Through no fault of their own, a subset of physicians and other health professionals participating in the federal electronic health-record incentive payment program may get hit with Medicare penalties next year.
At the heart of the problem is the logic built into a CMS website that's unable to handle attestations from a narrow subset of program participants declaring they've complied with the program's requirements for meaningful use of the technology.
Organizations representing physicians and practices are asking the government to extend the deadline to accommodate the problem. “That's only reasonable,” said Robert Tennant, senior policy advisor to the Medical Group Management Association. “If (a participant) is trying to attest and cannot, it's patently unfair if they can't because their website is unable to handle it.”
Although an exact date is uncertain, mid-October is when an upgrade to the CMS' Web portal is expected to be complete, according to several sources.
But, under a CMS rule, mid-month will be too late to meet the Oct. 1 filing deadline to avoid 2015 Medicare penalties. The affected physicians and other eligible professionals are at risk of losing 1% of their Medicare reimbursements next year.
Ironically, the computer logic problem was created because the agency needed to modify the registration system to incorporate changes made to the program in late August to provide more flexibility in the program and help providers remain eligible for incentive payments and avoid the same Medicare penalties.
EHR incentive payments won't be affected by the problem, provided the portal is fixed.
All professionals in the program will still have the rest of this calendar year to meet their meaningful-use targets and until the end of February 2015 to attest that those targets have been met in order to receive their incentive payments.
It's unclear how many participants are at risk of the penalties because of the problem, but they are affected by a narrow set of circumstances.
They include anyone who enrolled in the Medicare portion of the program this year, chose to use 2011 Edition software (or a hybrid of 2011 and 2014 editions) to achieve Stage 1 meaningful use, and will be eligible for an expanded hardship exemption approved this year.
They also include those who first participated in the Medicaid portion of the EHR incentive payment program last year (and are therefore required to meet Stage 1 meaningful use requirements for the first time this year), are either using 2011 Edition software or a hybrid of 2011 and 2014 editions, and also will be eligible for an expanded hardship exemption.
The expansion of hardship exemptions approved earlier this year were to address those providers that were unable to buy or upgrade to higher-functioning 2014 Edition software specified by an earlier CMS rule to be used for the first time this year. The exemptions were granted after the CMS saw it was apparent providers and EHR vendors would be unable to meet the program's software upgrade requirements in time for use this year.
Physicians and other EPs entering the Medicare incentive payment program for the first time this year are eligible to receive $12,000 next year while those that started in the Medicaid program last year received $21,500 for adopting, upgrading or implementing a qualified EHR and would received another $8,500 for their participation as meaningful users this year.
That money would likely far offset any Medicare penalties either might receive in 2015.
The program has paid nearly $24.9 billion thus far, including $9.6 billion to physicians and other EPs, nearly $14.9 billion to more than 4,000 hospitals, and $407,000 to physicians in Medicare Advantage plans.
Follow Joseph Conn on Twitter: @MHJConn
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