A major Electronic Prescribing (eRx) Incentive Program deadline is approaching for both individual eligible professionals (EPs) and group practices participating in the Group Practice Reporting Option (GPRO). If you are an EP or an eRx GPRO participant, you must successfully report an electronic prescriber before June 30, 2013 or you will experience a payment adjustment in 2014 for professional services covered under Medicare Part B’s Physician Fee Schedule (PFS).
The 2013 eRx Incentive Program 6-month reporting period (January 1, 2013 to June 30, 2013) is the final reporting period available to you if you wish to avoid the 2014 eRx payment adjustment.
If you do not successfully report, a payment adjustment of 2.0% will be applied, and you will receive only 98.0% of your Medicare Part B PFS amount for covered professional services in 2014.
Avoiding the 2014 eRx Payment Adjustment
Individual EPs and eRx GPRO participants who were not successful electronic prescribers in 2012 can avoid 2014 eRx payment adjustment by meeting specified reporting requirements between January 1, 2013 and June 30, 2013. Below are the 6-month reporting requirements:
- Individual EPs – 10 eRx events via claims
- eRx GPRO of 2-24 EPs – 75 eRx events via claims
- eRx GPRO of 25-99 EPs – 625 eRx events via claims
- eRx GPRO of 100+ EPs – 2,500 eRx events via claims
Additional resources on the 2014 payment adjustment are available on the CMS eRx Incentive Program Payment Adjustment Information webpage, including the resource Electronic Prescribing (eRx) Incentive Program: Updates for 2013.
Beginning January 1, 2015, Medicare eligible professionals that do not attest successfully to meaningful use of certified technology will incur payment adjustments. The payment adjustments are mandated through the HITECH Act to begin the first day of the 2015 calendar year. CMS will determine the Medicare payment adjustments based on meaningful use data submitted prior to the 2015 calendar year. The adjustments will be applied to the providers covered services submitted through the Medicare physician fee schedule.
Only EPs that are eligible for the Medicare EHR Incentive Program are subject to payment adjustments. Those Medicaid EPs that can only participate in the Medicaid EHR Incentive Program and do not bill Medicare are not subject to these payment adjustments.
The following is guidance from CMS on Medicare payment adjustments and what year of participation in the EHR Incentive Program. EPs must also continue to demonstrate meaningful use every year after their initial year to avoid payment adjustments in subsequent years.
EPs that began participation in 2011 or 2012: EPs who first demonstrated meaningful use in 2011 or 2012 must demonstrate meaningful use for a full year in 2013 to avoid payment adjustments in 2015.
EPs that plan to begin participation in 2014: EPs 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 9 months of calendar year 2014, and EPs must attest to meaningful use no later than October 1, 2014, in order to avoid the payment adjustments.
EPs that begin participation this year (2013): EPs 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.
More details for EPs: How Payment Adjustments Affect Providers Tipsheet.
Information from: HITECH Answers
InformationWeek Names Kentucky REC’s Director, Dr. Carol Steltenkamp, to the “20 Health IT Leaders Who Are Driving Change”
InformationWeek Named Dr. Carol Steltenkamp of UK HealthCare and Kentucky REC one of the “20 Health IT Leaders Who Are Driving Change” in their organizations and the industry. This list calls out leaders in informatics, in data integration, even the CEO of a health information exchange. This mix reflects the fact that many people are influencing the tech decisions at health organizations.
I am not a techie,” concedes Dr. Carol Steltenkamp, chief medical information officer of University of Kentucky HealthCare. Yet she has positioned the academic health system as a leader in IT since she arrived in 2006, carrying on a legacy that predates her tenure.
In January 2011, UK HealthCare became the first organization in the U.S. to get a bonus Medicaid check for Meaningful Use. Years earlier, in 2003 and 2004, the health system took the then-daunting step of installing computerized physician order entry at a time when the Leapfrog Group was touting CPOE as one of its four key “safety practices.”
“The very first thing we did on the inpatient side was CPOE,” Steltenkamp says. CPOE usually is one of the toughest pieces of clinical IT — the medical staff at Cedars-Sinai Medical Center in Los Angeles rebelled against a poorly implemented system in 2003 — but UK HealthCare got it done and has been refining it for years.
But the order sets at UK had gotten unwieldy. “We have too dang many,” Steltenkamp says. So UK is updating its technology as a beta customer of Elsevier’s InOrder cloud-based system for creating and managing order sets. For example, the health system had nine order sets related to stroke care across its main UK Chandler Hospital, the adjacent Kentucky Children’s Hospital and the UK Good Samaritan Hospital. It has condensed those to two. A pediatrician who practices part-time, Steltenkamp sees her clinical background as helpful in understanding how to cull order sets and build useful ones backed by proper medical evidence.
As a CMIO, her challenge is to apply data to deliver actionable knowledge at the right point in the workflow to help clinicians make “judicious decisions,” she says. Steltenkamp looks at the multitudes of clinical data UK HealthCare has compiled and deems it “untapped.”
Kentucky REC is very proud of our fearless leader, Dr. Carol Steltenkamp!
Kentucky REC’s Dr. Barry Little Contributes to ONC Health IT Resources for Critical Access Hospitals and Small Rural Hospitals
ONC is launching the first in a series of web pages tailored to meet the Health IT needs of Critical Access Hospitals (CAHs) and small, Rural Hospitals (RHs). This effort is in support of the ONC goal to see 1000 CAHs and RHs achieve Meaningful Use by the end of 2014. The pages are filled with resources, lessons from the field, Health IT implementation support tools and more. Federal funding opportunities for Health IT infrastructure (e.g., hardware, software, broadband) are also included on these pages.
“We’ve witnessed CAHs and small rural hospitals make great progress—As of February 2013, over 700 received a CMS Meaningful Use incentive payment. A key strategy for supporting CAHs and small, rural hospitals is convening the Rural Community of Practice. This tremendous group of leaders and experts from across the country is dedicated to identifying the most pressing barriers that rural safety-net hospitals face, developing tools and resources for overcoming these challenges and then hand-picking the best among these tools to make available on healthit.gov,” says Leila Samy, ONC’s Rural Health IT Coordinator.
Barry Little, MD, Physician Advisor & Informaticist for the Kentucky REC, serves on the nationwide leadership team developing the content for the first waves of Health IT content tailored to CAHs and RHs.
“Dr. Little is a true expert. He is dedicated to the needs of the Kentucky rural health care providers that he serves. Dr. Little is also a part of the leadership team collaborating to support CAHs and small, rural hospitals nationwide. He offer a vision that is grounded; he contributes a structured path forward for the task forces on which he serves, enabling them to craft a successful path forward and deliver ambitious results. He is among the select group of individuals from across the country who received a special award signed by the National Coordinator for Health IT, titled: Critical Access & Rural Hospital Champion. The award is in recognition of groundbreaking collaborative efforts with public and private sector partners to accelerate Meaningful Use among CAHs and RHs nationwide,” says Leila Samy.
To access these web pages, visit: http://www.healthit.gov/ruralhealth. Stay tuned more for updates.
We invite you to participate in the nationwide call to action in support of CAHs and rural hospitals by sharing comments and success stories. Follow this link to the challenge and then scroll to the bottom of the page to “Leave a Reply.”
Today HHS, CMS and the Office of the National Coordinator for Health IT announced an important healthcare milestone – more than 50% of eligible professionals nationwide are using EHRs meaningfully in their offices and more than 80% of U.S. hospitals are using EHRs.
To Kentucky’s Meaningful Users: Congratulations on your role in this important milestone. Better use of EHRs leads to more coordinated care, fewer medical errors, and lower costs to the system. It is an honor to act as your partner in achieving the different stages of meaningful use and using health IT as a springboard to the many initiatives that will be critical to the new healthcare landscape.
For additional information on this important milestone check this Health IT article.