GE Healthcare Camden Group Insights Blog

New EHR Attestation Deadline for Eligible Hospitals: 12/31/14

Posted by Matthew Smith on Nov 24, 2014 3:01:00 PM
Courtesy of Centers for Medicare & Medicaid Services 

CMS, EHR, Meaningful UseCMS is extending the deadline for eligible hospitals and Critical Access Hospitals (CAHs) to attest to meaningful use for the Medicare Electronic Health Record (EHR) Incentive Program 2014 reporting year from 11:59 pm EST on November 30, 2014 to 11:59 pm EST on December 31, 2014.

This extension will allow more time for hospitals to submit their meaningful use data and receive an incentive payment for the 2014 program year, as well as avoid the 2016 Medicare payment adjustment.

CMS is also extending the deadline for eligible hospitals and CAHs that are electronically submitting clinical quality measures (CQMs) to meet that requirement of meaningful use and the Hospital Inpatient Quality Reporting (IQR) program. Hospitals now have until December 31, 2014 to submit their eCQM data via Quality Net.

Note: This extension does not impact the deadlines for the Medicaid EHR Incentive Program.

How to attest?
Medicare eligible hospitals and CAHs will use the Registration and Attestation System to submit their attestation for meaningful use for the 2014 reporting year. The system is open and fully operational, and includes the 2014 Certified EHR Technology (CEHRT) Flexibility Rule options. Medicare eligible hospitals and CAHs can attest any time to 2014 data until 11:59 pm EST on December 31, 2014 to meet the new 2014 program deadline.

Attestation Tips
Here are some steps to help make the attestation process easier:

  • Consider logging on to use the attestation system during non-peak hours, such as evenings and weekends
  • Log on to the registration and attestation system now and ensure that your information is up to date and begin entering your 2014 data  
  • If you experience attestation problems, call the EHR Incentive Program Help Desk and report the problem

Reminder: Medicare eligible hospitals must attest to demonstrating meaningful use every year to receive an incentive and avoid a payment adjustment.

2016 Payment Adjustments
Payment adjustments will be applied at the beginning of FY 2016 (October 1, 2015) for Medicare eligible hospitals that have not successfully demonstrated meaningful use in 2014. Read the eligible hospital payment adjustment tipsheet to learn more.

Note:  CAHs have a different payment adjustment schedule than Medicare eligible hospitals. Review the CAH Payment Adjustment and Hardship Exception Tipsheet.

The EHR Information Center is open to assist you with all of your registration and attestation system inquiries. Please call, 1-888-734-6433 (primary number) or 888-734-6563 (TTY number). The EHR Information Center is open Monday through Friday from 7:30 a.m. – 6:30 p.m. (Central Time), except federal holidays.

Attestation resources are available on the Educational Resources webpage of the EHR Incentives Programs website.

Topics: EHR, EMR, Meaningful Use, Medicare, CMS, Medicaid, Attestation

Study: Americans Still Don’t Understand Affordable Care Health Law

Posted by Matthew Smith on Mar 21, 2013 9:41:00 AM

Affordable Care ActIt’s been three years since President Barack Obama signed the Affordable Care Act into law, yet two-thirds of uninsured adults — the very people the law sets out to help — say they still don’t know what it means for them.

Sixty-seven percent of the uninsured younger than age 65 — and 57 percent of the overall population — say they do not understand how the ACA will impact them, according to a poll released Wednesday by the Kaiser Family Foundation (KHN is an editorially independent program of the foundation). The poll also found that Americans’ expectations of how the law will affect health care costs, quality and consumer protections are more negative than positive.

Enrollment for new coverage in the exchanges and Medicaid expansion is set to begin on October 1. That gives states and the federal government less than a year to educate consumers about signing up for coverage through online portals, by phone or with the help of in-person assistance.

But the public does not seem to be focusing on state implementation efforts.

Specifically, 48 percent say they have heard nothing at all about whether their state will run its own exchange. Seventy-eight percent say they haven’t heard enough to say whether their state plans to expand Medicaid, a decision the Supreme Court made optional in its landmark ACA decision last year. “This is equally true in states where the governor has states they will expand Medicaid and in those whose governor has said they will not move forward with the expansion,” the pollsters note.

In fact, the public seems actually to be even less knowledgeable about the health law’s more popular provisions than they were three years ago, including tax credits to small business to buy insurance, subsidy assistance for individuals and guaranteed issue of health insurance.

Many also continue to hold false impressions of the law: 57 percent incorrectly believe that the ACA includes a public option. Nearly half believe the law provides financial assistance for illegal immigrants to buy insurance. And 40 percent — including 35 percent of seniors —  still believe that the government will have “death panels” make decisions about end-of-life care for Medicare beneficiaries.

Overall, the evidence suggests that the Obama administration, state governments, advocates and the health care industry have a big job ahead of them to educate the public by 2014.  The stakes are high: In order for the financial structure of the ACA to hold up, a healthy cross-section of Americans must sign up for both Medicaid and the new exchanges. If they don’t, the pool will likely be filled with sicker individuals, and premium rates could skyrocket.

The poll was conducted March 5 through March 10 and surveyed 1,204 adults. The poll has a margin of error of +/- 3 percentage points.

via Kaiser Health News

Topics: ACA, Medicaid, Affordable Care Act, Obamacare

Healthcare Spending In America: Two Graphs to Show the Money Flow

Posted by Matthew Smith on Feb 6, 2013 5:00:00 PM

Healthcare costsSpending on healthcare has, of course, been rising in the U.S. for decades. Healthcare now accounts for 18 cents of every dollar Americans spend, up from 7 cents in 1970.

But where, exactly, is all that money going? And, for that matter, where is the money coming from to pay for all that healthcare? We found answers to both of these questions in this data set.

First, here’s where the money is going:

Despite huge changes in medicine and medical technology, the share of health dollars that flows to each major category has changed little in the past 40 years. In other words, spending on each category — drugs, hospitals, doctors, etc. — has increased at about the same rate.

What has changed dramatically is where the money comes from:

In 1970, by far the biggest share of health care spending was what people spent out of their own pockets. Today, insurance (private plans along with Medicare and Medicaid, which are government-run) covers almost everything.

What has had the largest impact? Insurance coverage has become much more comprehensive.

For example, in 1970, people typically had to pay for drugs out of their own pockets. By 2000, it had become routine for private insurance to cover drugs. Medicare drug coverage began in 2006.

What’s more, in many cases, employees gave up some freedom of choice in healthcare in exchange for less out of pocket spending. But that trend is reversing itself. Now we are going the other way, with higher deductibles and coinsurance for employer-based plans.

giant, long-term study conducted in the ’70s and ’80s is relevant here. Researchers randomly assigned people to receive different types of insurance — some had full coverage, while others had to pay for a big chunk of the care they received.

People had to pay more for care tended to get less care. And people who were poor and who had to pay more for care fared worse on some key health measures.

The underlying question here is one of the oldest and most contentious in health economics: What costs should health insurance cover, and what costs should be left to individual patients?

Courtesy of  and Kaiser Health News.

Revenue Cycle Assessment

Topics: Medicare, Hospitals, Medicaid, Healthcare spending

The Fiscal Cliff: 6 Questions About its Impact on Medicare & Medicaid

Posted by Matthew Smith on Dec 10, 2012 4:54:00 PM

Fiscal CliffThe impending "fiscal cliff" is a package of automatic spending cuts and tax hikes set to kick in next month unless President Barack Obama and Capitol Hill agree on a way to stop them.

Negotiations to avert the cuts are ongoing and both sides have exchanged offers. The president and congressional Democrats have said they will reduce spending on entitlements, including Medicare, if Republicans will agree to increase tax rates on the highest earners. While Republicans have agreed to more revenue, they oppose increasing tax rates, preferring to focus on closing loopholes and eliminating some deductions.

Here are a few questions and answers about what could happen in the weeks before the end-of-year deadline.

Q: If no deal is struck, how would that affect Medicare patients as well as the hospitals and physicians and other providers who care for them?

A: Under the series of automatic spending cuts known as "sequestration," Medicare providers would be subject to an across-the-board 2 percent payment cut, or $11 billion in fiscal 2013.  According to a September report from the Office of Management and Budget, hospitals would bear the largest share of the cuts, with payments reduced by about $5.8 billion.

Seniors would see no changes in their benefits.

Q:  How does that 2 percent cut in payments to physicians affect the 27 percent cut in Medicare payments to doctors already scheduled to occur in January? 

A: Physicians who accept Medicare patients would face the 2 percent cut on top of an already scheduled 27 percent reduction in January unless Congress steps in to stop it.

That payment formula was created in a 1997 deficit reduction law that called for setting Medicare physician payment rates through a formula based on economic growth. It’s known as the "sustainable growth rate" (SGR).

For the first few years, Medicare expenditures did not exceed the target and doctors received modest pay increases. But in 2002, doctors reacted with fury when they came in for a 4.8 percent pay cut. Every year since, Congress has staved off the scheduled cuts. But each deferral just increased the size – and price tag – of the fix needed the next time.

A deal on the SGR could be part of a "grand bargain," if congressional fiscal cliff negotiators decide to include it. To that point, Obama’s offer to Republicans included $25 billion to stop the scheduled cut. Congress could also pass separate legislation to stop the cuts. Some doctors say that if Medicare reimbursements are further reduced they may stop accepting Medicare patients.

Q: If negotiators do reach a deal, what could that mean for Medicare?

A: It depends on how large a role Medicare plays in a broader deal.  Some of the proposals include raising Medicare's eligibility age to 67, asking wealthier Medicare beneficiaries to pay more for their coverage and paying Medicare providers less. All are complicated and many Democrats have said that they do not want to make changes that harm beneficiaries or shift costs from the government onto seniors.  Republicans are insisting that entitlement savings play a large role in any deficit reduction deal.

Q: How is Medicaid affected, either way?

A: Medicaid does not face any automatic cuts starting Jan. 1.  The Supreme Court's ruling made the health law’s Medicaid expansion optional for states, so there’s concern that any reductions in federal Medicaid spending might make governors even more reluctant to expand the federal-state program.

Many Republicans, including GOP presidential nominee Mitt Romney and his running mate, Rep. Paul Ryan, R-Wis., favor changing Medicaid into a block grant, where states are given a set amount of money and more freedom to decide who is covered and what benefits they would receive. But the block grant concept is a non-starter with Obama and Democrats.

Q: If no deal is reached by Jan. 1, what happens to federal funding for medical research?

A:  The National Institutes of Health would see a $2.5 billion reduction in 2013, which means that the agency would "have to halt or curtail scientific research," according to the OMB analysis. Other agencies would see cuts, too. For example, the Centers for Disease Control and Prevention would face cuts of $490 million, and the Food and Drug administration would see reductions of about $318 million.

Q:  If no deal is reached, what happens to health care for members of the military and veterans?

A: The TRICARE program for active members of the military system would also face an across-the-board 2 percent cut. The Veterans Affairs health system, however, is exempt from sequestration.

Q&A courtesy of Kaiser Health News.

Topics: Medicare, Medicaid, Fiscal Cliff, Tricare

Meaningful Use: An Illustrated Infographic

Posted by Matthew Smith on Oct 3, 2012 10:06:00 PM
Meaningful Use Infographic
Meaningful Use infographic created by Greenway.

Topics: Meaningful Use, Medicare, Medicaid, Meaningful Use Attestation, Healthcare Infographics, Medicare MU, Stage 2 Meaningful Use

What You Need to Know About the CMS Meaningful Use Audits

Posted by Matthew Smith on Aug 14, 2012 10:05:00 AM

CMS LogoPractices that receive a letter from the Centers for Medicare & Medicaid Services regarding a Meaningful Use audit will have two weeks to reply. The good news is that practices that retained all supporting documentation and reports used to attest to meaningful use should not have a problem.

The letters ask physicians to provide three things, according to CMS:

  1. Proof that the EHR system used to meet meaningful use requirements is certified. The Office of the National Coordinator for Health Information Technology maintains a list of certified systems on its website.
  2. Supporting documentation proving that core objectives were met. Fifteen core objectives must be met to achieve meaningful use during stage 1 of the initiative. EHR systems certified to meet meaningful use should generate reports showing that these objectives have been met. Electronic or paper copies of those reports should satisfy the request.
  3. Supporting documentation that menu objectives were met. Those attesting to meaningful use in stage 1 choose five menu objectives from a list of 10. EHR-generated reports, including those used to support clinical quality measures, can show that those objectives have been met.

In addition to providing those three things, hospitals will be asked for documentation supporting the method used to report emergency department admissions.

The auditing process, a congressional requirement under the 2009 federal stimulus package that authorized the EHR bonuses, will be carried out by Figliozzi and Co., an accounting firm based in Garden City, N.Y.

The firm will audit recipients who obtained their bonuses from Medicare and hospitals that received incentive payments from both Medicare and Medicaid. States and their individual contractors will audit incentive program participants who received bonuses from Medicaid alone.

Medicare has paid more than $1 billion in bonuses to eligible professionals as of June, CMS said. More than 55,000 physicians have earned incentives for demonstrating meaningful use in 2011 or 2012.

A doctor or hospital found ineligible for an EHR incentive after an audit would be asked to return the bonus payment. The Government Accountability Office issued a report in April recommending that CMS examine its process for auditing the incentive program. The GAO suggested that CMS collect more information from physicians before bonus payments are made, so doctors won’t have to return money to the government if found to be noncompliant after the fact. CMS agreed with those recommendations but set no deadline or timetable for implementing them.

When asked about the audits, CMS spokesman Joseph Kuchler referred to the CMS website, which states that any eligible professional or hospital can be chosen for an audit. “Some may be selected based on specific information or risk factors, but they may also be random selections,” according to CMS. Physicians attesting to meaningful use should keep all documentation supporting compliance for at least six years after attestation, CMS said.

Physicians should be careful not to expose personal health information when sending the documentation to auditors, even though the letters say the information will be kept confidential, Wieland said. Future audits may require more detail, such as patient lists with personal information, but this round is a general survey that requires only high-level lists. “Practices shouldn’t view this as a threat,” he said.


Topics: EHR, EMR, Meaningful Use, Medicare, CMS, Medicaid, Physicians, Medical Practices

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