Over 200,000 EPs Will See Meaningful Use Fines This Year

Ken Terry

January 14, 2016

Approximately 209,000 eligible professionals (EPs) will lose up to 2% of their Medicare reimbursement this year for failing to show meaningful use of electronic health records (EHRs), according to a fact sheet posted by the Centers for Medicare & Medicaid Services (CMS) on October 30, 2015.

The penalties will be assessed for the 2014 performance year, so they won't be affected by the recent legislation that makes it easier for providers to obtain hardship exemptions in meaningful use stage 2. That law applies to the 2015 performance year, which is supposed to be the basis for penalties in 2017. Physicians have until March 15 to apply for these exemptions.

Whether those penalties will remain in effect if CMS ends the current meaningful program this year, as CMS Acting Administrator Andy Slavitt promised on Tuesday, is still unclear.

For most EPs affected by Medicare payments this year, the penalty amounts will be less than $1000. While 13,900 EPs will lose less than $100, the payment adjustments for 103,000 EPs will be $100 to 1000. Penalties of $1000 to $5000 will be assessed to 30,400 EPs; 56,000 will lose $5000 to $10,000; and 5700 will receive a payment adjustment of $10,000 or more. A total of 44,579 EPs did not file any Medicare physician claims.

In 2015, CMS penalized 256,000 physicians for failing to show meaningful use in 2013. Again, most of them lost less than $1000 of their Medicare reimbursement.

If the upcoming changes in the government's EHR incentive program do not end the meaningful use penalties, those who failed to attest to meaningful use for a 90-day period in 2015 will face a 3% penalty in 2017; the same will be true in 2018 for those who do not attest this year (assuming that the meaningful use program continues through the end of 2016).

The payment adjustments sunset at the end of 2018 under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). However, MACRA's Merit-Based Incentive Program, which begins in 2019, includes a component for meaningful use of information technology, along with quality of care, resource use, and clinical practice improvement activities. So even under MIPS, part of a physician's incentives and penalties will depend on the use of EHRs.

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