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Departments: Practice Points
Cathy Thomas Hess, BSN, RN, CWOCN, is Vice President and Chief Clinical Officer, Net Health. Ms Hess presides over Professional Services, which offers products and solutions to optimize process and work flows. Address correspondence to Cathy Thomas Hess, BSN, RN, CWOCN, via e-mail:
In the past months, I have been working with clients to assist them in understanding the Meaningful Use roadmap for 2014. As we round the corner for the remaining part of this calendar year, there is 1 last deadline date available for the eligible professional (EP) to meet Stage 1 Meaningful Use. This calendar date is October 1, 2014, and is the final opportunity for EPs to begin the 90-day reporting period to demonstrate meaningful use (unless the EP has been granted a hardship exemption).
The Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs provide financial incentives for the “meaningful use” of certified EHR technology. Attestation is the part of the process to secure the Centers for Medicare & Medicaid Services (CMS) EHR Incentive Program reimbursements that requires providers to prove (attest to) that they are meaningfully using a certified EMR.
To receive an EHR incentive payment, providers have to show that they are “meaningfully using” their certified EHR technology by meeting certain measurement thresholds that range from recording patient information as structured data to exchanging summary care records. The CMS has established these thresholds for EPs, eligible hospitals, and critical access hospitals (CAHs).
The CMS EHR Incentive Programs include 3 stages with increasing requirements for participation. All providers begin participating by meeting the Stage 1 requirements for a 90-day period in their first year of meaningful use and a full year in their second year of meaningful use. After meeting the Stage 1 requirements, providers will then have to meet Stage 2 requirements for 2 full years. Eligible professionals participate in the program on the calendar years, while eligible hospitals and CAHs participate according to the federal fiscal year.
As discussed in previous columns, July 1, 2014, was the last opportunity to participate in the Medicare EHR Incentive Program and be eligible to receive incentive payments (without penalties) upon successful attestation.
October 1, 2014, is the attestation deadline for eligible EPs in their first year of participation (Stage 1) to avoid the payment adjustment. Although you will receive the incentive payment, you would also receive a 1% penalty. This payment adjustment will be applied to the Medicare physician fee schedule amount for covered professional services furnished by the EP during the year (including the fee schedule amount for purposes of determining a payment based on the fee schedule amount). The payment adjustment is 1% per year and is cumulative for every year that an EP is not a meaningful user.
If you have not begun to document for Meaningful Use, consider the following key points to get you started.
1. Determine if you can participate in an EP Medicare EHR Incentive Program
- doctors of medicine or osteopathy
- doctors of dental surgery or dental medicine
- doctors of podiatry
- doctors of optometry
2. Utilize certified EHR technology
All certified EHR technology adheres to the standards and criteria of the EHR Incentive Program, which means it is certified to include functionality that will help you accomplish the core and menu objectives you must meet. Certified EHR technology includes the ability to calculate the numerators and denominators for all of the objectives based on the patient information you enter as part of your everyday workflow.
3. Understand the core and menu set objectives
- 13 core objectives. These are objectives that everyone who participates in the program must meet. Some of the core objectives have exclusions that could exempt you from having to meet them. However, you must to report on all 13 core objectives and meet the thresholds established by those objectives.
- 9 menu objectives. You have to report on only 5 of the 9 available menu objectives. You can choose objectives that make sense for your workflow or practice. Again, some of these objectives have exclusions that could exempt you from having to meet them.
- 9 of a possible 64 Clinical Quality Measures (CQMs). Beginning in 2014, you must select and report 9 of a possible list of 64 approved CQMs. You don’t have to do any calculations for the CQMs! Your certified EHR will produce a report with CQM data, and you must enter that data exactly as your certified EHR produced it.
4. Document and attest on time!
To learn more about the Meaningful Use program, access http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/index.html?redirect=/ehrincentiveprograms.