ASA Clarifies EHR Program Rules

By Justin Vaughn, M.Div, CPC  12/7/2012

Recently, the ASA published a set of frequently asked questions (hereinafter, FAQ) regarding anesthesiologists and the EHR Incentive Program; and, in so doing, has finally put to rest some nagging questions I had submitted to the society over the preceding weeks.  As we earlier reported, the Final Rule for Stage 2 of Meaningful Usecontained a codicil exempting anesthesiologists from the program’s penalties over a 5-year period.  This was good news, but the wording of the Rule raised a few questions: 

• Was the exemption automatic or would the anesthesiologist have to file a request?

• If a request has to be filed, when is the deadline and what is the process for filing?

• Does the exemption from the penalty automatically exclude the anesthesiologist from participation in the incentive portion of the program?

ASA personnel had informed me that, after consulting with CMS, my questions would be addressed in an upcoming FAQ.  That document is now posted on the ASA website, and contains the following highlights:

1. The annual exemption from the penalties (which start in 2015) that applies to anesthesiologists is automatic, and is automatically renewed each of the 5 years of the exemption period.  Therefore, you will not have to file for the exemption—as long as anesthesiology is listed as your primary specialty in CMS’s Provider Enrollment, Chain and Ownership System (PECOS).
2. Having an automatic exemption from the penalty does NOT preclude you from participation in the program.  In other words, you can still attempt to earn the incentive payment even though you are not subject to the penalty.
3. CMS will audit those attesting to meaningful use (MU), and will not only recoup incentive payments erroneously made, but could impose penalties if willful intent to defraud is demonstrated.  Therefore, do not attest (legally certify) unless you are confident you have indeed met the MU criteria.
4. For anesthesiologists who practice in multiple locations (some of which may not have EHRs), and who wish to participate in the incentive program, CMS states:

“. . . an EP must have 50 percent or more of his or her outpatient encounters during the EHR reporting period at a practice/location or practices/locations equipped with [certified EHR technology (CEHRT)]. An EP who does not conduct at least 50 percent of their patient encounters in any one practice/location would have to meet the 50 percent threshold through a combination of practices/locations equipped with CEHRT.”

Though the ASA advised in its FAQ that it will neither support nor oppose an anesthesiologist’s decision to participate in the EHR program, the clarifications it elicited from CMS will at least lend a bit more light to those still considering the best course of action for them and their practice.

The information presented herein reflects general information that is current as of the date it was first published.  In light of changes that may occur in the health care regulatory and compliance environments, the author’s presentation of this information might become outdated.  Please check with your individual legal and/or compliance advisor(s) prior to taking any significant actions based upon the information and advice presented.