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In this issue
2010:
Time for practices to prepare for the $44,000 Medicare EHR incentive
The federal
government is expected to release regulations defining "meaningful
use" and certification standards for electronic health records (EHR)
in relation to the American Recovery and Reinvestment Act Medicare and
Medicaid incentives for physicians, hospitals and others to adopt EHRs.
Modeled broadly on the Physician Quality Reporting Initiative, eligible
professionals who are “meaningful users” of an EHR can be reimbursed for up
to $44,000 for adopting a “certified” system under the Medicare incentive program
and up to $63,750 under the Medicaid program. Medicare penalties begin in
2015 for those who are not meaningful EHR users. With the first incentive
payments available in 2011, a large number of medical groups are expected
to begin the transition to EHRs in 2010.
MGMA has
developed a comprehensive three-part Webinar
series to help members understand the specifics of the incentive
program and how to select and implement an EHR that best meets their
organizations' clinical and administrative requirements.
Important
CMS information on 2010 conversion factor and claims processing
On Dec.
21, the president signed into a law the Department of Defense appropriations
bill that freezes the Medicare conversion factor for 60 days. This language
addresses only the conversion factor; and all other 2010 policy changes to
the Medicare program become effective on Jan. 1.
Due to
ongoing healthcare reform negotiations, the Centers for Medicare &
Medicaid Services (CMS) recently announced that it would hold all Part B
claims until Jan. 15, and that the Physician Annual Participation
Enrollment Program would be extended from Jan. 31 to March 17. In the
announcement, CMS said:
“[It]
is working with Congress, health care providers, and the beneficiary
community to avoid disruption in the delivery of health care services and
payment of claims for physicians, non-physician practitioners, and other
providers of services paid under the Medicare physician fee schedule,
beginning January 1, 2010. In this regard, CMS has instructed its
contractors to hold claims for services paid under the Medicare Physician
Fee Schedule (MPFS) for up to the first 10 business days of January (January
1 through January 15) for 2010 dates of service. This should have minimum
impact on provider cash flow because, by law, clean electronic claims are
not paid any sooner than 14 calendar days (29 days for paper claims) after
the date of receipt. Meanwhile, all claims for services delivered on or
before December 31, 2009, will be processed and paid under normal
procedures.
The holding of claims allows Medicare contractors time to receive the new,
updated payment files and perform necessary testing before paying claims at
the new rates. CMS has instructed contractors to begin processing claims at
the new rates no later than January 19, 2010. Please note that most
contractors are closed on the January 18 Martin Luther King Day holiday.
Therefore, even absent a new update, most claims likely would not have been
paid any sooner than January 19, 2010, given the aforementioned statutory
14-day payment floor.
CMS
has extended the 2010 Annual Participation Enrollment Program end date from
January 31, 2010, to March 17, 2010– therefore, the enrollment period now
runs from November 13, 2009, through March 17, 2010.
The effective date for any Participation status change during the
extension, however, remains January 1, 2010, and will be in force for the
entire year.
Contractors will accept and process any Participation elections or
withdrawals, made during the extended enrollment period that are received
or post-marked on or before March 17, 2010.
In addition, be on the alert for more information about other legislative
provisions which may affect you.”
Additionally, CMS published educational articles pertaining to the Expiration
of Various Payment Provisions Under the Medicare Program and the 2010
Annual Participation Enrollment Program Extension.
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Dec. 30, 2009
Member Resources
Healthcare Reform Resource Center
Medicare
Provider Enrollment Toolkit
Physician Quality Reporting Initiative Resource Center
Recovery Audit Contractors Resource Center
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