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Meaningful USE Stage 2 & 3 	
  
MEDICARE PENALTIES
OVERVIEW
§ 	
  	
  MEANINGFUL USE : A LOOK BACK

§  REVIEW: 4 MARKS OF MEANINGFUL USE

§  MEDICARE PENALTIES: THE FACTS
Meaningful USE:
A LOOK BACK
Meaningful Use: A Look Back
$11.8 Billion in Total Incentives Program to Date
	
  
	
  
Meaningful Use: A Look Back
$11.8 Billion in Total Incentives Program to Date
  o  $2.4 Billion in Medicare Incentives Paid –
     Hospitals/Providers


	
  
	
  
Meaningful Use: A Look Back
$11.8 Billion in Total Incentives Program to Date
  o  $2.4 Billion in Medicare Incentives Paid –
     Hospitals/Providers
  o  $1.8 Billion in Medicaid Incentives Paid –
     Hospitals/Providers


	
  
	
  
Meaningful Use: A Look Back
$11.8 Billion in Total Incentives Program to Date
  o  $2.4 Billion in Medicare Incentives Paid
     – Hospitals/Providers
  o  $1.8 Billion in Medicaid Incentives Paid
     – Hospitals/Providers
  o  $7.3 Billion in Medicare/Medicaid to
     Hospitals


	
  
Meaningful Use: A Look Back

       o  372,000 Hospitals / Professionals
          registered
	
  
	
  
Meaningful Use: A Look Back

       o  372,000 Hospitals / Professionals
          registered

       o  49 States, D.C. and PR have launched
          Medicaid Programs
         * Hawaii, Guam, Am. Samoa – Unknown
         * Virgin Islands – Unknown


	
  
	
  
Meaningful Use: A Look Back

Active Registrations:


	
  
	
  
Meaningful Use: A Look Back

Active Registrations:

       o    Hospitals → 4,257 (5,724 in U.S. – 74%)



	
  
	
  
Meaningful Use: A Look Back

Active Registrations:

       o    Hospitals → 4,257 (5,724 in U.S. – 74%)


       o    Medicare Eligible Providers → 253,477 (834,769
            U.S. Physicians – 30%)
	
  
	
  
Meaningful Use: A Look Back
Active Registrations:

     o    Hospitals → 4,257 (5,724 in U.S. – 74%)

     o    Medicare Eligible Providers → 253,477 (834,769
          U.S. Physicians – 30%)

     o    Medicaid Eligible Providers → 114,866 (U.S.
          Physicians – 14%)
Meaningful Use: A Look Back

Total Attestation:

       	
  

	
  
	
  
Meaningful Use: A Look Back

Total Attestation:

       o      Hospital Attestation → $7,861,299,090

       	
  

	
  
	
  
Meaningful Use: A Look Back

Total Attestation:

  o      Hospital Attestation → $7,861,299,090


  o      Medicare EP Stage 1 Attestation →
         $2,134,906,925

  	
  
Meaningful Use: A Look Back

Total Attestation:

  o    Hospital Attestation → $7,861,299,090


  o    Medicare EP Stage 1 Attestation →
       $2,134,906,925


  o    Medicaid EP Year 1 & 2 Attestation →
       $1,595,896,115
Review:
4 MARKS OF MU
stage 1
q    Adopt & Use EHR


              	
  
stage 1
q    Adopt & Use EHR
q    Capture Data

              	
  
stage 2
ü    Adopt & Use EHR
ü    Capture Data
q    Move Data

              	
  
stage 2
ü    Adopt & Use EHR
ü    Capture Data
q    Move Data
q    Report Data

              	
  
PENALTIES:
THE FACTS YOU
NEED TO KNOW
Medicare PENALTIES
Applies to all providers treating
  Medicare Part B PFS Patients

               	
  
Medicare Penalties
  HITECH requires Payment
Adjustment if a provider shows
       no MU by 2015

             	
  
Medicare Penalties
Payment Adjustment based on
  prior year’s reporting period
               	
  




 	
  
Medicare Penalties
Payment Adjustment based on
  prior year’s reporting period
               	
  



 *
 	
  
Medicare Penalties
Payment Adjustment based on
  prior year’s reporting period
                           	
  
         There will be a 2 year lag between when the

 *
 	
  
         data is reported and when they apply the
         payment adjustment	
  
         	
  
Medicare Penalties
     If provider attested to MU
 in 2011/2012, they will need a
full year of MU reporting in 2013
          to avoid penalty.
                	
  
 	
  
REMEMBER:
      	
  




 Adopting, Implementing or
Upgrading your EHR is not MU!



             	
  
Medicare Penalties
           Any MU in 2013
                 =
        No Adjustment in 2015

	
  
                 	
  
Medicare Penalties
Complete Medicare MU registration
   & attestation by 10/1/2014
            =
   No Adjustment in 2015
  	
  

                 	
  
Medicare Penalties
         WHICH MEANS: 	
  
90-day reporting period no later
         than 7/1/2014

                	
  
	
  
Medicare Penalties
    Providers must continue
 to meet MU annually to avoid
adjustments in subsequent years

               	
  
	
  
Medicare Penalties
            Hospital-based EPs
       (90% of Services) not eligible
        so not subject to penalties

                      	
  
	
  
Learn more about Mu stage 2:	
  
http://www.successehs.com/item/meaningful-use-stage-2-core-and-menu-measures.htm

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MEANINGFUL USE STAGE 2 & 3: MEDICARE PENALTIES

  • 1. Meaningful USE Stage 2 & 3   MEDICARE PENALTIES
  • 2. OVERVIEW §     MEANINGFUL USE : A LOOK BACK §  REVIEW: 4 MARKS OF MEANINGFUL USE §  MEDICARE PENALTIES: THE FACTS
  • 4. Meaningful Use: A Look Back $11.8 Billion in Total Incentives Program to Date    
  • 5. Meaningful Use: A Look Back $11.8 Billion in Total Incentives Program to Date o  $2.4 Billion in Medicare Incentives Paid – Hospitals/Providers    
  • 6. Meaningful Use: A Look Back $11.8 Billion in Total Incentives Program to Date o  $2.4 Billion in Medicare Incentives Paid – Hospitals/Providers o  $1.8 Billion in Medicaid Incentives Paid – Hospitals/Providers    
  • 7. Meaningful Use: A Look Back $11.8 Billion in Total Incentives Program to Date o  $2.4 Billion in Medicare Incentives Paid – Hospitals/Providers o  $1.8 Billion in Medicaid Incentives Paid – Hospitals/Providers o  $7.3 Billion in Medicare/Medicaid to Hospitals  
  • 8. Meaningful Use: A Look Back o  372,000 Hospitals / Professionals registered    
  • 9. Meaningful Use: A Look Back o  372,000 Hospitals / Professionals registered o  49 States, D.C. and PR have launched Medicaid Programs * Hawaii, Guam, Am. Samoa – Unknown * Virgin Islands – Unknown    
  • 10. Meaningful Use: A Look Back Active Registrations:    
  • 11. Meaningful Use: A Look Back Active Registrations: o  Hospitals → 4,257 (5,724 in U.S. – 74%)    
  • 12. Meaningful Use: A Look Back Active Registrations: o  Hospitals → 4,257 (5,724 in U.S. – 74%) o  Medicare Eligible Providers → 253,477 (834,769 U.S. Physicians – 30%)    
  • 13. Meaningful Use: A Look Back Active Registrations: o  Hospitals → 4,257 (5,724 in U.S. – 74%) o  Medicare Eligible Providers → 253,477 (834,769 U.S. Physicians – 30%) o  Medicaid Eligible Providers → 114,866 (U.S. Physicians – 14%)
  • 14. Meaningful Use: A Look Back Total Attestation:      
  • 15. Meaningful Use: A Look Back Total Attestation: o  Hospital Attestation → $7,861,299,090      
  • 16. Meaningful Use: A Look Back Total Attestation: o  Hospital Attestation → $7,861,299,090 o  Medicare EP Stage 1 Attestation → $2,134,906,925  
  • 17. Meaningful Use: A Look Back Total Attestation: o  Hospital Attestation → $7,861,299,090 o  Medicare EP Stage 1 Attestation → $2,134,906,925 o  Medicaid EP Year 1 & 2 Attestation → $1,595,896,115
  • 19. stage 1 q  Adopt & Use EHR  
  • 20. stage 1 q  Adopt & Use EHR q  Capture Data  
  • 21. stage 2 ü  Adopt & Use EHR ü  Capture Data q  Move Data  
  • 22. stage 2 ü  Adopt & Use EHR ü  Capture Data q  Move Data q  Report Data  
  • 24. Medicare PENALTIES Applies to all providers treating Medicare Part B PFS Patients  
  • 25. Medicare Penalties HITECH requires Payment Adjustment if a provider shows no MU by 2015  
  • 26. Medicare Penalties Payment Adjustment based on prior year’s reporting period    
  • 27. Medicare Penalties Payment Adjustment based on prior year’s reporting period   *  
  • 28. Medicare Penalties Payment Adjustment based on prior year’s reporting period   There will be a 2 year lag between when the *   data is reported and when they apply the payment adjustment    
  • 29. Medicare Penalties If provider attested to MU in 2011/2012, they will need a full year of MU reporting in 2013 to avoid penalty.    
  • 30. REMEMBER:   Adopting, Implementing or Upgrading your EHR is not MU!  
  • 31. Medicare Penalties Any MU in 2013 = No Adjustment in 2015    
  • 32. Medicare Penalties Complete Medicare MU registration & attestation by 10/1/2014 = No Adjustment in 2015    
  • 33. Medicare Penalties WHICH MEANS:   90-day reporting period no later than 7/1/2014    
  • 34. Medicare Penalties Providers must continue to meet MU annually to avoid adjustments in subsequent years    
  • 35. Medicare Penalties Hospital-based EPs (90% of Services) not eligible so not subject to penalties    
  • 36. Learn more about Mu stage 2:   http://www.successehs.com/item/meaningful-use-stage-2-core-and-menu-measures.htm