A major Electronic Prescribing (eRx) Incentive Program deadline is approaching for both individual eligible professionals (EPs) and group practices participating in the Group Practice Reporting Option (GPRO). If you are an EP or an eRx GPRO participant, you must successfully report as an electronic prescriber before June 30, 2013 or you will experience a payment adjustment in 2014 for professional services covered under Medicare Part B’s Physician Fee Schedule (PFS.)
The 2013 eRx Incentive Program 6-month reporting period (January 1, 2013 to June 30, 2013) is the final reporting period available to you if you wish to avoid the 2014 eRx payment adjustment.
If you do not successfully report, a payment adjustment of 2.0% will be applied, and you will receive only 98.0% of your Medicare Part B PFS amount for covered professional services in 2014.
Avoiding the 2014 eRx Payment Adjustment
Individual EPs and eRx GPRO participants who were not successful electronic prescribers in 2012 can avoid 2014 eRx payment adjustment by meeting specified reporting requirements between January 1, 2013 and June 30, 2013. Below are the 6-month reporting requirements:
- Individual EPs – 10 eRx events via claims
- eRx GPRO of 2-24 EPs – 75 eRx events via claims
- eRx GPRO of 25-99 EPs – 625 eRx events via claims
- eRx GPRO of 100+ EPs – 2,500 eRx events via claims
Exclusions and Hardships Exemptions
Exclusions from the 2014 eRx payment adjustment only apply to certain individual EPs and group practices, and CMS will automatically exclude those individual EPs and group practices who meet the criteria. CMS may exempt individual eligible professionals and group practices participating in eRx GPRO from the 2014 eRx payment adjustment if it is determined that compliance with the requirements for becoming a successful electronic prescriber would result in a significant hardship. Requests for hardship exemptions must be submitted by June 30, 2013. More information on exclusion criteria and hardship exemption categories can be found on the Electronic Prescribing (eRx) Incentive Program: 2014 Payment Adjustment Fact Sheet.
Resources from CMS
Additional resources o n the 2014 payment adjustment are available on the eRx Incentive Program Payment Adjustment Information webpage, including the resource Electronic Prescribing (eRx) Incentive Program: Updates for 2013.
Questions about eRx?
If you have questions regarding the eRx Incentive Program, eRx payment adjustments, or need assistance submitting a hardship exemption request, please contact the QualityNet Help Desk at 866-288-8912 (TTY 1-877-715-6222) or via firstname.lastname@example.org . The Help Desk is available Monday through Friday from 7am-7pm CT.
To learn more about the eRx Incentive Program and program alignment under the CMS eHealth initiative, please visit www.CMS.gov/eHealth.
Reposted from Centers for Medicare & Medicaid Services Daily Digest Bulletin
The 2013 theme is Delivering Quality and Innovation in Patient Care. As always, the dates for National Nurses Week are May 6-12. National Nurses Week is celebrated annually from May 6, also known as National Nurses Day, through May 12, the birthday of Florence Nightingale, the founder of modern nursing.
In honor of this week, Wide River TEC would like to acknowledge one of our members of the Meaningful Use Vanguard (MUV) program, Jennifer Neilan. As a MUVer (member of the MUV program) Ms. Neilan is a Nurse Practitioner (NP) with Milius, Gibbens, Friesen, Hattan, Martin & Rauner, LLC located in Lincoln, Nebraska. Ms. Neilan joined the MUV program in September 2012. She is one of over 200 Nurse Practitioners working with Wide River TEC.
Late last year her clinic began using the patient portal function of their electronic health record (EHR). Practicing at an OB/GYN clinic, she mainly sees OB patients who have gestational diabetes. She said it took some time initially to set the portal up, but the impact of using the portal thus far has been very positive. She expressed the amount of time she saves has been one of the greatest benefits. She loves that she can communicate with her patients via the portal regarding their condition while assisting them in managing their care.
Ms. Neilan takes the time with each of her patients to show them how the patient portal works and makes sure they are comfortable with using it before they leave her office. Her patients are able to report to her their blood sugar levels any time of day they want. This flexibility is appreciated by both her and her patients.
As an NP, she was eligible for the Medicaid Incentive Payment Program, which provides up to $63,750 over six years for eligible providers to adopt and demonstrate meaningful use of an EHR. She was the only NP in her clinic to do so and received her first payment earlier this year.
Ms. Neilan stated, “Wide River TEC came to our office and went through the Meaningful Use criteria measure by measure, to assure we were on the right track.”
The ONC recently featured an article on Health IT Buzz that highlighted the success of ONC’s national network of Regional Extension Centers’ partnership with NPs to enable better care and better health through EHR adoption and Meaningful Use. Highlights of the brief include:
- Of the 41,000 plus primary care NPs nationwide, more than 20,800 nurse practitioners (50%) are partnered with Regional Extension Centers to enable better care and better health through EHR adoption and MU.
- Four out of five Regional Extension Center NPs are live on an EHR. Almost one-quarter of all Regional Extension Center NPs are already meaningful EHR users.
- More than half of all primary care NPs (58%) in rural areas work with a Regional Extension Center.
- Regional Extension Center NPs are 59% more likely to be paid for CMS MU incentives than non-enrolled NPs.
- Regional Extension Centers are also providing assistance to NPs who are not eligible for the incentive payments, and more than 1,000 of these providers have already demonstrated Meaningful Use.
Wide River TEC is proud of the work Ms. Neilan has accomplished at her clinic and the many other clinicians across Nebraska who are working to improve patient care with the use of Health Information Technology.
Read more about Jennifer Neilan on her MUVer page.
Wide River TEC became aware of the following initiative. Please see the message below for this important information.
In March 2013, legislation introduced in the U.S. House would exempt certain physicians from Medicare payment penalties starting in 2015 for failing to achieve meaningful use of electronic health records. This bill would amend certain requirements and penalties implemented under the Medicare and Medicaid programs by the HITECH Act of 2009, which would otherwise impede eligible professionals from adopting electronic health records to improve patient care.
Rep. Diane Black (R-Tenn.) is sponsor of H.R. 1331, and a member of the powerful Ways and Means Committee. That could make it easier for Black to tack provisions of the bill on other legislation going through Congress.
The bill as introduced would provide a three-year exemption to Medicare payment penalties for eligible professionals in a solo practice, or at or near retirement age. The legislation also would shorten the two-year gap between a performance period and application of a financial penalty to no more than one year. Presently, eligible physicians not becoming meaningful users during 2013 would receive a cut in Medicare reimbursements during 2015. The legislation also would prohibit applying a Medicare payment penalty on eligible professionals who are Medicaid meaningful users.
Other provisions in the bill include deeming providers in rural health clinics as eligible professionals and being eligible for the meaningful use program, using specialty registries to aid specialists in meeting quality measures, and establishing a formal appeals process before application of financial penalties. Text of the legislation is available at http://thomas.loc.gov.
As many as 10 percent of physicians and other health care professionals who attested to EHR meaningful use may be selected for a prepayment audit of their application as stated in a recent article featured on the AAFP website. All eligible professionals (EPs), eligible hospitals and critical access hospitals (CAHs) attesting to receive an incentive payment for either the Medicare or Medicaid Electronic Health Record (EHR) Incentive Program may be subject to an audit.
CMS and its contractor, Figliozzi & Company, perform audits on Medicare and dually-eligible (Medicare and Medicaid) providers who are participating in the EHR Incentive Programs. States perform audits on Medicaid providers participating in the Medicaid EHR Incentive Program. Physicians selected for an audit will receive a letter from Figliozzi & Company, a certified public accountant firm based in Garden City, NY, and selected by CMS in April 2012 to conduct audits associated with the programs.
In addition to the post-payment audits that have been conducted since 2012, CMS began pre-payment audits this year, starting with attestations submitted during and after January 2013.
CMS Releases New Resources to Prepare for Audits
For those providers selected for pre-payment or post-payment audits, CMS and its contractor will request supporting documentation to validate submitted attestation data. To help providers prepare for a potential audit, CMS has created the new Supporting Documentation for Audits Fact Sheet. The fact sheet and a sample audit request letter for both EPs and eligible hospitals are also available on the Educational Resources page of the EHR Incentive Programs website.
Contact your Wide River TEC Project Lead for questions about preparing for an audit today! If you do not have a contract with Wide River TEC, please contact us at 402-476-1700 or via email, for more details about the assistance available through our program.
On March 19, 2013, Rep. Jeff Fortenberry [R-NE1] became a cosponsor to the H.R. 986: Rural Health Clinic Fairness Act of 2013. We would like to express our gratitude to Rep. Fortenberry for taking notice to this important initiative for rural health clinics (RHCs). This bill was established to address the lack of federal HIT (meaningful use) support in RHCs.
If you could please continue to reach out to your respective delegations and ask that they co-sponsor H.R. 986. Click here to view the sample letter to use when asking for co-sponsorship. Click here to view the bill.
Again, thank you for your effort on this important initiative.
Wide River TEC became aware of the following initiative pertaining to Rural Health Centers. Please see the message below for this important information.
Recently, Congressmen Schock (R-IL) and Braley (D-IA) re-introduced the Rural Health Clinic Fairness Act, H.R. 986, to address the lack of federal HIT (meaningful use) support in RHCs. This bill is bipartisan and has the support of House leadership including the House Ways & Means Committee Chairman Camp (R-MI). As you may recall, last Congress H.R. 3458 was introduced by Congressman Schock and it generated 25 House sponsors. While they do not anticipate formal committee action on this new measure, they do believe this legislation is under serious consideration for expedited action on the House Suspension Calendar.
Call to Action: If you could please reach out to your respective delegations and ask that they co-sponsor H.R. 986. Click here to view the sample letter to use asking for co-sponsorship. Click here to view the bill.
Thank you for your effort on this important initiative.
In February, communities across America celebrated American Heart month to promote healthy lifestyles and provide Americans with resources to prevent and control heart disease.
Every year, approximately 935,000 Americans suffer from a heart attack, and about 600,000 people die from heart disease, which is 1 out of every 4 American deaths. Heart Disease is the leading cause of death for both men and women in the United States.
In September 2011, federal agencies partnered with private and non-profit organizations such as the American Heart Association, American Pharmacists Association and the YMCA to launch a national initiative to prevent 1 million heart attacks and strokes over the next 5 years known as Million Hearts. Although the goal is straightforward, the work necessary to achieve this milestone and reduce critical risk factors of heart disease may be arduous and complex.
The initiative focuses on “Remembering your ABCS”:
- A — Appropriate Aspirin Therapy
- B — Blood Pressure Control
- C — Cholesterol Management
- S — Smoking Cessation
In our state, CIMRO of Nebraska is supporting physician practices in reducing patient risk factors for cardiac disease through the ABCS Learning and Action Network (LAN). The LAN works to align efforts and help partners experience success as we work towards common, unifying goals of ABCS. Currently, they are supporting 12 practices, which represent 92 providers in Nebraska.
The primary focus is on using the functionality of the EHR to identify patients that are lost to follow up, have gaps in care or have poorly controlled risk factors. If you are interested in learning more or joining the ABCS LAN in Nebraska, visit their web page or contact Peg Wasser or Tammy McNeil, CIMRO of Nebraska Quality Improvement Advisors at 402-476-1399.
ONC’s Support of Million Hearts
There are numerous healthcare organizations across the United States helping to improve care delivery for patients at risk for cardiovascular disease. For example, as the largest healthcare provider organization in Washington, DC and Maryland, Medstar’s partnership with the Million Hearts Campaign is improving cardiovascular outcomes for a large number of patients in this metropolitan area. Medstar is committed to ensuring that every adult patient seen by a Medstar primary care doctor will have their ABCS assessed over the course of a series of visits. Furthermore, every adult patient’s end-of-visit clinical summary includes their ABCS report card which empowers patients to have conversations with their care providers regarding their cardiac risk factors. Medstar has also set an exciting goal of increasing blood pressure and lipid management to 65% of all their patients by the end of the calendar year.
What are you doing to keep one million hearts beating strong? Share Your Story With ONC!
Although American Heart Month has ended, Million Hearts continues to beat on! Together, this ambitious goal can be achieved to find more ways through Health IT to live longer, healthier lives.
If you are a health care provider or patient, the ONC wants to know how you have used health IT to support improvements in patient care! Please share your story or visit the Blue Button Pledge Program.
Source: Portions of this post were taken from the March 5, 2013 post on Health IT Buzz by Larry Jessup / Regional Extension Center Cooperative Agreement Program, Project Officer, and Sheetal Shah / State Health Information Exchange Cooperative Agreement Program, Project Officer.