ICD-10 Moving Forward

Is ICD-10 going to be delayed again?

The answer seems to be a hearty "No." The Senate just passed the Sustainable Growth Rate (SGR) formula bill this week. There were no "additional riders" or other mention of holds listed in there that would in any way indicate any further delay for ICD-10. This bill was the last hold-out people were waiting for, as this is where ICD-10 got surprisingly derailed last year. If you are not on board with ICD-10, you should be buying a ticket fast!

Register for one of our weekly ICD-10 webinars NOW!

CMS Re-Opens 2015 Hardship Exceptions Through November 2014

Per the ONC:

CMS announced that it is going to reopen the submission period for hardship exception applications for eligible professionals and eligible hospitals, allowing them to possibly avoid the 2015 Medicare payment adjustments for not demonstrating (via attestation) EHR meaningful use with Certified Electronic Health Record Technology (CEHRT).

The new deadline will be November 30, 2014. (The previous application deadline was April 1, 2014 for eligible hospitals and July 1, 2014 for eligible professionals.)

This is especially noteworthy for anyone who missed attesting for stage 1 year 1 attestation last week.
For more information about the payment adjustments or hardship guidelines, visit the CMS page HERE.

Here is the application form.

CMS Issues Final Rule for 2014 EHR Incentive Program Participation

CMS just released a final rule regarding provider EHR incentive program participation for the 2014 program year.

It has been a long haul for those trying to implement and use an EHR program to complete the government’s incentive program.  Especially this year, as the transition from stage 1 to stage 2 meaningful use is supposed to be occurring.  Nothing is ever easy. Even for those providers who started their EHR journeys a couple of years ago, there was change that needed to occur.  Most had hoped that the EHRs they’d invested in would progress and roll with the government changes.  Many found out that this was not going to happen without additional work, frustration, pain, and money from them, so many have dropped out. 

Senate Passes House Bill 4302

The US Senate passed House Bill 4302 ( a bill) on March 31, 2014.   This is the bill we just told you about and it's primary purpose is to extend (another temporary measure) the 24% Medicare SGR (Sustainable Growth Rate) increase given until they can resolve the SGR in a better way.  Of course this extension would mean that the SGR would again- NOT be fixed.

Somehow, someone was able to also tuck a clause into this bill, that if it passes, it will delay the planned ICD-10 implementation until Oct. 1, 2015. This bill will now proceed to the President for final approval or veto before becoming law.

Unfortunately this quick fix, from not fixing the SGR (WHICH STILL NEEDS TO BE FIXED)- while seemingly getting you your money - will in fact cost millions and then some.  Plus more millions for delaying ICD-10 implementation for another year (CMS had previously estimated another delay may potentially have a price tag of $6.6 billion impact).

I could find nothing that said that there would be any delay on the 1% Medicare take-backs scheduled to being for not meaningfully using an EHR (attesting by this year at latest - within the first 9 mo, for 90 days).  Or that there would be any delays regarding Stage 2 Meaningful Use.  Which makes sense as both of these are tied to the 2009 ARRA "stimulus" act, not the SGR (but considering they managed to throw an ICD-10 delay in there, it was worth a look).

Here is a link to the bill.
Here is a link to another good article discussing what this delay means to you, from EHR Intelligence.
Here is a link to a great Fierce Healthcare article & it has links at the bottom for the AMA, AHIMA, HIMSS.

Genius Seminars are @ Soaring Eagle Next

Be An Office Hero!

August 12

@Soaring Eagle Casino & Resort
6800 Soaring Eagle Blvd
Mt. Pleasant, MI  48858
888.732.4537

Morning Seminar Time: 9 am - 1 pm
Afternoon Seminar Time: 2 pm - 4:30 pm 

Click here for more information.
Click here to view and print the event flier with registration.

CMS Threatens to Slash Medicare Payments by 27.4%

Ok, technically CMS just issued a teaser of their final Medicare payments rule which is due to finalized and out November 28, 2011.  But when you really look at it and think about it, it really is a threat of you vs. the federal government.  At the beginning of this month CMS (Center for Medicare & Medicaid Services) released a final rule stating that unless Congress does something by January 1, 2012 physicians and non-physicians (who receive reimbursements under the Medicare Physician Fee Schedule) will have subsequent payments slashed by 27.4%.  Although this number is down from the 29.5% cut CMS had estimated would occur earlier this year (because Medicare physician services have fallen below increased practice costs).

Permanent EHR Certification Program Delayed by ONC

Dr. Farzad Mostashari the coordinator for the Office of the National Coordinator for Heath IT (ONC) announced last week (click here for the posted announcement) that the permanent EHR certification would be delayed about 6 months, from January 1, 2012 to mid-2012.  This shift also coincides, deliberately, with implementation of the Phase 2 meaningful use standards.

Worried about ICD-10? Relax, ICD-11 is on its way!

Picture courtesy of http://icanhascheezburger.com

Yes, just when you thought your life couldn’t get any more complicated and governmentally annoying, someone just had to say it… ICD-11.  Yes, after a 23 year process to integrate ICD-10 codes, from their inception, into our United States vernacular, there are already newer codes looming on the horizon.  Perhaps if we hadn’t waited so long to move into ICD-10, this wouldn’t be like dripping ice water down your sun-warmed backs. 

Have you added the eRX programs to your WritePad?

The last 90-day Meaningful Use reporting period for 2011 begins October 3rd.

As mentioned in the WritePad training earlier this month with Dr. Arkfeld, if you want to earn the Medicare Stimulus money for 2010, you must begin at the beginning of October to complete the 90-day window. You also must have the WritePad eRx (e-Prescribing) add-on to be able to fulfill all of the Meaningful Use portions to receive the money.

We just got word from WritePad today that you MUST purchase/have the eRx or eRx Check add-on by no later than this coming Monday, September 26, 2011 or you cannot start your reporting period. Per WritePad, it can take as long as a week to complete the registration process and you must have the service installed and functioning by October 3rd in order to be able to complete your reporting and be eligible for this year’s funds.

Call the WritePad client relations manager at 800-496-2001 extension 2 for installation information.

Special Webinar- Registering for the MR Incentive Program

eTHOMAS/Writepad Roundtable Discussion Series- Registering for the Medicare Incentive Program

So, you've purchased & begun using a Certified EHR, now what?

Join us for a Roundtable Webinar with Dr. Ted Arkfeld to make sure you know exactly what you need to do, to get the Incentive money you deserve. Get information from the expert, and have a chance to ask questions. Dr. Arkfeld will take you step-by-step through the registration process for the government's ARRA "Meaningful Use" Incentive Program for healthcare providers.

Don't be stressed out, we've got your back. 

Mark your calendars for Tuesday, September 27th, from 12:30-1:00pm EST. Don't miss out!

Register for this Special webinar here.

ICD-10: Gone are the Days

ICD-10—Potpourri:
General State of Readiness- How you can & should be Preparing for the Inevitable, Part 4 of 4

ICD-10 Heralds the Death of the Superbill 

 
This article goes into a bit more detail, but I think you can gather from the above discussions that a superbill just isn’t going to be super enough to cut it for ICD-10.  Gayl Kirkpatrick, from 3M HIS Consulting Services, gave an example from a hospital her team consulted with. "We took a two-page superbill in ICD-9 and translated that into ICD-10," Kirkpatrick said. "It became a 48-page superbill." (1)

ICD-10: Concerns & Preparations

ICD-10—Potpourri:
General State of Readiness- How you can & should be Preparing for the Inevitable, Part 3 of 4

“When healthcare transitioned to ICD-9 on Oct. 1, 1984, there was still great confusion 18 months later on how to submit the codes. There was great deal of frustration both on the provider side as well as the health plan side. There was also a huge lack of training to prepare the doctors for the transition to ICD-9. As a result, for almost a year, there were large drops in revenue.

I am seeing things now, for ICD-10, that I witnessed back then for ICD-9. A great deal of people have not even started their processes.” Ben Michelson, of Hayes Management Consulting ...(1.)

Why ICD-10?

ICD-10—Potpourri:
General State of Readiness- How you can & should be Preparing for the Inevitable, Part 2 of 4

This article “ICD-10 Implementation: Top concerns for healthcare providers” quotes Jim Jacobs, senior vice president and product management and health information management for QuadraMed. "If you want to understand outcomes and understand the protocols that are working, the protocols that have measured benefits, then you need quite a bit of specificity."

New Changes to RAC Program

Per an article by Sheri Porter on the AAFP website, Medicare is making a change to the RAC programs that might help out family physicians and their offices, beginning January 3, 2012.

Genius Solutions 5010 Update

Genius Solutions is currently working with BCBS as a 5010 pilot tester (currently in Michigan).   We are working closely with BCSBEDI (MI) in testing 5010 format using 5010 test files.  BCBS is only working with about 100 pilot testers at this point and Genius is one of them.  At this time, only the pilot testers are allowed to submit 5010 test files into BCBSEDI.

Genius Solutions Inc. has sent test files from several of our providers into BCBS (MI) which are currently being tested and checked.  We are also hoping to continue to expand our testing within the next few weeks by starting to work with other payors and clearing houses as they become prepared to test. We will be ready to submit 5010 files come 01/01/2012.

Meaningful Use 2-part Webinar for WritePad Users

Meaningful Use 2-Part Series!

Part I and II of the Meaningful Use webinar series are a must for all doctors who are serious about the October 3rd, 2011 reporting period.

We wanted to make sure that all of our WritePad clients and users were aware of the upcoming webinars being provided by WritePad.  If you have any additional questions regarding these webinars, please e-mail scannon@writepad.com

EHR Stuff: All-in-one or Buffet-style? It’s your choice!

I’m sure you know how hard it is to find a good practice management (PM) system (when I say “good”, I mean gets you paid” AND makes your office life easier, not harder).  But now your life has just gotten complicated again.  Now you are being told that you need to have and use an EHR in your office.  Ok, even if you don’t give a hoot about participating in meaningful use.  The fact still remains that Medicare is threatening that if you are not meaningfully using an EHR by 2015 they are going to assess you a 1% penalty, with an additional percent being added each year up to 5% by 2020.  (Of course this could all change with the current state of healthcare and the influx or repeal of Obambacare.)  It is true.  There is a lot on the table with so many variables in play.  It’s more like a game of 52-card pick up than any organized card game.  (Seriously, have you ever tried to play Poker with someone who is playing Go Fish?)  Plus there are additional regional variations for Medicaid and third-party payers (Euchre anyone?). 

ICD-10 Deadline Fast Approaching- Only 28 Months Away?

By Penny Henriksen, Genius Solutions' News Editor

Ok, yes, I can hear you rolling your eyes.  You're thinking, "28 months, are you kidding?  That's 2 years and 2 vacations away...really?" Being out and about over the last year and speaking with many of you I also have actually heard "Yeah, but it's the CMS.  It's going to get bumped."  Let's reason together for a few minutes and reflect on this, shall we?

First Incentive Paychecks Mailing Out to Non-Hospital EPs This Week

Per an Update e-mail from the ONCHIT (the Office of the National Coordinator of Health Information Technology), the first paychecks will be going out this week for individual eligible providers who completed their attestation for having met the meaningful use and other necessary requirements.  Per one of their Twitter messages this week:  “Incentive Programs have paid out $83,294,778.06 since January.”  Up to this point that would be mostly money that has gone out to Hospitals and possibly some Medicaid payments.

The ONCHIT’s newsletter also reiterated some of the money rules that apply to these payments, this year:

• Payment is based on 75% of Medicare allowed charges that are submitted no later than 2 months after the end of 2011 (the charges had to be this year, but you seem to have a grace period for reporting of up to 2 additional months).
• The max allowed incentive charges for this year is $24,000, which will yield a max check of $18,000 incentive payment.
• An eligible professional must meet the minimum threshold of $24000 in Medicare charges before they can be paid the incentive.  (I know they say you only have to report for 90 consecutive days this year, but it sounds like you may have to give yourself a longer than 90-day window if it will take you longer to generate the $24000 minimum Medicare charge threshold.  Bear this in mind as you decide when you want to start your attestation period this year to give yourselves enough time to generate the proper amount of charges.)
• You will receive payment to the TIN (taxpayer identification number) you selected during your registration for the incentive program.

Want to know more?  Check out the Medicare “Path to Payment” Incentive page.

Changes this month…. New National Coordinator at the ONCHIT

Dr. David Blumenthal stepped down as the National Coordinator for Health Information Technology this month, replacing him is Farzad Mostashari, MD, ScM . Dr. Mostashari is not new to the ONCHIT office, he has been working with them and the previous National Coordinator since 2009. He was the Deputy National Coordinator for Programs and Policy when I was reviewing the big ONC HIT 2009 review at the end of last year.