Process for meaningful use payments begins

The wait is over for physicians who have gone through the process of becoming what the Dept. of Health and Human Services has defined as meaningful users of electronic medical record systems.

It's time to start collecting incentive payments.

Beginning April 18, physicians and hospitals who think they have met the objectives to qualify for meaningful use incentives under Medicare can start attesting to having met the criteria. It's known as the start of the "attestation period."

Though registration for meaningful use began Jan. 1, physicians are required to meet the meaningful use criteria for 90 consecutive days before they qualify for incentive pay of up to $44,000 over five years.

As of January, more than 21,000 physicians had registered for either the Medicare or Medicaid incentive programs. The attestation period for the Medicaid program began Jan. 3.

Each state administers the Medicaid incentive plan, which involves a separate set of criteria from the Medicare plan and pays up to $63,750 over six years. By February, 11 states had a program up and running, four of which started issuing checks.

Experts say the most time-consuming part of the attestation process is collecting the data needed to support the information reported, but there are tips that can make the process go more smoothly.

Michele Mann, principal with the California consulting group CSC, said physicians already should know which menu objectives and which additional quality measures they are reporting before they start the attestation process. She said keeping a workbook for each of the criteria and having all the necessary reports run before sitting down to the online attestation system will help keep physicians organized.

Todd Shores, senior manager at Deloitte Consulting in Dallas, said many doctors are too focused on the core and menu clinical objectives and don't have a true understanding of the quality reporting that is required. There are three core quality measures, and physicians pick an additional three to report on. For each, a numerator and denominator made up of patient numbers are required. Physicians can practice generating those numbers before the attestation process begins.

Mann said physicians continuously should check the required percentages needed for their core and menu objectives to ensure that required thresholds are met. For example, a core requirement is that 30% of all unique patients who have seen a doctor and are on at least one medication need to have had at least one medication ordered using a computerized physician order entry system. By the end of the 90 days, physicians should know whether they have met that threshold, Mann said.

Although doctors are not required to send raw data for stage 1 attestation, they should keep the reports that support them having met the requirements, Shores said. Reports with supporting data will be needed for stage 2. If, for some reason, a physician qualifies for stage 1 but does not qualify for later stages, there's a greater likelihood the doctor will be audited for stage 1, he added.

Many regional extension centers can help with documentation, said Kim Dunn, MD, PhD, executive director of the Gulf Coast Regional Extension Center at the University of Texas Health Science Center in Houston. She said centers in Texas keep the supporting reports on file for physicians. A list of regional extension centers is online (link).

RECs can help walk physicians through the entire process, Dr. Dunn said. But if doctors choose to go it alone, CMS offers several tools on its website to help.

Mann estimates it will take 15 to 20 hours to compile all the reports and documentation needed for attestation. After the 90-day consecutive-use cycle, physicians have 60 days to go through the attestation process. CMS said it plans to issue checks within 30 days of receiving attestation documentation.

Dr. Dunn said many physicians are in the early stages of meaningful use, and some still may be shopping for an EMR.

Information on the incentive program and its checklists is online (link).