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HIGHLIGHTED ASPECTS OF MEDICARE USAGE OF EHR TECHNOLOGY FOR HOSPITALS!

Healthcare industry emphasizes on value-based medical services to patients with the correct use of technology and innovation. The purpose is to empower physicians’ RCM and patients with the right to choose quality care services. MIPS is a great addition in this context. It allows physicians taking small steps towards a better healthcare system. However, along with MIPS, the Medicare EHR incentive program also shares the responsibility with the same approach.

Since many hospitals don’t use EHR technology until now. However, the healthcare industry will only progress forward in a secure environment when using the latest technologies. For encouraging physicians and boosting their RCM, The American Recovery and Reinvestment Act of 2009 (ARRA) initiated a program under Medicare. It was to facilitate eligible physicians to use the Certified Electronic Health Record (CEHR) technology meaningfully.

CMS named this program as Medicare Promoting Interoperability (PI) since last year. MIPS also contains this category featuring the benefits of this program, ensuring advancement in healthcare services with the appropriate use of EHRs. This measure appreciates interoperability efforts and applauses for allowing reasonable access of patients to information.

What if Clinicians don’t meet the Promoting Interoperability (PI) criteria!

Healthcare organizations that don’t illustrate correct depiction of PI will not get payment adjustment for the respective year.
Healthcare, which participates in both incentive programs i.e; Medicare and Medicaid EHR programs can subject to payment adjustments only when it demonstrates the true value in its reporting.

Reporting Criteria for EHR Incentive Program

Prior to 2018, physicians demonstrated EHR use via either CMS Medicare EHR Incentive Programs Attestation System or the state’s attestation system. Now, QNet System confirms the EHR meaningful use and payment adjustments are calculated via a formula specified by the CMS.

What Expectations should clinicians have for payment adjustments for 2019?

Eligible healthcare organizations, which are not meaningful EHR users, get payment adjustment as a reduction to the applicable percentage proportional to the Inpatient Prospective Program System (IPPS). Thus, it reduces the IPPS standardized amount of healthcare centers.

What are the hardship exceptions?

Eligible hospitals can avoid negative payment adjustments through hardship exceptions on day-to-day scenarios. Sometimes, CMS itself determines that eligible healthcare falls in an exceptional case.

To apply as an exception, clinicians or hospitals can get information on the official CMS website.

https://www.cms.gov/Regulations-and- Guidance/Legislation/EHRIncentivePrograms/PaymentAdj_Hardship.html

Given below are the categories for hardship exception cases.

1. New Eligible Healthcare Organizations

Healthcare organizations having new CMS Certification Numbers (CCNs) and insufficient time to submit data can get relaxation for 1 year.

2. Infrastructure Liabilities

Eligible hospitals having no Internet access in their operating area or with insufficient resources to meet the threshold of EHR meaningful use.

3. Unexpected Circumstances

In the case of natural disasters or unforeseen conditions.

4. Vendor Related Issues

Hospitals can apply for this category when they encounter EHR vendor issues to obtain a certification or due to related delays.

What will physicians get in return for their efforts?

  • The foremost purpose is to avoid negative Medicare payment adjustment, and thus revenue cycle management becomes efficient, supporting all the financial matters.
  • The healthcare system improves, and the transparency travels across the board from a higher level to a lower level.

Thus, EHR technology is not just about technology incorporation but a way to fill gaps between patient and physician. Moreover, the advancement in its context helps in successfully submitting clinical data for MIPS as well. Consequently, the healthcare industry flourishes.

Consult the official CMS website for further information https://www.cms.gov EHRIncentivePrograms

Or, visit our LinkedIn page

https://www.linkedin.com/company/p3-healthcare-solutions

Key Points:

  • EHR incentive program
  • The result when not submit data for this program
  • Payment adjustment criteria
  • Hardship exceptional cases
  • Advantages

FAKE MEANINGFUL USE MAY COST EHR $1BILLION IN LAWSUITS

An estate of a cancer patient, Stjepan Tot, filed a class action lawsuit against eClinicalWorks. The estate maintains the patient could not refer to earlier cancer symptoms due to faulty meaningful use software.

eClinicalWorks is hit with a class action lawsuit since the patients can no longer trust the accuracy of their medical records. The lawsuit point towards the flaws in the software clearly, defying the meaningful use core objectives.

Lawsuit Adds to eClinicalWorks Financial Struggles

eClinicalWorks had to deal with a huge settlement claim of $155 million only six months ago. The False Claim Act alleged that eClinicalWorks incentivized its customers to promote its products.

Details of the $1 Billion Lawsuit Against EHR Vendor

Kristina Tot, who represents Stjepan Tot estate, filed the lawsuit in New York’s Southern District. She claimed $999 million in monetary damages for gross negligence. Furthermore, the lawsuit also states that Stjepan Tot died because of cancer.

He could not search his electronic medical records to ascertain when was the first diagnosed with cancer. As there was no accuracy in the display of the medical records.

The lawsuit also alleges that millions of patients relying on eClinicalWorks cannot sort out their medical history. Thus, the software provided by eClinicalWorks fails to meet the meaningful use core objectives. Therefore, eClinicalWorks software does not meet the necessary requirements.

eClinicalWorks Lawsuit Reminds of the Report by HHS-OIG

The US Department of Health and Human Services or HHS-OIG released a report this June. The report samples 100 electronic health record providers getting payments from CMS for meaningful use. This report points to the failure of meeting meaningful use requirements of these health care providers, using incentive payments to the tune of $729 million. HHS-OIG found many of these healthcare providers not qualifying for these meaningful use incentives.

Large Scale Implications of eClinicalWorks Lawsuit

This lawsuit would have widespread implications for eClinicalWorks customers. The lawsuit indicates over 850,000 health service providers relying on this software. These new findings clearly reflect the need for better checks on software development companies offering health care provides with the EHR software.