MU: Payment Adjustments 08/05/14

 August 2014 
Meaningful Use Update – Payment Adjustments
Understanding Meaningful Use Penalties
As part of the American Recovery and Reinvestment Act of 2009 (ARRA), Congress mandated payment adjustments to be applied to Medicare-eligible professionals and hospitals who are not Meaningful Users of Certified Electronic Health Record (EHR) Technology under the Medicare EHR Incentive Programs. Medicaid-eligible professionals who can only participate in the Medicaid EHR Incentive Program and do not bill Medicare are not subject to these payment adjustments.  
There are significant differences in the calculation and timing of penalties in the form of reduced Medicare re-imbursement between acute care, critical access and eligible providers. Depending upon when you first attest, penalty timeframes may vary. The Stage 2 Rule has established the timeline for how reductions in Medicare reimbursement will be calculated for EHs and EPs who fail to meet Meaningful Use requirements for a given year.  
Payment Adjustment for Medicare Subsection (d) Eligible Hospitals  
Eligible hospitals that are not Meaningful Users will be subject to a payment adjustment beginning on October 1, 2014. This payment adjustment is applicable to the percentage increase of the Inpatient Prospective Payment System (IPPS) payment rate for those eligible hospitals that are not Meaningful EHR Users. These hospitals will receive a reduced update to the IPPS standardized amount. The payment adjustment is cumulative for each year that an eligible hospital is not a Meaningful EHR User.  
Eligible hospitals that first demonstrate Meaningful Use in fiscal year 2011 or 2012 must demonstrate Meaningful Use for a full year in fiscal year 2013 to avoid payment adjustments in 2015.  
Eligible hospitals that first demonstrate Meaningful Use in fiscal year 2013 must demonstrate Meaningful Use for a 90-day reporting period in 2013 to avoid payment adjustments in 2015. They must continue to demonstrate Meaningful Use every year to avoid payment adjustments in subsequent years.  
“Depending upon when you first attest, penalty timeframes
may vary.”
 

Jim Deren
Healthcare IT Planning Specialist
CareTech Solutions

Eligible hospitals that first demonstrate Meaningful Use in fiscal year 2014 must demonstrate Meaningful Use for a 90-day reporting period in 2014 to avoid payment adjustments in 2015. This reporting period must occur in the first nine months of fiscal year 2014, and must attest to Meaningful Use no later than July 1, 2014, in order to avoid the payment adjustments. Eligible hospitals must continue to demonstrate Meaningful Use every year to avoid payment adjustments in subsequent years.
Payment Adjustment for Critical Access Hospitals  
Critical Access Hospitals (CAHs) that are not Meaningful Users will be subject to a payment adjustment for fiscal year 2015. This payment adjustment is applicable to a CAH’s Medicare reimbursement for inpatient services during the cost reporting period in which they failed to demonstrate Meaningful Use. If a CAH has not demonstrated Meaningful Use for an applicable reporting period, then for a cost reporting period that begins in FY 2015, its reimbursement would be reduced from 101 percent of its reasonable costs to 100.66 percent. For a cost reporting period beginning in FY 2016, its reimbursement would be reduced to 100.33 percent of its reasonable costs. For a cost reporting period beginning in FY 2017 and each subsequent fiscal year, its reimbursement would be reduced to 100 percent of reasonable costs.
In order to avoid the payment adjustments, CAHs must demonstrate Meaningful Use within the full federal fiscal year that is the same as the payment adjustment year. The adjustment would then apply based upon the cost reporting period that begins in the payment adjustment year (that is, FY 2015 and thereafter).
CAHs are required to submit their attestations for Meaningful Use by November 30 of the following fiscal year. For example, if a CAH is attesting that it was a Meaningful EHR User for FY 2015, the attestation must be submitted no later than November 30, 2015 in order to avoid payment adjustments.
Payment Adjustments for Medicare-Eligible Professionals
Medicare-eligible professionals who are not Meaningful Users will be subject to a payment adjustment beginning on January 1, 2015. This payment adjustment will be applied to the Medicare physician fee schedule (PFS) amount for covered professional services furnished by the eligible professional during the year. The payment adjustment is one percent per year and is cumulative for every year that an eligible professional is not a Meaningful User. Depending on the total number of Medicare eligible professionals who are Meaningful Users under the EHR incentive programs after 2018, the maximum cumulative payment adjustment can reach as high as five percent.
Eligible professionals who first demonstrate Meaningful Use in 2011 or 2012 must demonstrate Meaningful Use for a full year in 2013 to avoid payment adjustments in 2015.
Eligible professionals who first demonstrate Meaningful Use in 2013 must demonstrate Meaningful Use for a 90-day reporting period in 2013 to avoid payment adjustments in 2015.
Because all providers must upgrade or adopt newly certified EHRs in 2014, all providers, regardless of their stage of Meaningful Use, are only required to demonstrate Meaningful Use for a three-month (or 90-day) EHR reporting period in 2014. Eligible professionals who first demonstrate Meaningful Use in 2014 must demonstrate Meaningful Use for a 90-day reporting period in 2014 to avoid payment adjustments in 2015. This reporting period must occur in the first nine months of calendar year 2014, and eligible professionals must attest to Meaningful Use no later than October 1, 2014 in order to avoid the payment adjustments.  
Eligible professionals must continue to demonstrate Meaningful Use every year to avoid payment adjustments in subsequent years.  
Upcoming Meaningful Use topic: Attestation Timelines


For an archive of our newsletters, please visit the
Resources page on CareTech.com.

 

 

CareTech Solutions Caps Banner Year by Signing Pennsylvania’s Lehigh Valley Health Network, Tennessee’s Covenant Health, and Ohio’s Marietta Memorial Hospital to Provide Web Services

CareTech’s Web Services Division Marks 60-Percent Growth in Client Roster, Expansion into Nine New States, and Continued Industry Recognition in National Web Award Competitions

TROY, Mich. – February 24, 2009 – CareTech Solutions, an information technology (IT) and Web products and services provider for hospitals and health systems, announced today that it has signed agreements to provide a comprehensive suite of Web products and services to Lehigh Valley Health Network of Allentown, Penn., Covenant Health of Knoxville, Tenn., and Marietta Memorial Hospital of Marietta, Oh.

2008 was a banner year for CareTech’s Web Services division, marked by:

  • Sixty-percent growth in the division’s client roster since 2007;
  • Providing Web products and services for health systems in nine new states: Tennessee, Missouri, Pennsylvania, Texas, Connecticut, Maryland, Indiana, New York and California;
  • Sixty-four new or extended customer agreements; and
  • Continued broad industry recognition in major national Web award competitions.

“The unprecedented success and growth of CareTech’s Web Services division over the past year speaks to the value our client hospitals receive in working with a talented team of professionals who are committed to helping them use Web technology to improve the patient care experience,” said Jim Giordano, President and CEO of CareTech Solutions. “CareTech Solutions’ broad portfolio of Web products and services was developed in direct response to our clients’ needs for enhanced communication, improved efficiency, and increased productivity in the hospital environment. We look forward to sharing those benefits with more hospitals and health systems in 2009 and beyond.”

Highlights of growth and success in CareTech’s Web Services division in 2008 include:

  • A multi-year agreement to provide Broward Health of Fort Lauderdale, Fla. with Web services, including intranet and Internet development and hosting using CareWorks CMSTM.
  • An agreement to serve as Web services provider to Binghamton, New York’s United Health Services. CareTech is providing website development, support and hosting using its CareWorks CMSTM product, which will serve as the foundation of United Health Services’ Web presence.
  • A five-year agreement to provide BJC HealthCare of St. Louis, Mo. with Web services. BJC and 11 of its affiliated hospitals will be provided with CareTech’s CareWorks CMSTM content management system, as well as its BoardNetTM communications portal for hospital boards of directors.
  • The implementation of a comprehensively designed Web site at southeast Michigan’s Garden City Hospital. Using CareTech Solutions’ CareWorks CMSTM content management system, the site now incorporates advanced functionality that includes a physician finder, an employment opportunity module, patient preregistration, class registration, “e-greeting” cards and an online medical equipment store.
  • Top recognition for six of CareTech’s client-hospital Web sites in the Web Marketing Association’s 2008 WebAward competition – the most of any Web services firm in the healthcare provider category. Of note is Hendricks Regional Health of Danville, Ind., which received the category’s “Outstanding Web site” award, and is one of only two in the category to do so. As one judge stated, “Having judged many health-oriented sites over the years, this is one of the best.”
  • Receipt of Strategic Healthcare Communications’ eHealthcare Leadership Awards by seven CareTech-client hospitals. Organizers noted CareTech’s achievement of Silver Awards for two of its healthcare-client Web sites – Holy Family Memorial Health of Manitowoc, Wis. for Best Health/Healthcare Content and The Detroit Medical Center of Detroit, Mich. for “Best Web 2.0/Rich Media.” eHealthcare Leadership Awards Chairman Mark Gothberg states, “Combined with its numerous other winning entries, CareTech is to be congratulated for its particularly strong performance in these highly competitive categories.”

About CareTech Solutions, Inc.

CareTech Solutions, Inc., an information technology service provider for hospitals and health systems, is committed to creating value for clients through customized, flexible solutions that contribute to improving patient care while lowering healthcare costs. From implementing emerging technologies to supporting day-to-day operations, CareTech offers clients expert services across the entire patient data lifecycle.

CareTech Solutions won a coveted 2008 Best in KLAS award for the IT Outsourcing (Extensive) market segment, as ranked by healthcare executives and professionals in the 2008 Top 20 Best in KLAS Awards report. CareTech’s Best in KLAS distinction follows the company’s achievement of market-leading overall performance scores in KLAS’ 2008 Extensive IT Outsourcing Study. CareTech’s overall performance score was 94.6 on a 100-point scale – the top score among six competing extensive IT outsourcing firms cited in the report, and the highest score KLAS has measured since first measuring extensive IT outsourcing performance in 2005. CareTech earned 100-percent scores in each of the “business indicator” categories of Would You Buy it Again, Avoids Nickel-and-Diming, Keeps all Promises, Services Delivered within Budget/Cost and Would You Recommend to a Friend/Peer.

Information Technology Services – Web Products and Services – CableCare™ Structured Cabling and Wiring

For more information, please visit www.caretechsolutions.com.

CONTACT:
Jody Meehan
CareTech Solutions
(248) 823-0900
jody.meehan@caretechsolutions.com

Brian Barthelmes
Airfoil Public Relation
(248) 304-1451
barthelmes@airfoilpr.com