More than Half of Docs Received EHR Incentive Payments, but They Are More Dissatisfied with Them than Ever Before

So, we’ve finally done it – we’ve reached the sticking point in the battle of electronic health records. Apparently, as of April 2013, more than half of all office-based physicians and other eligible professionals received their meaningful use incentive payments for successfully using and adopting EHRs.

Which means … you guessed it – more than 50 percent of eligible professionals successfully used a certified EHR (of course the number is higher if you calculate the number of physicians not using a certified system).

According to Modern Healthcare, in April 191,305 physicians and EPs received EHR incentive payments from Medicare, and 88,903 have received payments from Medicaid and 11,117 from Medicare Advantage under programs created by the American Recovery and Reinvestment Act of 2009.

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CommonWell Opens Up Interoperability, or Does It?

If you love drama, there may be no better time than now to be in health IT. Specifically, the CommonWell Health Alliance movement – spearheaded by vendor giants Allscripts, Athenahealth, Cerner, Greenway and McKesson — to promote health information exchange.

However, as we all know, the one giant in the room not to be invited to the dance, Epic, is crying foul.

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In Light of $12 Billion in Federal Incentives,’s Top Frequently Asked Questions

In light of recent reports that nearly 220,000 hospitals, office-based physicians and other eligible professionals have received more than $12 billion in federal incentive payments, I thought I’d highlight the top questions as featured on’s FAQ section.

But, a little perspective first. According to Modern Healthcare, to this point, 3,757 hospitals, or 75 percent of the 5,011 U.S. hospitals that are eligible to receive federal funds under the program, have received an EHR incentive payment.

Also, “215,500 physicians and other EPs, or 41 percent, of the 527,200 total physicians and other professionals deemed eligible to participate, have been paid. Some 85 percent of hospitals and 70 percent of physicians/EPs are registered under the programs, the CMS reports.”

So, back to the original story:’s Frequently Asked Questions and the answers. If you’re not aware of the resource, it serves a broad base audience with a smattering of questions and responses. For example, there a variety of topics including billing, e-health, data navigation, EHR incentive programs, well, you get the point.

Here’s a short list of some questions and their answers:

How and when will incentive payments for the Medicare Electronic Health Record (EHR) Incentive Programs be made? For eligible professionals (EPs), incentive payments for the Medicare EHR Incentive Program will be made approximately eight to 12 weeks after an EP successfully attests that they have demonstrated meaningful use of certified EHR technology. However, EPs will not receive incentive payments within that timeframe if they have not yet met the threshold for allowed charges for covered professional services furnished by the EP during the year. Payments will be held until the EP meets the threshold in allowed charges for the calendar year ($24,000 in the EP’s first year) in order to maximize the amount of the EHR incentive payment they receive. Medicare EHR incentive payments are based on 75 percent of the estimated allowed charges for covered professional services furnished by the EP during the entire calendar year. If the EP has not met the threshold in allowed charges by the end of calendar year, CMS expects to issue an incentive payment for the EP in March of the following year (allowing two months after the end of the calendar year for all pending claims to be processed).

Does CMS have a website to find out more information about the CMS Section 508 Program? Yes, CMS has a website section.  It can be found at

What is CMS? The Centers for Medicare & Medicaid Services (CMS) is a branch of the U.S. Department of Health and Human Services. CMS is the federal agency which administers Medicare, Medicaid, and the Children’s Health Insurance Program. Provides information for health professionals, regional governments, and consumers.  Additional information regarding CMS and it’s programs is available at

When eligible professionals work at more than one clinical site of practice, are they required to use data from all sites of practice to support their demonstration of meaningful use and the minimum patient volume thresholds for the Medicaid EHR Incentive Program? CMS considers these two separate, but related issues. Meaningful use: Any eligible professional demonstrating meaningful use must have at least 50% of their of their patient encounters during the EHR reporting period at a practice/location or practices/locations equipped with certified EHR technology capable of meeting all of the meaningful use objectives. Therefore, States should collect information on meaningful users’ practice locations in order to validate this requirement in an audit.

How do physicians join or leave a group? If both the physician and the group are already enrolled with the same carrier, the physician and the group together are required to complete a CMS 855R showing the date the physician joined the group and reassigned benefits to the group. If a physician leaves a group, the physician or the group should complete the CMS 855R, showing the date the physician left the group. When leaving the group, the CMS 855R does not need to be signed by both the physician and the group. If either the physician or the group have not enrolled with the carrier, they must first complete the appropriate CMS 855 for either an individual (CMS 855I) or group (CMS 855B) before the reassignment can be effective.

For the list of top questions CMS addresses, visit the following link:

If nothing else, this makes for good reading. In light of all the changes and ever-present developments, I felt it worth sharing.

Will Regulation of Mobile Health Devices and Apps By the FDA Be the Industry’s Sin Tax?

Your smartphone a medical device? There’s a possibility that this could happen as Washington and its players continue to evaluate whether in the Food and Drug Administration should regulate mobile apps technologies, including health-related apps.

Based on the interpretation of the current administration’s perspective of mobile health innovation and regulation and how those innovations benefit patients will likely determine whether regulation, and ultimately, taxes are assessed on them.

Mobile health apps can range from an iPhone app that monitors diet to mobile or wireless technologies used in hospitals and home-care settings.

Obviously, developers and those producing the apps want more clarification on the issue. As expected from a federal agency, the FDA has issued draft guidance in 2011 according to Modern Healthcare about how it plans to oversee mhealth apps, but nothing final has been released. So, what we’ve seen may not ultimately be what we get.

Some people believe health apps will help solve the overwhelming cost crisis in healthcare; thus, shackling them with additional oversight, taxes and regulation will stifle a burgeoning industry. As such, according to Modern Healthcare, there needs to be “’predictable, transparent and risk-based regulation,’ the value of interoperability, and reimbursement policy that aligns stakeholders.”

I couldn’t have said it better myself, and I agree with the fear that some lawmakers have about a concern that FDA regulation of smartphones, tablets and apps could mean those technologies are subject to the medical device excise tax, a 2.3 percent tax on the sales of certain devices that went into effect in January.

The tax is part of the Patient Protection and Affordable Care Act and is considered the device industry’s contribution to financing healthcare reform.

In a March 1 letter to FDA Commissioner Dr. Margaret Hamburg (PDF), the House committee leading testimony asked the FDA to clarify whether the smartphones and mobile health apps will be subject to the tax. No response as yet. Not surprising. Additionally, leadership also requested that the agency provide information about when it plans to issue final guidance on how it plans to oversee mobile medical apps.

“Most Americans have no idea that their smartphone, tablet or the mobile apps that have become part of their daily lives could be subject to added red tape or a new tax under Obamacare,” Energy and Commerce Committee Chairman Fred Upton (R-Mich.) said in a news release.

According to the Washington Post, “In 2012, Congress gave the FDA the green light to define which medical apps would require its attention. The agency has asked for comment on a proposal that would give it regulation authority over accessories to existing medical devices, such as apps that show MRI scans, as well as apps and accessories that transform mobile devices into regulated medical devices, such as attachments or apps that turn smartphones into heart monitors.”

For those with an interest at stake here, they should feel some level of concern, no matter the side of the isle they happen to sit. Further regulation, and definitely taxation (especially at the app user level), will destroy the momentum gained by these tools to the market since they’ve been developed.

In the very least, the seemingly unending and elusive patient engagement game that plays on may find itself put on pause as this has the potential to once again remove personal control of tools designed to help manage and improve one’s health and to regulate it.

In many ways this seems like a sin tax. High taxes are used to get people to quit bad behavior, like smoking. When the prices gets too high, they (ideally) quit.