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
