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MU STAGE 2 RULE PROPOSAL

Click the above link if you care to view the new MU Stage 2 rules. These were released 2/23/12. The document is only 455 pages long, no big deal. It was a quick read (just kidding, I didn't read it).

Or view the STAGE 2 SUMMARY PAGE on the CMS website.

Seems to me that this now makes it absolutely vital that AC be able to provide a built in patient/provider portal in order for users to be able to comply with the new mandates.

So, Leslie....are you saying that after V7 is out, you want AC to make MU2 their next priority...before fixing any of the issues in the older versions?

Well, I have managed to "get by" for years without them fixing the things we have clamored for. If I am going to be able to complete MU (and unfortunately I find myself having to do this) I cannot do it without PURCHASING additional software. If AC can tackle the PM task I think they can tackle the portal task. And personally, I do not understand why they cannot focus on more than one task at a time. I know JB really does not want to send out a bunch of 6.1.2.3.4.5.6.7....etc. but why can they not attend to some of the older issues while also taking on the new? Once the PM is out, they should have plenty of time and resources to do both.

From the last brief contact I had with Tech Support, the 6.2 update "soon to be out" should have the interface for Practicomm set. And we're not paying anything for the web portal set up from them (I believe Horizon is footing the bill if I recall properly). The combo of AC and Practicomm should be enough to qualify for the portal needs for MU. At least, that's what the NJ HI-TEC rep reports after they were so quick to recommend them.

Of course, it would have been nice to see Practicomm up and running already, considering they came into the office claiming to already be able to integrate with AC last year. What a waste of time it was trying to get it working then, only to find out from AC after it failed that the interface wasn't set up yet.

Since the only portals with an AC interface is Practicom and Updox, I'm really anxious for the Practicom portal to go live. I'd like to change our portal this year in June when the contract is up for renewal, and I need to compare the two solutions.

I went to the Practicom site over a week ago and requested a demo....never heard back. Hope this is not a sign of things to come once they are up and running with AC. I would much prefer to have this function as an internal part of AC rather than a partnered function. That way, when things do not work as advertised, (e.g. eprescribing) we know who to contact about it.

The Practicom solution works fairly well, but does require the patient to pay a nominal monthly fee. All pt. can receive a lite version which allows them to receive messages from the office, but not reply, have access to the practicom site and use the journals to record/print out bp, blood sugars, wt, access to health information, etc.

Even before the full interface to AC you can just go to summary page and export CCD/CCR to the integration machine in your office and it will auto upload to the pt. who have the paid service. The beta interface which does auto uploading of CCD is undergoing some final testing, but they seem to have added some cool features.

I will contact Practicom and ask them to come on the vendor section.......P.S. I have no financial interest other than using them.

JB made it pretty clear that after V7, time and resources were going to go into improving the clinical side of Amazing Charts.

I really hope that after the CCHIT delay and then the Meaningless Use huge delay, we don't go another nine to twelve months waiting on a patient portal.

Haven't read all the requirements yet, however what concerns me is requirements for laboratory orders, x-ray orders to be sent electronically. With me ordering from at least four different hospitals in two different laboratory companies who was going to setup these interfaces and also pay for all these interfaces, ouch!

Oops damn voice recognition software meant ordering not watering in above post

koby,

Next time you may want to just edit your post directly rather than editing it with another post. You have six hours to edit any post.

I have gone to the Practicom site and asked for a demo. I'll let you know when/if they ever respond.

We have been in touch with Practicom to arrange a demo. Sounds like things are in a bit of transition there but they are responding enthusiastically. Leslie, have you heard from them?

No. And back to your earlier question...do I want a patient portal before fixing the other things? Yes. I can get my Medicare money without a PM program. I can get my Medicare money without a decent letter writer. I can get my Medicare money even though I am not happy with the way the Imported items is slow to open. I cannot however get my Medicare money without a working patient portal. Before when my head was still easily above water and I could care less what Medicare thought I could care less about Meaningless use. But the government intrusions, demands, poor economy, diminished primary care reimbursements and rising costs to practice are about to do me in. If jumping through the MU hoops means I can remain in solo practice (which means in practice at all) then dadburn it I HAVE to jump through those hoops. My priorities have been shifted for me, thank you very much Obamacare.

Hi Wayne,

My name is Justin Stone and I am a representative from Practicom. I am more than happy to schedule a demonstration at your convenience to show you all the wonderful tools that Practicom's Virtual Medical Office can provide to practices and patients. Please email me at your convenience or call me to put a time on the books.

Best Regards,

Justin Stone
Jstone@practicom.com
Phone: (561) 901-1741

Hi Leslie,

My name is Justin Stone and I am a representative from Practicom. Let me first apologize for the delayed response. There was a glitch in the demo requesting ability on our site which we are in the process of fixing. I am more than happy to demonstrate the amazing capabilities of the Practicom Virtual Medical Office to you at your convenience. Please email me at jstone@practicom.com or call me at (561) 901-1741 so that we can put something on the books. Hope all is well.

Best Regards,

Justin Stone

Like I said, Leslie..."enthusiastic". Doubly enthusiastic.

Thank you, Justin. I will call you to discuss Practicom. But i, in fact, my patients have to pay to use it I am not sure I will be interested. But I also said that about the whole MU stuff.

Thank you Justin. I'll be contacting you directly within the next couple of days.

Leslie,

I look forward to hearing from you. We have altered our pricing structure. Patients no longer pay for the service. We are running a special for Amazing Charts Users that makes the product extremely affordable for Providers and in most cases actually serves as a revenue generator for practices. I will go into more details on the call.

Hope all is well,

Best Regards

Justin

I look forward to hearing from you.

Best Regards,

Justin

That may be the very amount of time it takes to make the thing, debug it, beta test it, etc.

JamesNT

"...any provider who first attested to Stage 1 criteria in 2011 would have to begin using Stage 2 criteria in 2013."

Is there going to be any requirement that once you start you have to continue, or give stage 1 money back??

Chris, good question.
Haven't seen any presentations/online documents that state giving Stage 1 (or year 1 and 2 if you "do" 2011 and 2012 using stage 1 critieria) money back for not getting to Stage 2 and Stage 3, other than penalities for not doing so after 2015.
But, there are a lot more knowledgable Doc's on this board who will chime in.

CMS revised the rules so that if you attested in 2011, you do not have to do Stage 2 until 2014.

Penalties for not reporting MU don't come into play until 2015 when it will be required for everyone. You might as well learn to do it in the intervening years, and get paid something for doing it.

Just now attested for MU in 2011. Heck, had 1 whole day more I could have waited!

Agreed, the stage 2 "rules" START in 2013, meaning attestation for 2012 will be Stage 1 MU requirements.

No, Stage 2 rules do not start until 2014

From CMS "..eligible professionals will continue using the Stage 1 criteria for Meaningful Use in 2012 and 2013."

How about getting paid to do Stage 1 but dropping Medicare at Stage 2. This will be a likely scenario if their rules too difficult to make practicing medicine possible.

I stand corrected, and smiling.
That means I can collect 38 K BEFORE having to do any stage 2 stuff!

Roger,

That is exactly right!

You collect the bulk of the available bonuses with the easiest set of criteria.

It remains to be seen, depending on how onerous the final stage 2 criteria are, whether it will be worth the trouble.

I will predict many of us will consider doing MU up through Stage 2, then no longer playing the MU game. I'm considering that myself. I don't have tons of medicare, so my losses for non-participation will not be back breaking.

That is my plan, Adam. My practice is primarily Medicare. My intent will be not to stop taking it but to stop taking Medicare assignment. My patients are very responsible, for the most part, and I feel they will be good at paying their bills. I will even file their Medicare for them and likely will keep my charges in line with what Medicare approves. I just won't tolerate being penalized by Medicare.

If you go non-par (as I am), you are still subject to limitations linked to the Medicare fee schedule, MU, and penalties. You are still REQUIRED to submit the claims for patients. And, there are still items for which you are required to accept assignment. What the patient pays you will be impacted by the penalties.

The only way to not be impacted is to OPT OUT, which is a totally different ball game.

Hmmmm....I guess I have been under the wrong assumptions for many years now. I will have to look into this further. Thanks, Donna

Non-participating status for Medicare is punitive against the non-par doctor. There is a separate fee schedule for non-participating physicians, which is set 5% less than the participating fee schedule.
-- If you do not accept assignment on a claim, the maximum amount you may charge is 115 percent of the approved fee schedule amount for non-participating providers. This amounts to only 9.25 percent more than the fee schedule amount for participating providers (115% x 95%).
-- Non-participating providers may accept assignment on a claim-by-claim basis, but these claims are approved at 95 percent of the participating physician fee schedule for the same service.

If you choose to Opt-out of Medicare entirely (the feds call this "Private Contracting"), the patient gives up all Medicare or supplement payment for services furnished by the "opt out" physician. Essentially, you now have an uninsured patient.

Every time I read through this, I wonder how I got myself into this deal with the devil.

Yes, John explains Medicare non-par correctly.

The advantages are:
-Initial 9.25% increase in reimbursement from your previously par collections by setting fees at the the limiting charge.
-Patients pay you at the time of service, and they wait to be reimbursed by Medicare for covered amounts. Submit the claim and you're done. No billing to track or post, diminishing office workload/overhead. This is what I refer to as the "retail" model = provide a service, collect a payment.

The big problem is that you are still tied to the Medicare fee schedule, so that if there is a cut at some point, you still are affected by it.

If you are non-par with insurers other than Medicare, there is no limit on your fees. You can set whatever you consider to be fair.