KENTUCKY REGIONAL EXTENSION CENTER

Payment Adjustments

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