July 23, 2013
Meaningful Use Penalties for Medicare Providers | Practice Fusion
Under the new Merit-based Incentive Payment System (MIPS), separate payment adjustments under the
Physician Quality Reporting System (PQRS), Value-Based Payment Modifier (VM), and the Medicare EHR
Incentive Program will sunset December 31, 2018. MIPS payment adjustments will begin January 1,
- Please visit our MACRA / QPP resource center for more information.
Eligible professionals who can participate in either the Medicare or Medicaid EHR Incentive Programs
will be subject to the payment adjustments unless they are meaningful users under one of the EHR
Incentive Programs in the time periods specified below
Meaningful Use Penalties Timeline
| EP Payment Adjustment Year | % Decrease of the MPFS amount |
|---|---|
| 2015 | 1% |
| 2016 | 2% |
| 2017 | 3% |
| 2018 | 3% |
You may have just become familiar with the Meaningful Use incentive requirements, but make sure you remember the penalty for not keeping up.
The EHR incentive program has been rewarding providers since 2011 for successfully meeting Meaningful Use requirements, but the penalties for this program will start to kick-in for those who don’t continue to meet and attest to the requirements in 2013 and onward.
EHR Incentive program penalties will apply specifically to Medicare eligible professionals (EPs) who do not demonstrate and attest to Meaningful Use. However, Medicaid EPs who see patients under the Medicare Physician Fee Schedule (PFS) are also subject to a payment reduction. Learn more about your eligibility in the Practice Fusion Meaningful Use center.
Unless you successfully meet Meaningful Use requirements this year, you will become subject to a 1% reduction in your 2015 Medicare PFS reimbursements. The penalties, which are applied two years later, will increase each year up to 5% if you continue to fail the Meaningful Use requirements.
Exception for new Eligible Professionals in 2014
Eligible Professionals participating in the EHR Incentive Program for the first time in 2014 can also avoid the 2015 penalty by successfully attesting to Meaningful Use before October 1, 2014. This requires first time participants to start their reporting period no later than July 1 in 2014.
More Information
If you would like additional information about penalties related to Meaningful Use, including hardship exceptions, take a look at the Payment Adjustment Tipsheet from CMS.