News Feature | October 6, 2014

Recent Update In EHR Incentive Program Could Mean Penalties For Your Clients

By Megan Williams, contributing writer

Making Revenue Cycle Solutions Accessible To Your Clients

Some of your EHR clients may be hit with a penalty next year, and it’s not their fault.

The Problem

Modern Healthcare reports the problem lies in the logic built into the Centers for Medicare and Medicaid Services (CMS) website. It’s unable to process attestations from a small group of health professional participants who’ve genuinely complied with program requirements for Meaningful Use. Affected organizations have asked the government to extend the deadline to accommodate the issue.

Senior policy advisor to the Medical Group Management Association Robert Tennant has weighed in on the issue, stating “That's only reasonable. If (a participant) is trying to attest and cannot, it's patently unfair if they cannot because their website is unable to handle it.”

The Solution

The upgrade to fix the issue is expected to be complete in mid-October, but according to the existing rule, that is beyond the October 1 filing deadline that would allow providers to avoid 2015 Medicare penalties. The penalty would mean providers losing 1 percent of their Medicare reimbursements in the next year.

The Root Of The Problem

The Modern Healthcare article explains that the problem was originally created when the agency worked to adjust the program logic to accommodate changes to the program made in late August, ironically, giving providers more flexibility and allowing them to stay eligible for incentive payment and avoid penalties. If the portal is fixed, EHR (electronic health records) incentive payments will not be affected.

As of now, it is not clear how many participants are at risk of penalties because of the problem. The circumstances that will determine who’s affected include:

  • Who enrolled in the Medicare portion of the program this year and chose to use 2011 edition software (or a 2011/2014 hybrid) to achieve Stage 1 Meaningful Use, and will qualify for an expanded hardship exemption in 2014.
  • Anyone who first participated in the Medicaid portion of the EHR incentive payment program in 2013, is using 2011 edition software (or a 2011/2014 hybrid), and will be eligible for expanded hardship exemption.

The hardship exemptions were allowed after CMS saw that providers and EHR vendors could not meet upgrade requirements in time for use this year.

You can read more on the exemptions and penalties at Modern Healthcare.