Meaningful Use Penalty to Hit 171,000 Clinicians Next Year

Posted by ddeardorff
December 22, 2016
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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.

 

SOURCE:  Robert Lowes | Medscape | December 21, 2016

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