In the American Recovery and Reinvestment Act of 2009 (ARRA), Congress mandated that payment adjustments be applied to Medicare eligible professionals, eligible hospitals, and critical access hospitals (CAHs) that are not meaningful users of certified EHR Technology under the Medicare EHR Incentive Program.
Providers eligible to participate in the Medicare EHR Incentive Program must demonstrate meaningful use in either the Medicare EHR Incentive Program or in the Medicaid EHR Incentive Program (or be granted a hardship exception) to avoid a payment adjustment.
Medicare hospitals began to receive payment adjustments on October 1, 2014, and Medicare eligible professionals began to receive payment adjustments on January 1, 2015.
Note: Medicaid providers who are only eligible to participate in the Medicaid EHR Incentive Program are not subject to these payment adjustments.
2016 Payment Adjustments
Providers receive the Medicare payment adjustment amount that is tied to a specific calendar/fiscal year. An eligible professional or eligible hospital that did not successfully demonstrate meaningful use for an applicable EHR reporting period in 2014 will receive a payment adjustment in calendar/fiscal year 2016.
Though the deadlines for 2016 hardship exception applications have passed, more information about the 2017 applications for avoiding the 2017 payment adjustment will be available in early 2016.
For the eligible hospitals that received a Medicare payment adjustment letter for 2016, the application submission period for reconsiderations is October 1, 2015 - November 30, 2015. The application is now available.
For eligible professionals, the submission period for 2016 reconsiderations will be January 1, 2016 – February 29, 2016. An announcement will be made when the application is available.
To learn more, visit the Payment Adjustments & Hardship Exceptions page on the CMS EHR Incentive Programs website. A fact sheet on the 2016 payment adjustments for Medicare eligible hospitals is also available.