After deliberations between Medicare and Medicaid Program managers, CMS provided consolidated and clarifying guidance to State Medicaid EHR Incentive Program administrators for Program Year (PY) 2015 MU attestation and 2016/2017 Medicare payment adjustments. The following information is presented here to assist Alabama’s dual-eligible EPs in understanding whether they may be affected by Medicare’s payment adjustments.
CMS has determined that for Program Year 2015 (PY 2015), Medicaid Eligible Professionals (EPs) no longer have to attest to Meaningful Use (MU) on or before the end date for the CMS Medicare PY 2015 attestation period, 3/11/16, in order to avoid 2016 or 2017 Medicare payment adjustments.
Medicaid EPs may wait until their respective Medicaid States can accept attestations, and then attest to Medicaid MU for PY 2015 through their Medicaid State EHR Incentive program. This means that Alabama EPs may wait until Medicaid’s SLR is reactivated and is ready to receive PY2015 attestations. EPs will then have until the end of the grace period for submitting 2015 attestations. Following the close of Alabama’s submission period, Medicaid will prepare a list of all Alabama EPs that have satisfied MU requirements for PY2015 and submit it to CMS. CMS has offered assurances that once CMS has entered these Medicaid MU records in the NLR, the Medicaid EPs who have attested to MU for PY 2015 will either:
Never get scheduled for Medicare payment adjustments in 2016 and 2017, OR
Will have any 2016/2017 Medicare payment adjustments that are already scheduled/
It is important to point out that Medicaid EPs who obtain an AIU incentive payment for PY 2015 have NOT achieved MU for PY 2015, and are thus subject to Medicare payment adjustments. This is not a new policy– 1st-year participating Medicaid EPs in PY 2013 and PY 2014 who received the AIU payment did get scheduled for Medicare payment adjustments in
CMS notes that several Medicaid EPs have already successfully completed the Alternate Medicare MU attestation for PY 2015. These EPs face no extra difficulties whatsoever. In fact, those providers have already avoided Medicare payment adjustments in 2016 and 2017. This means that any Alabama EP that is included in this group can proceed with submitting an Alabama Medicaid MU attestation for PY 2015 in order to obtain the PY 2015 Medicaid Incentive payment.
These EPs should know that there will be no extra challenges in processing the Medicaid Incentive payments at CMS-NLR. There are automated processes at the NLR that make sure that for a Medicaid EP in a given Program Year, any prior attestation record from completion of the Alternate Medicare MU attestation is deleted as soon as a Medicaid Incentive payment (for MU or AIU) is reported by the EP’s respective State.
EPs must also be aware that if the EP receives a Medicaid Incentive payment for AIU in PY 2015, after the Medicare MU attestation record is deleted, the Medicaid EP will become subject to Medicare payment adjustments in 2016/2017. Medicaid EPs who have received a Medicaid Incentive payment that has been reported to CMS by the EP’s respective State will not even be able to access or attempt the Alternate Medicare MU attestation at the CMS Registration & Attestation UI (CMS RNA); the EP will be politely informed a Medicaid Incentive payment has been recorded for the same Program Year already.
The Alternate Medicare MU attestation that is available to Medicaid EPs remains available only during the Medicare attestation period. For PY 2015, the Medicare attestation period is scheduled to end 03/11/16. Providers may obtain additional information and fact sheets regarding payment adjustments and hardships at the CMS website at: