Changes to the Medicare EHR Incentive Payment Program (Physicians) – Eff 1/1/16

From: CMS Transmittal 1591 (Pub 100-20) – 1/8/16

Background:

Beginning January 1, 2015, Section 1848(a)(7) of the Social Security Act as amended by Section 4101(b) of the HITECH Act requires CMS to adjust the Medicare physician fee schedule rates (MPFS) downward for Eligible Professionals (EPs) that are not meaningful EHR users, not determined to be hospital-based or have not been granted a hardship exception.

An EP designated as an unsuccessful meaningful user was subjected to a 1% negative payment adjustment in 2015 which applied to all of the EPs MPFS services. This resulted in the EP receiving 99% of the MPFS amount that would otherwise apply to such services during 2015. The necessary changes in systems to implement the EHR payment adjustment were implemented for the 2015 payment adjustment year.

The purpose of this Change Request (CR) is to detail the new payment adjustment percentage necessary to implement the second year of the Medicare EHR Incentive Program negative payment adjustment beginning January 1, 2016.

Changes to the Medicare EHR Incentive Payment Program (Physicians) – Eff 1/1/16

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