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First-time meaningful use participants who are using older technology, but who did not get a hardship exemption by July 1, will see their Medicare pay reduced 1% in 2015.
Because of a confluence of factors, a certain subset of physicians who engaged in meaningful use for the first time this year will not be able to attest to their participation by the Oct. 1 deadline set by the Centers for Medicare & Medicaid Services – and thus, will be penalized.
“Physicians are not only frustrated, but perhaps reaching despondency on the topic,” Dr. Steven J. Stack, president-elect of the American Medical Association, said in an interview.
Overall, about half of physicians had not participated in meaningful use as of the beginning of this year. Theoretically, all of them could face the 1% reduction in Medicare pay, though it’s likely that a smaller subset will, Dr. Stack said.
Those who did not meet meaningful use criteria in 2013 and who anticipated that they would not do so again in 2014 could have applied for a hardship exemption by July 1 to avoid a penalty in 2015. Physicians who were starting on the meaningful use process for the first time in 2014 also had until July 1 to apply for that exemption.
After determining that many vendors did not have 2014 software ready for physicians, CMS proposed in late May to give all meaningful users more flexibility. Physicians were told they could use either a 2011 version, a 2014 version, or some combination, and not be penalized in 2015. That proposal was made final in late August.
Applying for that flexibility will be done via the CMS website, which is slated to be ready a few weeks after Oct. 1.
But first-time meaningful use participants must make their attestation to the CMS by Oct. 1.
The bottom line is that first-time participants who are using older technology and did not get the exemption will be penalized.
A CMS spokesman said that they could still receive an incentive payment for 2014 – if they go online in mid-October and apply for the flexibility option.
But Dr. Stack called that little consolation. It is as if the CMS took away $100 of a $1,000 pot and said that there was still $900 left, he said.
“It doesn’t seem reasonable and certainly undermines the premise that they offered any kind of relief,” said Dr. Stack.
Thom Kuhn, a staff member at the American College of Physicians, also said that the CMS explanation was not good enough.
“Failure to have a system ready by the time a final rule is issued is a management failure,” said Mr. Kuhn, in an interview.
Meanwhile, two members of Congress - Rep. Renee Ellmers (R-N.C.) and Rep. Jim Matheson (D-Utah) - have called on the CMS to extend that Oct. 1 deadline. In a letter to the agency, they requested "an administrative delay" for those attempting to attest to meaningful use for the first time in 2014.*
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*Correction, 9/24/2014: An earlier version of this article implied that the administrative delay was requested in legislation. It was requested in a letter.