Sunday, December 17, 2017

OCMA Blog

AMA Statement on Meaningful Use Hardship Exemption Announcement

Due to significant pressure from the AMA, the Centers for Medicare & Medicaid Services (CMS) announced the reopening of its Meaningful Use (MU) hardship exception application for physicians and hospitals to avoid the 2015 penalty. 
 
CMS' action gives physicians the opportunity to seek exemption from meeting Meaningful Use requirements in 2014 and avoid Medicare payment penalties in 2015.
 
The new deadline will be November 30, 2014.  Previously, the hardship exception application deadline was April 1, 2014 for hospitals and July 1, 2014 for physicians.
 
While all Medicare physicians have until February 28, 2015 to attest to any 90-day reporting period in 2014 to obtain an MU incentive, Medicare physicians who started the program this year were required to attest by October 1, 2014 to avoid a penalty of up to 2 percent in 2015.  Those new to the MU program can now apply for a hardship exception to avoid this penalty if they missed the October 1 deadline.  In addition, even if you are prepared to attest by February 28, 2015, you can still apply for a hardship exception as a fallback precaution to avoid the penalty.  We believe this hardship exemption will be interpreted broadly by CMS and we therefore encourage all physicians who meet the following criteria to apply by the November deadline.
 
The hardship exception, however, only provides relief from the MU penalty and will not earn you an incentive.  Meaningful Use incentives are still available for those who are able to meet and attest to the Stage 1 or Stage 2 measures by the February deadline. 
 
This reopened hardship exception period is for Medicare physicians and hospitals that:

  • Have been unable to fully implement 2014 Edition CEHRT due to delays in 2014 Edition CEHRT availability; and
  • Physicians who were unable to attest by October 1, 2014 and hospitals that were unable to attest by July 1, 2014 using the flexibility options provided in the CMS 2014 CEHRT Flexibility Rule.

The CMS 2014 CEHRT Flexibility Rule allows physicians to use older certified EHR technology (Version 2011), a combination of old and new technology (Version 2011 and Version 2014), or just new technology (Version 2014) to attest for their 2014 reporting period. A more in-depth review of the rule can be found on the AMA website under "Avoiding meaningful use penalties / Hardship Exceptions." Unfortunately, the CMS system was not ready to accept attestations by the October 1, the last date Medicare physicians new to MU could attest to avoid a penalty.  This is part of the reason why CMS elected to re-open the hardship filing period, ensuring more doctors avoid a 2015 penalty.
 
For more information, and for a link to the hardship exemption application, visit the CMS website.

Below is the AMA press statement.


FOR IMMEDIATE RELEASE

October 7, 2014
 
AMA Statement on Meaningful Use Hardship Exemption Announcement
Statement attributed to:
Robert M. Wah, MD
President, American Medical Association
 
"The American Medical Association (AMA) is pleased that the Centers for Medicare and Medicaid Services (CMS) has taken a step towards addressing AMA concerns and has decided to reopen the Meaningful Use hardship submission period.  Medicare physicians who were unable to fully implement their new certified electronic health record software due to delays in receiving it and who were unable to successfully attest by the October 1 deadline can apply for the exception through November 30th. This change will allow more physicians to avoid an unfair Meaningful Use financial penalty in 2015.
 
"Giving physicians more time to file for a hardship exemption provides necessary relief as many physicians are struggling to meet a number of reporting mandates to avoid multiple penalties.
 
"The AMA remains committed, however, to ensuring that the Meaningful Use program requirements are in fact meaningful and deliver the intended improvements in patient care and practice efficiencies. We look forward to continuing to work with the Administration to make the program requirements more flexible and ensure physicians have certified products that better support their practices and patients' needs."


Physician Financial Transparency Reports (Sunshine Act) Begins August 1, 2013

Tracking of Industry Gifts to Physicians Begins in August

Don't miss your chance to challenge false or misleading data before it goes public!

Beginning August 1, 2013, manufacturers of drugs, medical devices and biologics that participate in federal health care programs must begin tracking and reporting certain payments and items of value—including consulting fees, travel reimbursements, research grants and other gifts—given to physicians and teaching hospitals. The new law, known as the Sunshine Act, also requires manufacturers and group purchasing organizations (GPOs) to report certain ownership interests held by physicians and their close family members.

The intention of the law is to increase transparency and reduce the potential for conflicts of interest that can influence research, education and clinical decision making.

The reports will be submitted to the Centers for Medicare and Medicaid Services (CMS) on an annual basis. The majority of the information contained in the reports will be made available on a public, searchable website beginning in September 2014. Physicians will, however, have the right to review their reports and to challenge any information that is false, inaccurate or misleading. By statute, physicians are provided, at a minimum, 45 days to review the transparency reports and make corrections before they are made public.

“Data accuracy is the number one goal of our program,’’ said Anita Griner, CMS’s deputy director for the Data Sharing and Partnership Group, speaking to the American Medical Association's House of Delegates in June. “We do not want to perpetuate any false information about a physician or teaching hospital…. And that will come from you tracking your own transfers and checking the website before it goes public.’’

 

 

The Sunshine Act covers all physicians who have an active state license, even if they do not participate in federal health care programs, but excludes residents and medical students.

Payments of less than $10 do not need to be reported unless the aggregate amount exceeds $100 annually. The $10 threshold will increase every year, based on the Consumer Price Index.

How to challenge false, inaccurate or misleading reports

Physicians will have 45 days after the annual reports are completed to challenge the data before it is made public. The reports will be available to physicians for their review via an online portal sometime after the close of the calendar year. The portal will also facilitate contact between a physician with a dispute and the manufacturer/GPO that submitted the disputed information.

 

Manufacturers then have 15 days to correct any misinformation. If a resolution is not reached within the allotted time period, the disputed information will be flagged, but the report will be posted on a public webpage. Physicians will, however, have two full years to contest or seek corrections to data contained in the reports, even after it has been made public.

 

Physicians are encouraged to proactively check with any manufacturer from which they have received payments or any items of value to see what information they are tracking and intend to report. If you hold any ownership interests, you should also check to ascertain what they intend to report. (Ownership or investment interests in publicly traded securities and mutual funds are excluded from reporting.)

What you can do now to prepare for the Sunshine Act

Update your disclosures regularly. Ensure that all financial disclosures and conflict of interest disclosures required by employers, advisory bodies and entities funding research, for example, are current and updated regularly.

If you have an NPI, update the information and ensure your specialty is correctly designated. Physicians who have a National Provider Identifier (NPI) should ensure all information in the NPI enumerator database is current and regularly updated as needed. This information will be used by industry reporters, among other unique identifiers, to ensure that they have accurately identified you.

Inform your industry contacts that you want ongoing notice of what they report to the government. Ask all manufacturer and GPO representatives with whom you interact to provide you with notice and an opportunity to review and, if necessary, correct all information that they intend to report before it is submitted to the federal government.

For more information

 

Physicians are encouraged to register for the CMS Open Payments listserv to receive periodic email updates about the program. To register, visit http://go.cms.gov/openpayments. Questions about the program can be sent to openpayments@cms.hhs.gov.

Some information in this article was republished with permission from the American Medical Association. For more information, visit www.ama-assn.org/go/sunshine.

 

Sidebars

Key Dates

August 1, 2013: Manufacturers begin collecting and tracking payment, transfer and ownership information.

January 1, 2014: CMS is expected to launch the physician portal that allows physicians to sign up to receive notice when their individual consolidated report is available for review. This portal will also allow physicians to dispute the accuracy of a report.

March 31, 2014: Manufacturers/GPOs report 2013 data to CMS.

June 2014: CMS is expected to provide physicians with access to their individualized consolidated reports for the prior calendar year. Physicians will be able to access the reports online and will be able to seek correction or modification by contacting the manufacturer/GPO via the web portal.

September 30, 2014: CMS will release most of the data on a public website.

Exemptions

The Sunshine Act includes a number of exemptions from the reporting requirements; among them are:

  • Samples intended for patient use, including coupons and coupons to obtain samples
  • Certified and accredited continuing medical education activities funded by manufacturers
  • Educational materials ultimately intended to be used with patients (for example, wall models or anatomical models)
  • Buffet meals, snacks, soft drinks, or coffee generally available to all participants of large-scale conference or similar large-scale events
  • The loan of a medical device for a short-term trial period
  • Discounts (including rebates)
  • In-kind items used for the provision of charity care
  • A dividend or other profit distribution from a publicly traded security or mutual fund

UPDATE: Congress stops Medicare cuts for one year as part of fiscal cliff legislation

This morning (Jan. 3) CMS released instructions to contractors for implementation of the revised fee schedule.  In order to allow sufficient time to develop, test, and implement the revised 2013 Medicare physician fee schedule, Medicare contractors have been instructed that they can hold claims with January 2013 dates of service for up to 10 business days. CMS expects these claims to be released into processing no later than January 16, 2013.  The claim hold should have minimal impact on physician cash flow because, under current law, clean electronic claims are not paid sooner than 14 calendar days (29 for paper claims) after the date of receipt. Based on prior history of similar fee schedule updates, CMA believes that physicians may expect to see claims paid in approximately 21 days, rather than the usual 14 days. Medicare contractors will be posting the new payment rates on their websites no later than January 23, 2013. 

Home   |   About Us   |   Membership   |   For Physicians   |   News   |   For Patients   |   Advocacy   |   Events
Copyright (c) 2017 Orange County Medical Association