The American Recovery and Reinvestment Act
There has been a great deal of buzz about the government’s healthcare stimulus package and as Doctors of Chiropractic, the plan is of great interest—as well as great confusion. The promising news is that this package can provide reimbursement payments to qualifying chiropractors of up to $39,000 over the next few years. But as there has been much talk of the stimulus plan, there has also been much misinformation and speculation. So let’s take this time to set the record straight.
The evolution of the stimulus package and the pertinent dates to keep top-of-mind.
Each provider's incentive reimbursement will be issued based upon their approved Medicare submissions. Our review and analysis has suggested the following:
- The calendar year submissions will determine the level of reimbursement. The first year requires only 90 days of attestation to qualify.
- Reimbursement payments will be distributed in a lump sum for each qualifying year.
- Each provider is eligible for a reimbursement of 75% of their approved Medicare submissions up to $24,000.
- Reimbursements will be provider-specific. If there are two approved providers in the same office, there is an opportunity for two incentives.
Approved submissions of $10,000 = reimbursement of $7,500 (75%)
Approved submissions of $24,000 = reimbursement of $18,000 (75%)
- Incentive Schedule
- Stimulus Breakdown By Year
- 15 Core Objectives
- 10 “Menu Set” Objectives
- Clinical Quality Measure Reporting
We must certify our software through an authorized testing and certification body, as determined by the Office of the National Coordinator (ONC).
It is the responsibility of each provider of a clinical, office-based practice to demonstrate meaningful use of their certified software(s). Understanding meaningful use and implementing a capable and reliable EHR system is an important part of preparing for the reimbursement schedule.
To register for the the Medicare EHR Incentive Program, you must supply:
- National Provider Identifier (NPI)
- National Plan and Provider Enumeration System (NPPES) ID and Password
- Payee Tax Identification Number (if you are reassigning your benefits)
- Payee National Provider Identifier (NPI)(if you are reassigning your benefits)
Providers must use a system which fulfills these requirements before the year 2013 to receive the full incentive payout, and penalties for not adopting a qualified EHR system will start taking effect after 2015, including a 1-5% cut in Medicare payouts.
This is your roadmap. Read through this document thoroughly.
Click on the links within the PDF above to find specific information about each meaningful use requirement and what you as a provider must do to comply. This includes the requirements for attestation. You will attest on how you comply with each measure based on the specifications here, provided directly from the Centers for Medicare and Medicaid Services.
If you research and make an educated decision about your EHR system now while you have the time, you can ensure a boundless return on your investment before a mandated switch causes you to scramble for a system that may not meet the specific needs of your office. Selecting the right software for your practice is an important decision, and not one to make hastily when penalties for non-compliance are creeping up, and you’ve missed your chance at a sizable stimulus payout.
- Pays 75% of Part B claims submitted for codes 98940, 98941, and 98942, using the AT modifier.
- Potential incentive was $44,000 paid out over five (5) years that began in 2011
- Current maximum incentive potential is $39,000 paid out over the next (3) years
- Maximum payout requires qualification before 2013
- Penalties begin in 2015 for those that do not implement a fully certified EHR system or combination of systems
- Allocated government incentive distribution: $34.6 billion
- Anticipated late penalties: <$17.2 billion>
- Allocated expenses for HIT/EHR certification: $2.2 billion
In order to be eligible for the FULL payout of $39,000, clinics must submit over $25,000 their first incentive year in Medicare Part B claims under a certain set of chiropractic treatments. These treatments are narrowed to include only the treatmentof spinal subluxations, submitted using the AT (Active Treatment) modifier to ensure that they fall under the umbrella of medical necessity.
- HHS - Health and Human Services (www.hhs.gov)
- ONC - Office of the National Coordinator for Health Information Technology, a subset of the HHS
- CMS - Centers for Medicare & Medicaid Services (www.cms.gov)
- NIST - National Institute of Standards and Technology (www.nist.gov)
Other Useful Sites: