Commentary

Online tool calculates Medicare incentives, penalties

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Finally!

Dr. Stuart M. Garay, FCCP, comments:

Meeting CMS requirements for Medicare reimbursement is becoming increasingly complicated. During the past few years e-prescribing, EHR meaningful use, and PQRS have been rolled out to physicians with different incentive and penalty schedules. Physicians have been presented a confusing mess! Finally CMS has provided an online tool to sort this out. Take advantage; don't miss out!


 

Not sure if you’re going to be getting a bonus or paying a penalty to Medicare this year? You’re not alone.

Between the Medicare e-prescribing program, the "meaningful use" incentives for implementing electronic health records (EHRs), and the Physician Quality Reporting System (PQRS) – all with different incentive and penalty schedules – it’s hard to keep track of whether payments are going up or down and by how much.

© Brian Jackson/iStockphoto.com

Officials at CMS have launched an online tool that allows physicians to click through a few questions and figure out what their payment adjustments will look like based on 2013 participation in the eRx Incentive Program, the Medicare EHR Incentive Program, and the PQRS.

Apparently, officials at the Centers for Medicare and Medicaid Services (CMS) agree. They have launched an online tool that allows physicians to click through a few questions and figure out what their payment adjustments will look like based on 2013 participation in the eRx Incentive Program, the Medicare EHR Incentive Program, and the PQRS.

For instance, if a physician attested to meaningful use of certified EHR technology in 2013 and plans on demonstrating that use, then he will avoid the 2015 payment adjustment and be eligible for incentive payments of between $8,000 and $12,000, depending on the year that he first demonstrated meaningful use.

The tool can also help physicians figure out how the three programs interact. If a physician reported the eRx measure’s numerator code at least 25 times in 2012, he will avoid the 2014 eRx penalty. But if he also successfully attested to meaningful use in 2012, then he can’t "double dip" and pick up the 1% eRx bonus, according to the CMS.

–By Mary Ellen Schneider

mschneider@frontlinemedcom.com

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