MU & PQRS Incentive & Penalty Guidance

CMS requires that healthcare providers who provide care to Medicare and Medicaid patients attest to Meaningful Use (MU). Certain providers also have to report PQRS measures to the Physician Quality Reporting System (PQRS).

If you are eligible, you can earn incentives for complying, but if you fail to attest to MU or report to PQRSyou will face penalties which increase annually. By 2017, non-compliance can reduce Medicare Part B reimbursements by up to 10%. (This gap may continue to increase if less than 75% of providers comply).

Our staff can explain the details of the incentive, penalty and adjustment system used by CMS to drive compliance. We can advise how to attest to MU and earn incentives for implementing Health IT via the EHR Incentive Programs. If you are not eligible for the incentives, you will still need to attest to MU to avoid the penalties separately via the CMS' Attestation Form. If you are eligible to participate in PQRS, get started via the PQRS page.

EHR Incentive Payments

CMS and EOHHS monitor compliance with the Health IT laws through the Medicare and Medicaid EHR Incentive Programs. If you are eligible, you can receive up to $44,000 (Medicare) or $63,750 (Medicaid) for implementing Health IT. The amount is per eligible provider, so for a multi-provider practice this adds up to a substantial total. Incentive payments are disbursed upon reaching consecutive CEHRT and Meaningful Use implementation milestones. Read more

Meaningful Use Penalties

If you fail to attest to Meaningful Use, you will incur a 1% to 2% penalty on your 2014 Part B reimbursements. This penalty will increase by 1% every year until it reaches 3% in 2017. If by 2018 less than 75% of eligible providers are meaningful users, the penalty will continue to increase to 5%. The penalties are applied with a 2 year delay. For instance, a 2015 penalty will be deducted from 2017 reimbursements

PQRS Penalties and Adjustments

If you are eligible to report PQRS measures and choose not to report, you will be subject to 4% to 6% in penalties on your Part B reimbursements. If you do report, you may receive a -2% to +2% adjustment. The gap between reporting versus ignoring PQRS can therefore add up to 8% to your reimbursements. Furthermore, the MU penalties will be applied too. Read more  

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For questions, contact MeHI eHealth Services.



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