The government wants to shift the health industry into the digital age and has provided reimbursement incentives and an electronic medical records deadline for those who adopt electronic medical records (EMR). However, as with all government benefits, this electronic medical records mandate comes with strings attached. For those who do not meet the electronic medical records deadline for implementation, the government has laid out a series of penalties.
Penalties For Not Implementing EMR / EHR
According to EMRandHipaa.com, an average AAFP (American Academy of Family Physicians) user is reimbursed 20% by Medicare. For physicians who either have not adopted certified EHR / EMR systems or cannot demonstrate ” meaningful use” by the EMR deadline in 2015, Medicare reimbursements will be reduced by 1%.
The deduction rate increases in subsequent years by 2% in 2016, 3% in 2017, 4% in 2018, and up to 95% depending on future adjustments.
This means that overall, a private practice with $500,000 of annual income that fails to meet the electronic medical records mandate will lose $1000 in payments in 2015, $2000 in 2016, and so on.
Meeting the government’s mandate and electronic medical records deadline will not be easy for everyone in the health industry. “Rural hospitals and small, independent physician practices will have a harder time meeting the [digital medical records] requirements,” writes the Milwaukee Journal Sentinel. “But the incentives and potential penalties under the Recovery Act have made it clear that they no longer can put off the challenging task of parting with their paper charts.”
Digital Medical Records Incentive
On the other hand, as part of the American Recovery and Reinvestment Act, physicians can receive up to $44,000 in Medicare incentive payments beginning in 2011 for implementing EMR systems. Physicians must be able to demonstrate “meaningful use.”
About Meaningful Use
The Medicare EHR Incentive Program, popularly known as Meaningful Use, defines a set of standards that must be maintained when it comes to electronic health records(EHR), and sharing patient information between various entities such as hospitals, doctors, and insurance companies.
The “meaningful use” standard is measured in stages.
- Data capture and sharing
- Started in 2011 and ended in 2012.
- It requires that providers meet 14 to 15 core requirements and choose five more from a menu of 10 options. Some of these requirements include an electronic file system for all patients’ health records, medical billing system, and transcription services.
- Advanced clinical processes
- Extend capabilities of EHR
- Physicians will have until the end of 2014 to meet Stage 2
- Improved outcomes
- Enhance interoperability between EHR
- Improve patient outcomes
- Yet to be defined clearly
Meaningful Use was introduced as a part of the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act. It aims to address & strengthen the privacy & security concerns tied to the online sharing of confidential health information.
EMR Software Implementation Can Help Avoid Penalties
In order to avoid being penalized, physicians should prepare by understanding the EMR / EHR mandate, and knowing the process and requirements for implementing EMR systems. Experts predict that nearing the mid-decade, there will be more physicians looking to implement EMR/EHR than the support staff of certified EMR / EHR software providers can handle.
Since each physician’s digital medical records needs and requirements are different, the lead time for a certified EMR software provider to plan, install, and implement a system is around 2-4 months. There is also typically 6-8 months of training needed for each physician in a practice to qualify as a “meaningful EHR user.”
This does not include the time it takes to select an EMR software provider that is effective and efficient for the physician.
Here are some frequently asked questions on Electronic Medical Records Deadline.
What is Promoting Interoperability Program?
In 2011, the Promoting Interoperability (formerly known as the Medicare and Medicaid EHR Incentive Programs) was developed. The program encourages eligible professionals (EPs), hospitals, and critical access hospitals (CAHs) to adopt, implement, upgrade (AIU), and demonstrate meaningful use of certified electronic health record technology.
According to the Centers for Medicare & Medicaid Services, 2022 Medicare Promoting Interoperability Program Requirements are:
- A minimum EHR reporting period of any consecutive 90 days for new and returning participants.
- Must report on the four objectives and their associated measures:
- Electronic Prescribing
- Health Information Exchange
- Provider to Patient Exchange
- Public Health and Clinical Data Exchange
- Eligible hospitals and CAHs may use
- Existing 2015 Edition certification criteria
- The 2015 Edition Cure Update criteria
- A combination of the two in order to meet the CEHRT definition as finalized in the CY 2021 Physician Fee Schedule final rule (85 FR 84818 through 84828).
- Report on three electronic clinical quality measures (eCQMs) and the Safe Use of Opioids – Concurrent Prescribing eCQM using three self-selected quarters of data
- Attest to the following:
- Security Risk Analysis measure
- Safety Assurance Factors for EHR Resilience (SAFER) Guides measure
- Actions to limit or restrict the compatibility or interoperability of CEHRT attestation
- Office of the National Coordinator for Health IT (ONC) direct review attestation
When did EMR become mandatory?
As a part of the American Recovery and Reinvestment Act, all eligible professionals (EP) including public and private healthcare providers are required to adopt and demonstrate “meaningful use” of electronic medical records (EMR) by January 1, 2014.