Eligible Professionals Hit With $200M in EHR Penalties

February 11, 2015 in News

Eligible professionals this year will pay about $200 million in penalties for failing to meet Medicare meaningful use requirements, according to new data from the Office of the National Coordinator for Health IT, Health Data Management reports (Slabodkin [1], Health Data Management, 2/11).

Background

Under the 2009 economic stimulus package, providers who demonstrate meaningful use of certified electronic health records can qualify for Medicaid and Medicare incentive payments.

In December 2014, a CMS official said starting Jan. 1 the agency would send letters to providers notifying them of a 1% reduction in Medicare payments for not meeting program criteria (iHealthBeat, 12/17/14).

The latest ONC data show that as of Feb. 1:

  • 91,033 eligible professionals have attested to Stage 1; and
  • 36,782 eligible professionals have attested to Stage 2.

Penalty Details

At a joint Health IT Policy and Standards Committees meeting on Tuesday, Elisabeth Myers — head of CMS’ Office of eHealth Standards and Services — said that about 256,000 eligible professionals are subject to Medicare payment reductions (Slabodkin [1], Health Data Management 2/11).

According to Politico‘s “Morning eHealth,” most eligible professionals facing penalties will pay less than $1,000 (Gold, “Morning eHealth,” Politico, 2/11). Specifically, the data show that:

  • 34% of eligible professionals likely will receive a payment adjustment between $1 and $250;
  • 21% likely will see a payment adjustment between $250 and $1,000;
  • 14% likely will see a payment adjustment between $1,000 and $2,000; and
  • 31% likely will see a payment adjustment of more than $2,000.

However, Myers emphasized that these projections are “estimates,” noting that the actual payment adjustment “is a percentage of the claims that are submitted for Medicare services during 2015,” which have not yet been submitted (Slabodkin [1], Health Data Management, 2/11).

In a statement, the American Medical Association said it was “appalled” by the penalties, calling on CMS to overhaul the meaningful use program (“Morning eHealth,” Politico, 2/11).

AMA added, “The penalties physicians are facing as a result of the meaningful use program undermine the program’s goals and take valuable resources away from physician practices that could be spent investing in better and additional technologies and moving to alternative models of care that could improve quality and lower costs” (AMA release, 2/11).

Majority of Eligible Hospitals Achieve Meaningful Use

Meanwhile, Dawn Heisey-Grove of ONC on Tuesday shared data that showed 90% of the nearly 5,000 eligible hospitals had attested to some stage of meaningful use as of December 2014, Health Data Management reports.

Heisey-Grove noted that of the remaining eligible hospitals:

  • 5% are adopting, implementing or upgrading paid, meaning they have been paid to adopt certified EHR technology, but have not yet attested;
  • 4% are not participating; and
  • 1% are registered for the program.

Overall, ONC data show that as of Feb. 1:

  • 2,275 eligible hospitals have attested to Stage 1 for FY 2014; and
  • 1,815 eligible hospitals attested to Stage 2 for FY 2014.

About 4,200 eligible hospitals are expected to attest to Stage 2 of the program during fiscal year 2015, according to Health Data Management.

Meanwhile, Heisey-Grove said that small rural hospitals are attesting to meaningful use at a similar rate to larger hospitals, with a 95% attestation rate and 96% rate, respectively. However, small urban hospitals have attested at a lower rate of about 80%.

Among the program’s 100 children’s hospitals, the data show that:

  • 55% have attested;
  • 26% are adopting, implementing or upgrading paid; and
  • 9% are not participating (Slabodkin [2], Health Data Management 2/11).
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