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Last Updated: 01 June 2015
Created: 01 June 2015

As the Medicare EHR Incentive (meaningful use) Program shifts away from incentives and moves into a penalty phase, it is critical that physician group practices understand how they may be impacted. Some of the most frequently-asked MGMA member questions about the meaningful use penalty include:

Q: Are providers who elect not to participate with Medicare exempt from meaningful use penalties? 

A: No. Eligible professionals (EPs) are not exempt from meaningful use penalties based solely on their non-participation status in Medicare. However, as the penalty is applied to Medicare payments, those who do not submit claims to Medicare will not incur any penalty, regardless of their Medicare participation status. Members are also reminded that there are no penalties associated with the Medicaid EHR Incentive Program.

Q: Do hospital-based EPs have to apply for a hardship exception in order to avoid the meaningful use penalty?

A: No. EPs who perform substantially all of their services in an inpatient setting are exempt from the penalty, and the Centers for Medicare & Medicaid Services (CMS) will automatically make this determination based on place of service data pulled from Medicare claims. Specifically, EPs who performed 90% or more of their covered professional services in either an inpatient or emergency department are exempt and do not need to apply for a hardship exception. However, CMS has stated it may look at claims data from either 2014 or 2015 to determine whether an EP is hospital-based for the 2016 penalty.

 

 

 

 

Last Updated: 15 April 2015
Created: 15 April 2015

The Sustainable Growth Rate, the formula developed years ago by legislators intent on reducing government health care expenditures, reached a landmark yesterday when the Senate voted to approve a bill that would repeal it. Medicare providers struggled with impending reductions in their Medicare payments of over 21% annually due to the SGR formula and this action, pending approval by President Obama, seeks to eliminate those concerns. The Medicare Access and CHIP Reauthorization Act, H.R.2 (found HERE) was approved by the House of Representatives on March 26 and by the Senate on April 14 by a vote of 92 to 8.  Several advocates for physician practices including the MGMA and the AMA have strongly opposed the SGR for many years, and these sources indicate that President Obama has publicly stated that he will sign the bill into law.

Last Updated: 07 April 2015
Created: 16 March 2015

You have pulled together all of your tax documents, worked closely with your tax professional and found that you are entitled to a refund.  Great, but when can you expect to receive it?  The Internal Revenue Service and your state have made this information easy to access by clicking on the links that follow. All of the sites ask that you enter your Social Security Number or Tax Identification Number and the IRS will ask you for for filing status and the exact amount of your refund to get the information you need.  

Click on the following links to access the sites:

IRS

ILLINOIS

WISCONSIN

INDIANA

Last Updated: 08 April 2015
Created: 07 April 2015

Health care providers were due to get a 21% cut in their Medicare rates on April 1st and it appeared that actions were in place to avoid these cuts.  The House of Representatives approved a bill on March 26th intended to permanently repeal the Sustainable Growth Rate (SGR) formula and fix this problem for the future. Unfortunately, the bill went to the Senate and the Senate adjourned without taking action before its April recess. There is no resolution for now and the Senate will meet again on April 13th.  In the meantime, Medicare will withhold provider payments for the first 10 days of April. Please find CMS's explanation listed HERE

Last Updated: 07 April 2015
Created: 09 March 2015

Regulations may require dentists to enroll in Medicare or opt out of the program if they want to refer patients for covered benefits, such as Medicare Part D. The deadline is June 15, 2015, and they can elect to do nothing, enroll in Medicare, enroll as a Medicare Referring Provider, or opt-out of the program. See the American Dental Association's decision tree located HERE for guidance to help you with the decision.