EHR Meaningful Use Incentives

In 2011, CMS introduced financial incentives for eligible professionals (EPs) who became meaningful users of electronic health records (EHRs). EPs who meet the Stage 1 meaningful use requirements in either 2011 or 2012 remain eligible to earn the maximum financial incentives for their EHR transitions.

In their first year of the incentive program, EPs must attest that they have met meaningful use measures for a consecutive 90-day period; therefore, if you are planning to begin the EHR incentive program in 2012, you must begin your 90-day reporting period on October 3, 2012.

Under the initial EHR Incentive rule, EPs who met Stage 1 criteria in both 2011 and 2012 would then move into the Stage 2 meaningful use measures for calendar year 2013. However, when CMS released their proposed rule for the Stage 2 criteria, they recommended that the roll-out for Stage 2 of the Meaningful Use measures should be moved to 2014 in order to give EHR vendors the opportunity to develop and certify the new modules that will be able to meet any new requirements for Stage 2. Therefore, EPs can continue to use EHRs certified under the Stage 1 criteria until the end of 2013.

CMS’s proposed rule for Stage 2 Meaningful Use also addresses the payment penalty that is slated to be introduced in 2015 for Medicare physicians who have not become successful EHR meaningful users. CMS proposes that:

1. Any successful meaningful user in 2013 would avoid payment adjustment in 2015.
2. Any Medicare provider that first meets meaningful use in 2014 would avoid the penalty if they are able to demonstrate meaningful use at least 3 months prior to the end of the calendar or fiscal year (respectively) and meet the registration and attestation requirement by October 1, 2014 (EPs).
3. The following exceptions be instituted concerning the payment penalty:
a. Lack of availability of Internet access or barriers to obtaining IT infrastructure
b. A time-limited exception for newly practicing physicians who would otherwise be unable to avoid payment adjustments
c. Unforeseen circumstances such as natural disasters; these exceptions would be handled on a case-by-case basis.

EPs who are not exempted from the EHR requirements and have not met meaningful use as outlined above will be subject to a 1% payment penalty on their Medicare claims for 2015. This penalty will increase in subsequent years for physicians who do not become meaningful EHR users.

Finally, the proposed rule identifies the objectives for Stage 2 meaningful use. Almost all of Stage 1 criteria are carried over; however, the measures may have been tightened and EPs will have to demonstrate that they are meeting the objectives for a greater percentage of their patient population. There are two major changes that our physicians should be aware of:

1. Stage 2 Meaningful Use requires that physicians give patients “electronic/online access” to their health information. If this measure makes it to the final rule, physicians will have to operate or contract for an online portal that will allow their patients to access their health information at any time.
2. Stage 2 Meaningful Use will require that physicians provide a summary of care record for patients that are sent to other providers.