ICD-10 glitch leads CMS to relax physician quality penalties
The CMS issued something of a get-out-of-Medicare-penalties-free-card for two years to physicians and group practices due to a glitch with quality reporting measures based on a recent update to the ICD-10 diagnosis and procedure codes.
The CMS pointed its finger at updates that went into use Oct. 1, 2016, to the ICD-CM (Clinical Modification) and ICD-PCS (Procedural Coding System) and their impact on the Physician Quality Reporting System.
The updates “will impact CMS’s ability to process data reported on certain quality measures for the 4th quarter of CY 2016,” the agency said in a statement posted on its website.
The CMS said it will not apply the 2017 or 2018 PQRS payment adjustments to any “eligible professional” or “group practice that fails to satisfactorily report for (calendar year) 2016 solely as a result of the impact of ICD-10 code updates on quality data reported for the 4th quarter of (CY) 2016.”
“What they’re basically saying is that new coding updates apparently had some impact on their quality measures and they will not be able to process data on those,” said Stanley Nachimson, a health IT consultant expert on the ICD-10 codes. “It sounds like the first three quarters were fine, but in the fourth quarter it had some impact on their quality measures. They’re not going to penalize providers if they couldn’t come up with PQRS quality measures.”
Normally under the PQRS program, penalties are 2% of the Medicare fee schedule.
According to a page of frequently asked questions, problem areas concentrated in certain medical specialties, notes Sue Bowman, senior director of coding policy and compliance at the American Health Information Management Association.
“It says the majority of the codes are for diabetes, pregnancy, cardiovascular, oncology, mental health and eye diseases,” Bowman said.
So, when will the ICD-10 code update itself be updated?
Bowman said that’s not specified. But at least the CMS acknowledged the problem and is taking steps to correct it and mitigate its impact, she said.
“The CMS is pretty good about working with providers,” she said. “They recognized this is a problem and the providers shouldn’t be penalized for it.”
How to Make Your New Year’s Resolutions Stick
It’s that celebratory time of year where people both young and old make promises to themselves to improve upon their financial status, spend more quality time with family and minimize social history documentation in their medical record.
If you are like me, I have lofty aspirations to better myself so those around me can benefit too. I don’t necessarily have issue with creating the resolution however sticking to it can be a whole other chapter in a self-help book.
Luckily, I found this post online to share about actually following through on your resolutions. Happy 2017 from all of us at MediPro, Inc. We are truly thankful for our clients!
For many, sticking to a New Year’s resolution can be a breeze in the beginning, but as the year progresses, it becomes harder and harder to stay committed. It doesn’t have to be that way. Randy A. Shuck, DO, an osteopathic physician from St. Petersburg, Florida, outlines how to set a realistic resolution and stick to it by mentally preparing yourself.
Putting your goals in concrete, realistic terms and refusing to be derailed by mistakes can help you stick with your resolutions.
“People who are unsuccessful in keeping a New Year’s resolution often have problems identifying what they see as their final result,” says Dr. Shuck. “People might resolve to lose weight, keep a clean house, or spend more time with their children, but they don’t put their goals into concrete, realistic terms, such as losing 10 pounds, cleaning the house every other Sunday, or spending an hour a night playing a game or doing homework with their children. This lack of specificity can quickly lead to a failed resolution.”
6 Tips for Sticking With Your New Year’s Resolutions
To break the cycle of setting up and then giving up on a New Year’s resolution, Dr. Shuck outlines some tips for developing a realistic resolution and staying mentally strong all year long:
- Define your goal. Develop a time frame for your goal, with smaller goals to achieve along the way. For example, a goal of working out for 30 minutes every day should start with a small step such as 15 minutes every other day to work your way up to your goal. “When you are specific about what steps it will take to get you to your overall goal, your resolution will become easier to achieve,” says Dr. Shuck. “Make sure you can commit to the goal in the timeframe you give yourself.”
- Be mentally tough. Not every day is going to be easy. Knowing this ahead of time will prepare you for when you are tempted to break your resolution. “Have the power to keep moving towards your goal, no matter what setbacks may occur. When the going gets tough, get tougher,” says Dr. Shuck.
- Think positive. Thinking positively is a great trick when it comes to overcoming a bad habit, according to Dr. Shuck. “The voice inside your head needs to be thinking positive thoughts. Your own words of encouragement can eliminate self-doubt and will help when it’s tempting to fall back into old patterns,” he says.
- Be patient. Permanently changing your behavior can take months. You need to make a conscious effort to stay on track through the long process. “It takes more than just a physical action; mentally prepare yourself by accepting that it will take time to change,” says Dr. Shuck.
- Practice forward thinking. “Identify what went wrong in previous failed attempts at resolutions and then move on,” says Dr. Shuck. Don’t focus on what you have done in the past, only what you want to have in the future. “Picture what you want your end result to be. The feeling of future success should lead you forward,” he says.
- Choose not to fail. “No one but you can make your resolution happen,” says Dr. Shuck. Choose not to let mistakes derail you, take a day off every once in a while, power through the tough times, and see your end result. “When you make the decision to succeed, you leave no room to fail,” he says.
Keeping track of a resolution all year long can be difficult, but only if you let it. “Keep positive to enforce your positive change,” says Dr. Shuck. Use these tips as tools to keep you on track to a successful resolution. “The important thing is to remember that successfully changing your behavior comes from the inside out. Accept that it will take small steps in the right direction to have a positive outcome,” he concludes.
Meaningful Use Penalty to Hit 171,000 Clinicians Next Year
Next year 171,000 physicians, nurse practitioners, and other clinicians will take a 3% pay cut from Medicare for failing to demonstrate that they met the government’s requirements for meaningful use of an electronic health record (EHR) system in 2015, the Centers for Medicare & Medicaid Services (CMS) has announced.
A government liaison for a major medical association blames CMS for setting up clinicians to fail in the controversial EHR incentive program. However, there’s hope that the incoming administration of President-elect Donald Trump might undo the damage.
The snafu, said Robert Tennant, director of health information technology policy for the Medical Group Management Association (MGMA), goes back to October 6, 2015, when CMS issued its final Stage 2 rules for achieving meaningful use that year and avoiding a penalty in 2017. The agency said clinicians needed to meet the requirements only during a 90-day stretch of 2015. However, there were fewer than 90 days left in 2015 by October 6.
Fearful of widespread penalties, Congress passed a bill in December 2015 that allowed CMS to depart from its usual policy of granting meaningful use hardship exemptions on a case-by-case basis and grant one for an entire category of physicians who were beset by “extreme and uncontrollable circumstances” (as in tardy government regulations).
Many physicians apparently didn’t take advantage of this escape hatch, given the multitude facing a penalty next year, MGMA’s Robert Tennant said.
“What this tells me is that CMS didn’t do a sufficient job of outreach, letting physicians know that this hardship exception was available,” MGMA’s Tennant told Medscape Medical News. “Frankly, it’s unfair. They should have given everybody a hardship exception.”
Asked if CMS was responsible for many physicians flunking meaningful use in 2015 by issuing its final regulations so late that year, Tennant replied, “Absolutely.” CMS did not respond to a request for a comment on the matter as of 5 PM CST today.
“A Tough Sell”
After Trump takes office next month, MGMA may ask the US Department of Health & Human Services (HHS) to waive the penalty, Tennant said. “It will be a tough sell,” he said. “My guess is, the Trump administration will have bigger fish to fry in healthcare.”
Trump’s choice to head HHS is Rep. Tom Price, MD (R-GA), a fierce critic of government regulation in healthcare. “We may have a more sympathetic ear should Dr Price be confirmed as HHS secretary,” Tennant said.
One drawback to a waiver of the next year’s meaningful use penalty, he noted, would be the need to reprocess potentially millions of Medicare claims paid for services rendered beginning on January 1 at the reduced rate.
The number of clinicians facing a meaningful use pay cut in 2017 is down from 209,000 penalized in 2016, and 256,000 in 2015. The last year for a penalty — and the EHR meaningful use program itself — is 2018. However, elements of meaningful use will live on in the new reimbursement system created by the Medicare Access and CHIP Reauthorization Act.
Yes, medical software qualifies for possible write-off up to $500,000!
It’s that time of year to consult with your tax preparer or accountant to see what office deductions may be possible for the 2016 calendar year. If you haven’t purchased your Lytec upgrade or transitioned over to the CureMD PM/EHR software yet, you better get moving!
What is the Section 179 Deduction?
Most people think the Section 179 deduction is some mysterious or complicated tax code. It really isn’t, as you will see below.
Essentially, Section 179 of the IRS tax code allows businesses to deduct the full purchase price of qualifying equipment and/or software purchased or financed during the tax year. That means that if you buy (or lease) a piece of qualifying equipment, you can deduct the FULL PURCHASE PRICE from your gross income. It’s an incentive created by the U.S. government to encourage businesses to buy equipment and invest in themselves.
Several years ago, Section 179 was often referred to as the “SUV Tax Loophole” or the “Hummer Deduction” because many businesses have used this tax code to write-off the purchase of qualifying vehicles at the time (like SUV’s and Hummers). But, that particular benefit of Section 179 has been severely reduced in recent years, see ‘Vehicles & Section 179‘ for current limits on business vehicles.
Today, Section 179 is one of the few incentives included in any of the recent Stimulus Bills that actually helps small businesses. Although large businesses also benefit from Section 179 or Bonus Depreciation, the original target of this legislation was much needed tax relief for small businesses – and millions of small businesses are actually taking action and getting real benefits.
Essentially, Section 179 works like this:
When your business buys certain items of equipment, it typically gets to write them off a little at a time through depreciation. In other words, if your company spends $50,000 on a machine, it gets to write off (say) $10,000 a year for five years (these numbers are only meant to give you an example).
Now, while it’s true that this is better than no write-off at all, most business owners would really prefer to write off the entire equipment purchase price for the year they buy it.
In fact, if a business could write off the entire amount, they might add more equipment this year instead of waiting over the next few years. That’s the whole purpose behind Section 179 – to motivate the American economy (and your business) to move in a positive direction. For most small businesses, the entire cost can be written-off on the 2016 tax return (up to $500,000).
Limits of Section 179
Section 179 does come with limits – there are caps to the total amount written off ($500,000 for 2016), and limits to the total amount of the equipment purchased ($2,000,000 in 2016). The deduction begins to phase out dollar-for-dollar after $2,000,000 is spent by a given business, so this makes it a true small and medium-sized business deduction.
Who Qualifies for Section 179?
All businesses that purchase, finance, and/or lease less than $2,000,000 in new or used business equipment during tax year 2016 should qualify for the Section 179 Deduction.
Most tangible goods including “off-the-shelf” software and business-use vehicles (restrictions apply) qualify for the Section 179 Deduction. For basic guidelines on what property is covered under the Section 179 tax code, please refer to this list of qualifying equipment. Also, to qualify for the Section 179 Deduction, the equipment and/or software purchased or financed must be placed into service between January 1, 2016 and December 31, 2016.
The deduction begins to phase out if more than $2,000,000 of equipment is purchased – in fact, the deduction decreases on a dollar for dollar scale after that, making Section 179 a deduction specifically for small and medium-sized businesses.
What’s the difference between Section 179 and Bonus Depreciation?
Bonus depreciation is offered some years, and some years it isn’t. Right now in 2016, it’s being offered at 50%.
The most important difference is both new and used equipment qualify for the Section 179 Deduction (as long as the used equipment is “new to you”), while Bonus Depreciation covers new equipment only.
Bonus Depreciation is useful to very large businesses spending more than the Section 179 Spending Cap (currently $2,000,000) on new capital equipment. Also, businesses with a net loss are still qualified to deduct some of the cost of new equipment and carry-forward the loss.
When applying these provisions, Section 179 is generally taken first, followed by Bonus Depreciation – unless the business had no taxable profit, because the unprofitable business is allowed to carry the loss forward to future years.
For more information: IRS Website: click here
Section 179 Website: click here
Onsite HIPAA audits coming in 2017: ONC official
OCR senior adviser Linda Sanches, at the Healthcare Information and Management Systems Society Privacy & Security Forum in Boston this week, explained what healthcare leaders can expect from the process, according to Healthcare IT News.
“We’re looking for evidence that you are implementing the policies and procedures,” Sanches told the audience. “Two huge problems we’re seeing are implementation of risk analysis and risk management.”
HIPAA privacy audits were put on hold last year as the agency developed its phase 2 policy. This spring, HHS posted a new HIPAA audit protocol.
OCR will look “at risk analyses and risk management, notices of privacy practices and access and response to requests for access, and content timeliness of notifications,” OCR Director Jocelyn Samuels said at the time.
Currently, more than 200 desk audits are ongoing—most of them focused on providers, Sanches said, according to Healthcare IT News.