5 Things About MU Stage 3

5 Things You Need to Know About the Meaningful Use Stage 3 Proposed Rule

By Dr. Seth Flam, board certified in Family Practice and co-founder and CEO of HealthFusion

The proposed rule for Meaningful Use Stage 3 was announced on Friday, March 20, 2015, and is now available for comment by stakeholders. CMS will rule on comments and the rule will probably be finalized early in the third quarter of this year. Then the ONC will prepare testing information by the late third quarter/fourth quarter and EHR vendors will start building the necessary modules.

 Here are 5 things you need to know about the Stage 3 proposed rule:

 1.            2017 will now be a Flex Year – Meaningful Use Stage 3 was originally slated to begin in 2017 for providers that had completed Stage 2; now 2017 is a flex year. This means that providers who would have progressed from Stage 2 to Stage 3 in 2017 now have the option to stay in Stage 2 an additional year. Only providers who use an EHR certified to the 2015 ONC standards will be allowed to attest to Stage 3.

2.            Every provider will attest for Meaningful Use Stage 3 in 2018 even if 2018 is the provider’s first reporting year – In order to simplify the Meaningful Use program, all providers will be in the same stage. This will allow group practices to focus on a single set of measures for all providers.

3.            Meaningful Use Stage 3 is the final stage of Meaningful Use – However, CMS is clear that because they expect technology and care standards to evolve over time they will consider (and we expect) that there will be future rulemaking related to Meaningful Use Stage 3 somewhere down the line.

4.            All providers will report for one calendar year – in an effort to continue to align Meaningful Use with other government reporting programs such as PQRS, all providers will report for a full year based on the calendar with one exception. Medicaid first year providers will still be allowed to report for based on a 90-day period measurement period. In the past CMS has shortened measurement periods based on provider feedback and we expect that to be true about this year. This year (2015) was slated to be a full year for most providers but we expect it to be scaled back to a quarterly measurement period because of the continued side effects of the poor implementation of Stage 2 last year. For 2017 and beyond we expect the implementation will be smoother and we don’t foresee more flexibility on measurement periods beginning next year.

 

CURRENT STAGE OF MEANINGFUL USE CRITERIA

BY FIRST PAYMENT YEAR

PROPOSED STAGE OF MEANINGFUL USE CRITERIA BY FIRST YEAR

 

5.            There are 8 objectives and some objectives have more than one measure – the total number of measures that providers will be required to report is 16.

For an overview of the Meaningful Use Stage 3 Proposed Rule and its impact on practices, register now for a webinar on April 28: Meaningful Use Stage 3: What the Future Holds.

 

Dr. Seth Flam is one of the founders of HealthFusion and serves as the company's CEO and President. He is board certified in Family Practice and is one of the creative forces behind MediTouch EHR.

What You Should Know About the New Chronic Care Management Code

By Kathy McCoy, HealthFusion

As you may have heard, there is some good reimbursement news for primary care physicians in 2015: CMS has announced a new chronic care management program that went into effect on January 1 that will allow you to bill for providing care management for your patients with chronic conditions.

In other words, you can get paid for doing things you likely already do.

With this new code, chronic care management can provide a good source of revenue for your practice, if designed, managed and billed correctly. Since a provider can bill $41.92 per patient per month, if you have a number of patients with chronic conditions, you could easily see revenue of up to $50,000 per year.

Annually: $511.20 per year per patient X 600 patients = $306,720 per year

(Note: Assumes you bill 12 months out of the year)

But—there are very specific things you need to know about the program, and particular requirements you need to follow in order to get paid. Here are some of the things you need to do:

1. Identify your chronic care patients who qualify.

2. Eligible patients include those with two or more chronic conditions expected to last at least 12 months, or until death, that place the individual at significant risk of death, acute exacerbation/decompensation, or functional decline.

3. Only one provider can bill for the chronic care management code in a 30-day period.

4. You must have a signed agreement with the patient allowing you to bill for these services and detailing cancellation rights, copayments and types of services.

5. Among other things, you need to provide 20 minutes or more of chronic care management services per patient per 30 day billing period.

6. You will need to create a patient-centered care plan document compatible with the patient’s choices and values.

7. You must provide either a written or electronic copy of the care plan to the patient.

8. You will need to manage care transitions between and among health care providers and settings.

9. Bill in accordance with CMS requirements using CPT Code 99490, making sure your EHR software provides the information you need to manage and bill for this program.

In addition to the opportunity for physicians to get paid for care they have been providing without reimbursement, this program makes sense in terms of population health. Chronic diseases are among the most prevalent, costly, and preventable of all health problems, as the CDC has pointed out. Multiple studies have shown that care management of this type reduces total costs of care for patients with chronic conditions while improving outcomes.

Get your free step-by-step guide to getting paid under the new Chronic Care Management Code now.

Kathy McCoy, MBA, is Director, Content Marketing, for HealthFusion’s MediTouch® EHR & Practice Management Software. She can be reached at kmccoy@HealthFusion.com.

Stop Medicare Payment Cut of 25% on January 1, 2014

December 5, 2013 Dear Physicians – Unless Congress intervenes, once again physicians are facing cuts in Medicare payments January 1, 2014 - nearly 25% - due to the failed Sustainable Growth Rate or SGR formula which was adopted as part of the deficit reduction law in 1997. As you know, the DCMA, FMA and AMA fight these cuts every year. Stopping scheduled payment cuts caused by the SGR has become a yearly ritual on Capitol Hill, leading to physicians’ frustration with the system and a growing budget problem because each deferral increases the size and price tag of the next fix. Some positive news from The JAMA Forum, November 18, 2013 - The annual panic affecting the nation’s physicians is in full swing. “Medicare docs face 24% pay cut... again,” reported CNN Money this month. But after almost a decade of kicking the can down the road, Congress is closer than ever to solving one of Medicare’s most vexing problems. Recently, 3 congressional committees with jurisdiction over Medicare physician payment made progress towards replacing the Medicare Sustainable Growth Rate (SGR), a mechanism intended to help control Medicare spending. On July 31, 2013, the House Energy and Commerce Committee unanimously reported favorably on HR 2810, a measure to repeal the SGR, and on October 30, 2013, the Senate Finance and House Ways and Means committees released a joint proposal also to repeal the SGR formula and replace it with payment reform. Impressively, there appears to be bipartisan agreement to link SGR repeal with a strategy to move away from traditional fee-for-service payments to physicians. This recent congressional activity may be the best opportunity to fix the SGR permanently, and the physician community can and should take a leadership role, especially because any SGR fix would demand strong clinician innovation to identify payment and delivery reforms. (above emphasis and ‘color’ mine) All Physicians need to keep the pressure on Congress to: - Stop the almost 25% Medicare pay cut scheduled for January 1, 2014, and - Permanently replace the failed SGR formula used to set payment amounts. You can send an email to your representative and senators or place a phone call today via the AMA toll-free grassroots hotline at (800) 833-6354. Urge lawmakers to continue working in a bipartisan manner and tell them to elevate repeal of the flawed Medicare SGR formula to the top of their priority list for 2014. (Since Congress adjourns December 13, 2013 for the remainder of the year, this unfinished legislative item will move to 2014.) Be sure to visit FixMedicareNow.org for the latest information and resources on the AMA's campaign to engage physicians, patients and policymakers in the effort to repeal the flawed Medicare SGR formula and achieve reform that will transform Medicare into an effective, 21st century model of care. For more information, please visit:

Dear Physicians - Over 1,000 Miami-Dade County physicians whose licenses to practice medicine expire on January 31, 2013 have not yet renewed their license.  Please look at your license now to be sure you aren't one of these physicians.  Patricia

Calling All Active Members of DCMA!

Dear DCMA Members - The Dade County Medical Association Nominating Committee will be meeting in January, 2013. The Committee is responsible to nominate members to serve on the DCMA Board of Directors and as Delegates to the Florida Medical Association. The Nominating Committee requests your consideration to be placed, as a candidate, on the 2013 DCMA Ballot. Names of Active physician members of the DCMA should be submitted no later than Friday, January 11, 2013 to Patricia at the DCMA; email to phandler@miamimed.com or call 305 324-8717. We hope you will consider your name being placed in nomination to serve as a leader of the DCMA and help the DCMA shape your future. Patricia

Interactive Blog

Dear Physicians - Welcome to what the DCMA hopes will be a lively and interactive blog. From time to time, the DCMA Executive Committee and/or Board of Directors will be posting messages on the blog; so to will DCMA staff. We hope you will take the time to read the blog on a regular basis, and post a comment(s) of your own. For now, on behalf of the DCMA Board of Directors, and staff, during this holiday season, with the end of one year and the start of another, we pause to give thanks for the many blessings and people in our lives. Patricia