifier (VM) Program, the reports also contain information about how your performance is affecting your Medicare payments in 2015.
By a vote of 392 – 37, the House of Representatives passed H.R. 2, the Medicare Access and CHIP (Children's Health Insurance Program) Reauthorization Act of 2015, which, among other things, would permanently repeal and replace the SGR formula.
On Friday, CMS released a notice of proposed rulemaking (NPRM) for Stage 3, the next step in the implementation of the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. Concurrently, ONC also announced the proposed 2015 Edition certification criteria for health IT products. Both proposed rules focus on the interoperability of data across systems, and make the EHR Incentive Programs simpler and more flexible.
Eligible professionals now have until 11:59 pm ET on March 20, 2015, to attest to meaningful use for the Medicare Electronic Health Record (EHR) Incentive Program 2014 reporting year.
CMS extended the deadline to allow providers extra time to submit their meaningful use data. CMS continues to urge providers to begin attesting for 2014 as soon as they can.
To earn a 2015 incentive payment and avoid a 2016 payment adjustment, first-time participants should:
Eligible hospitals that miss this deadline can still earn a 2015 incentive payment—and avoid the 2017 payment adjustment—if they begin their reporting period by July 1 and attest by November 30. However, they will be subject to the 2016 payment adjustment unless they apply and qualify for a hardship exception.
Hospitals that successfully attest in 2015 will also be eligible to earn a 2016 incentive if they continue to participate.
Eligible hospitals that begin participating after 2015 will not be able to earn incentive payments. They will also be subject to payment adjustments in 2016 and 2017.
Reforms to Medicare regulations identified as unnecessary, obsolete, or excessively burdensome on hospitals and other health care providers will save nearly $660 million annually, and $3.2 billion over five years, through a rule issued today by the Centers for Medicare & Medicaid services (CMS).
The EHR Incentive Programs website offers tools and resources to help eligible hospitals to successfully participate:
News Update from www.CMS.gov
In response to input from health care providers and other stakeholders, CMS is considering the following changes to the Medicare and Medicaid Incentive Programs:
Shortening the 2015 reporting period to 90 days to address provider concerns about their ability to fully deploy 2014 Edition software Electronic Health Record (EHR)
Realigning hospital reporting periods to the calendar year to allow eligible hospitals more time to incorporate 2014 Edition software into their workflows and to better align with other quality programs
Modifying other aspects of the programs to match long-term goals, reduce complexity, and lessen providers’ reporting burden
While CMS intends to pursue these changes through rulemaking, they will not be included in the pending Stage 3 proposed rule. CMS intends to limit the scope of the pending proposed rule to Stage 3 and meaningful use in 2017 and beyond.
If you are an eligible professional participating in the Medicare EHR Incentive Program, you have until February 28, 2015 to attest to demonstrating meaningful use of the data collected during your EHR reporting period for the 2014 calendar year. If you are participating in the Medicaid EHR Incentive Program, please refer to your state’s deadlines for attestation information.
While patient portals are not new, getting patients to use them is a common challenge. Whether your practice has had a patient portal in place for years or months, getting your patients to use it is what matters most. The importance is magnified as Meaningful Use stage 2 requires that 5% of patients must actively use the patient portal. Getting your patients to use the patient portal isn’t impossible. In fact, patients want to use your patient portal. They are demanding access to their health information and want to take charge of their health. It is up to you to teach them how to do it.
2015 is here and with it comes 550 changes to CPT coding. Every year brings updates, additions, and deletions of CPT codes. How you handle the changes can make your start to 2015 profitable or painful.