What is the timeline for your practice?

Home/1st Healthcare Compliance, Dashboard Zone, HIPAA, HIPAA Zone/What is the timeline for your practice?

Running a practice requires adherence to a complicated timeline. 

Below is a summary of important dates to add to your calendar.

2013

eRx PAYMENT ADJUSTMENT of -1.5% for Eligible Professionals and group practices in GPRO who:

a) Were not successful electronic prescribers in 2011 or

b) Failed to report claims for 10 billable Medicare B PFS services provided           01/01/12-06/30/12 or

c) Did not apply for hardship exemption

eRx INCENTIVE of 0.5%  for :

Individuals who report eRx measure for at least 25 unique prescribing events

Group practices must meet GPRO specifications

VALUE BASED PAYMENT MODIFIER

Applies to groups >=100 physicians

Failure to report PQRS in 2013 will result in additional payment adjustment of  1.0% in 2015

PQRS MEDICARE INCENTIVE PAYMENT
12 MONTH REPORTING PERIOD

January 1, 2013- December 31, 2013

CLAIMS BASED REPORTING >= 50 % Medicare Part B Patients

>=3 individual measures

<3 individual measures subject to Measure Applicability Validation (MAV)

CLAIMS BASED REPORTING >= 20 Medicare Part B patients

>= 1measure group

REGISTRY REPORTING

Data on >=80% Medicare Part B Patients

>= 3 individual measures

Data on >=20 Patients (majority are Medicare B)

>= 1 measure group

EHR REPORTING

Direct or vendor reporting only

Data on >=80% of Medicare Part B

>=3 individual core measures

Direct or vendor reporting and incentive pilot

Report on 3 HITECH measures and 3 additional HITECH measures over reporting period

GROUP PRACTICE REPORTING OPTION (GPRO)

Must elect reporting method by OCTOBER 15, 2013

SIX -MONTH REPORTING PERIOD

July 1, 2013- December 31, 2013

REGISTRY REPORTING

Data on >=20 patients (majority are Medicare B)

>= 1 measure group

PQRS MEDICARE PAYMENT ADJUSTMENT

2013 is the performance year for 2015

-1.5% adjustment in 2015 can be avoided by submitting one valid core measure or measure group in 2013

Threshold of 50% for claims based reporting

Threshold of 80% for other methods of reporting

2013 MAINTENANCE OF CERTIFICATION PROGRAM

Eligible Professionals can earn an additional 0.5% if satisfactorily submitting data for PQRS reporting period and participate in MOCP with successful completion of MOCP assessment.

SEPTEMBER 23, 2013     HIPAA OMNIBUS FINAL RULE date of enforcement

Noncompliance with the Final Rule carries penalties up to 1.5 million dollars per violation.   Some of the pertinent changes affecting providers and covered entities include modification of Notice of Privacy Practices, Business Associate Agreements, and Breach Notification Protocols

OCTOBER 3, 2103 Meaningful Use

Last day for Eligible Professionals to begin 90 day reporting period for CY 2013

DECEMBER 1, 2013 OSHA

Staff must be trained on new OSHA labeling/SDS requirements

DECEMBER 31, 2013 Meaningful Use

CY 2013 Reporting period ends

JANUARY 1, 2014- DECEMBER 31, 2014

-2.0% eRx payment adjustment

FEBRUARY 28, 2014 Meaningful Use

Last day Eligible Professional can register and attest to receive an incentive payment for CY 2013

Fall 2014 Feedback Reports from 2013 PQRS

JANUARY 1, 2015

Failure to participate in Meaningful Use Medicare EHR Incentive Program 2013

Payment adjustment of -1.0%

2015 PQRS PAYMENT ADJUSTMENT of  -1.5% for

Eligible Professionals who failed to successfully participate in PQRS 2013

2015 VALUE BASED PAYMENT MODIFIER PROGRAM for physician groups of >=100

This will provide performance information to the physicians with the intention of improving quality and efficiency of medical care.  Physician reimbursement will be rewarded for value rather than volume.   Those who did not participate in 2013 will have an additional -1.0% adjustment in payment.

2016 MEANINGFUL USE EHR INCENTIVE PROGRAM payment adjustment of

-2.0% for failure to participate

2016 PQRS PAYMENT ADJUSTMENT of -2.0 % for failure to participate

2017 MEANINGFUL USE EHR INCENTIVE PROGRAM payment adjustment of

-3.0% for failure to participate

2017 VALUE BASED PAYMENT MODIFIER PROGRAM for all physicians

Payment adjustment will be in addition to any payment adjustment made resulting from failure to successfully participate in PQRS.

http://cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/index.html?redirect=/pqrs

http://www.hhs.gov/ocr/privacy/hipaa/administrative/omnibus/index.html

https://www.osha.gov/Publications/OSHA3642.pdf

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