Will your practice face Medicare penalties?

It’s very likely that your practice may face Medicare-Provider penalties. Nearly 40% of providers will have their payments docked 1.5% due to failing to submit data in 2013.

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The Centers for Medicare and Medicaid Services (“CMS”) said that providers who treat Medicare patients that did not submit their patients’ health data under the Physician Quality Reporting System will have their payments docked 1.5% this year.

Over 460,000 providers failed to comply in 2013. The 642,000 providers that did comply in 2013 will earn a 0.5% raise in payments this year.

These penalties and payments are being doled out pursuant to the 2007 federal quality-reporting program. The program was created to measure and improve quality of care.

Initially, there were only bonuses under the program. This is the first year that penalties for not participating will be enforced. Penalties were introduced under the Affordable Care Act.

Penalties will increase each year, and are issued two years after the reports are due.

Unfortunately, the 1.5% penalty is not the only penalty to be issued this year. Additional Medicare cuts and penalties include:

  • A 1% cut for failing to meet federal electronic medical record targets in 2013. This will affect 257,000 providers.
  • Cuts of 0.5% to 1% will be issued under the Value-Based Payment Modifier to providers in large practice groups.

Providers that failed to comply with all three federal programs will experience a Medicare cut of 9% in 2017.

We help our clients stay on top of important regulations and comply to avoid costly penalties and fines.

To avoid penalties some doctors may choose not to treat Medicare patients, rather than comply. Especially as the requirements increase.

To avoid penalties in 2013 in the quality-reporting system, providers had to report data on at least one possible measure. This year to avoid penalties, providers must report on nine.

It is essential for practices to stay on top of the regulations to avoid costly penalties.

In our next blog post, we will keep you informed of related issues.  To get this important information delivered directly to your mail box, 

Do you need help with understanding and complying with government regulations?  We can help. To contact us about your practice’s compliance with government regulations or your other legal needs:  CLICK HERE.

P.S. If you or your patients are interested in consumer healthcare issues, check out myhealthspin.com.

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