EHRs: Time running out to show meaningful use

2014 is the last year for Medicare-eligible professionals to initiate participation in the Medicare Electronic Health Record Incentive Program.

Those who are not meaningful users of certified Medicare electronic health records (EHRs) starting this year will be subject to a payment adjustment beginning on Jan. 1, 2015. The penalty will amount to 1 percent of covered professional services under the Medicare physician fee schedule.

By demonstrating meaningful use of a certified EHR this year, first-time reporters can qualify for an incentive payment equal to 75 percent of their Medicare-allowed charges up to a maximum annual cap of $12,000. And, if they continue to meet program requirements, they may receive additional payments of up to $8,000 and $4,000 in 2015 and 2016, respectively.

This year’s first-time demonstrators must report meaningful use for a 90-day period occurring during the first nine months of 2014. The deadline for attestation is Oct. 1, 2014.

Therefore, those who plan to participate for the first time, but have not yet started, must do so by July 2 to avoid the 2015 payment adjustment.

Eligible professionals who can participate only in the Medicaid EHR Incentive Program and do not bill Medicare are not subject to these payment adjustments. The last year to initiate participation for the Medicaid Incentive Program is 2016. Each state runs its own program.

The Centers for Medicare & Medicaid Services (CMS) offers an Eligibility Wizard on its website to help physicians and other eligible professionals determine their qualifications for each incentive program. Go to

Those who qualify for both incentive programs must select the program they wish to participate in when they register.

According to CMS data, 82 percent of all eligible professionals have registered for the meaningful-use program.

Annual requirement

Meaningful use must be demonstrated every year to avoid Medicare payment adjustments in subsequent years. Those physicians who first demonstrated meaningful use last year will avoid the penalty in 2015. But they must again demonstrate meaningful use this year if they wish to avoid the penalty in 2016.

Because all providers must upgrade or adopt newly certified EHRs in 2014, they are required to demonstrate meaningful use for only a three-month – or 90-day – EHR reporting period regardless of their state of meaningful use.

The accompanying table illustrates the timeline to avoid payment adjustments for Medicare-eligible professionals who first demonstrate meaningful use in 2014.

2014 First-Time Demonstrators – Timeline to Avoid Payment Adjustment

Payment Adjustment Year







90-Day EHR Reporting Period







Full-Year EHR Reporting Period







*Eligible professionals must attest to meaningful use no later than Oct. 1, 2014.

CMS makes an exception for newly practicing eligible professionals who do not have enough time to become meaningful users. They can apply for a two-year limited exception to payment adjustments.

Registration and attestation

To register or to attest to meaningful use, click here.

CMS provides a Registration User Guide for Eligible Professionals that can walk you through the process before you register so that you have all the information needed on hand. Click here to access the guide.

CMS also provides an EP Attestation Worksheet for eligible professionals in Stage 1 of meaningful use. It enables them to log their meaningful-use measures on the page as a reference when attesting for the Medicare EHR Incentive Program in the CMS system. To download the worksheet, click here.