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Meaningful use payment cuts affect more than 200,000 EPs

Physician Practice Insider, January 26, 2016

A total of 209,000 eligible professionals (EP) will be hit with negative Medicare Physician Fee Schedule (MPFS) payment adjustments in 2016 for failing to meet EHR meaningful use criteria, CMS announced in a fact sheet released January 12. Payment adjustments for 2016 are based on data gathered in 2014.

CMS estimates that most EPs will see an EHR Incentive Program payment reduction of less than $1,000. However, at the high end of the scale, a minority of EPs will be subject to a negative payment adjustment of more than $10,000. Estimated negative payment adjustments are:

• 13,900 EPs will receive a negative payment adjustment of less than $100
• 103,000 EPs will receive a negative payment adjustment of $100–$1,000
• 30,400 will receive a negative payment adjustment of $1,000–$5,000
• 56,000 will receive a negative payment adjustment of $5,000–$10,000
• 5,700 will receive a negative payment adjustment of $10,000 or more

EPs who are unable to meet meaningful use requirements can apply for hardship exceptions. Applications for hardship exceptions for the CY 2015 reporting period are due July 1. The Patient Access and Medicare Protection Act (PAMPA), signed into law December 28, 2015, allows CMS to create a fast-track process for meaningful use hardship applications for the CY 2015 reporting period filed before March 15. These applications will exempt EPs who were unable to meet meaningful use requirements in 2015 from suffering MPFS reductions in 2017. CMS announced the first PAMPA-related changes to the hardship exception process on January 22. Streamlined applications are now available and CMS will review all applications filed by the March 15 deadline using an expedited process, rather than the standard case-by-case review system. Applications submitted after March 15 will revert to the case-by-case review process. Groups of providers may also apply using a single application, according to CMS’ application instructions.

Nearly 50% of EPs saw their payments cut in 2015, according to the American Medical Association. However, CMS reports that currently more than 70% of EPs have successfully attested meaningful use requirements and received incentive payments. EPs who have participated in the program since its beginning in 2012 and successfully met requirements each year can be awarded up to $43,720 in incentive payments.

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