Dive Brief:
- More than 4,800 eligible hospitals participate in the federal EHR incentive programs. Those that aren't meaningful EHR users will have a payment adjustment starting Oct. 1. This is a reduction to the applicable percentage increase to Inpatient Prospective Payment System (IPPS) payment rate.
- The reduced update to the IPPS standardized amount will be a 25% decrease this year, bumped up to 50% for 2016 and 75% in 2017.
- Eligible hospitals can apply for hardship exceptions to avoid payment adjustments and are decided on a case-by-case basis. Certain categories apply for hardship, including lack of infrastructure, hospitals with new CMS Certification Numbers, a natural disaster or other unforeseen circumstance and 2014 EHR vendor issues where 2014 certification was delayed.
Dive Insight:
Hospitals must show meaningful use every year in order to avoid Medicare payment adjustments.
Eligible professionals may also be exempt from payment adjustments if they can show demonstrating meaningful use would result in significant hardship. They must complete a hardship exception application and, if approved, it's only valid for one payment year. There is a Hardship Exception Tool available to see if they will avoid the 2015 and 2106 Medicare EHR Incentive Program payment adjustments.
According to CMS, certain providers will automatically be granted a hardship exception:
- New providers in their first year;
- Eligible professionals who are hospital-based and provide more than 90% of services in inpatient setting or emergency room of hospitals;
- Those in which 90% of claims include Place of Service 21 and 23 and certain services using Place of Service 22; and
- Eligible professionals with certain specialties (anesthesiology, pathology, diagnostic radiology, nuclear medicine, interventional radiology) 6 months prior to the first day of the payment adjustments.