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Optometrists must use EHRs in 2013 to avoid penalties in 2015

August 13, 2013

Medicare eligible professionals (EPs) who do not demonstrate meaningful use under the Medicare Electronic Health Record (EHR) Incentive Program may be subject to payment adjustments beginning Jan. 1, 2015, the U.S. Centers for Medicare & Medicaid Services emphasized in a recent reminder.

Because payment adjustments are mandated to begin the first day of the 2015 calendar year, the CMS will determine the payment adjustments based on meaningful use data submitted prior to the 2015 calendar year.

The payment adjustments will be applied to the Medicare physician fee schedule amount for covered services provided in 2015.

EPs who do not demonstrate meaningful use in subsequent years will be subject to increased payment adjustments in 2016 and beyond.

Here is the breakdown:

  • EPs who first demonstrated meaningful use in 2011 or 2012 must demonstrate meaningful use for a full year in 2013 to avoid payment adjustments in 2015.
  • EPs who first demonstrate meaningful use in 2013 must demonstrate meaningful use for a 90-day reporting period in 2013 to avoid payment adjustments in 2015.
  • EPs who first demonstrate meaningful use in 2014 must demonstrate meaningful use for a 90-day reporting period in 2014 to avoid payment adjustments in 2015. This reporting period must occur in the first nine months of 2014, and EPs must attest to meaningful use no later than Oct. 1, 2014, in order to avoid the payment adjustments.
  • EPs must continue to demonstrate meaningful use every year to avoid payment adjustments in subsequent years.

Eligibility

Only providers eligible for the Medicare EHR Incentive Program are subject to payment adjustments. Optometrists are among the health care professionals eligible for the program. Practitioners can use the CMS’ Eligibility Widget to determine the incentive programs for which they are eligible.

Medicaid EPs who can only participate in the Medicaid EHR Incentive Program and do not bill Medicare are not subject to these payment adjustments.

Resources

For more information on EP payment adjustments, view the Payment Adjustments and Hardship Exceptions Tipsheet for EPs (http://tinyurl.com/EHRPayAdjTips) and the How Payment Adjustments Affect Providers Tipsheet (http://tinyurl.com/ MoreEHRPayAdjTips).

For additional information, the CMS urges practitioners to regularly visit http://tinyurl.com/8opzlun for the latest news and updates.

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