Home Forums Discussions Meaningful Use I JUST GOT PAID FROM CMS, 2012 ATTESTATION (year 2) $12,000

I'm happy to report that my biller announced to me she found a $12,000 deposit in our account today, representing our year #2 of M.U. attestation (for 2012). yay!!!

I am medium on whether clicking all those buttons is worth $12,000, and I'm borderline whether it's worth it for the $8,000 for year #3, but I'm in the process of click-click-clicking away for 2013 attestation.

I've made a decision however, I'm not going for attestation after 2013. The $4,000 and $2,000 incentive dollars for years 4 and 5 are definitely NOT worth it to my practice. Nor is the penalty for NON-participation in MU/PQRS/ERx. I'm actively reviewing the process for withdrawal from the medicare system b/c I don't think I'll survive any longer if we continue to accept medicare.

Adam,

I thought the $12k was for Stage 2 not year 2 of Stage 1. That is good news. How much time elapsed between your 2 attestations? A full year?
Thanks.

I am with you on doing just the first 3 yrs.

Bill

Attested Jan 1 2012 for year 2011, got paid April 1, 2012. $18,000
Attested Jan 1 2013 for year 2012, got paid March 1, 2013. $12,000

Since I began attesting calendar year 2011, Stage 2 is not required for attestation until year 2014.

In the meanwhile I will be attesting years 1 (2011), 2 (2012), & 3(2013) as Stage 1.

Depending upon WHEN an eligible provider begins attesting, they will either attest to stage 1, or stage 2 at different years.

Me too....must have been the big day...remember about taxes...and today it looks like we all took a 2 percent hit on Medicare for doing our job....trying not to hijack...and can someone tell me how to easily start a new post as I forgot..thanks

Adam,
Thanks for the info. I attested last yr in March. I will wait until that date comes and attest again! Gotta grab my 12k before they cancel the whole program.

Todd,
Click on Forum list at the top, choose the appropriate category for your post and click New Post.

Bill: not to be the bearer of bad news, but yesterday was the deadline for attesting for year 2. Check the CMS website; if you act quickly, they may let you attest or apply for an exception/extension.

I would attest but will not do any good. I am an NP, meet all the rules, but can not get paid because we bill properly, under MY Numbers not incident too! I do not have a 30% Medicaid population so do not qualify for Medicaid either.

I called CMS because I was confused. This may help others in the same boat. I attested last March for a 3 mo period. That then is my attestation for 2012. My next attestation period is now 1/1/13 through 12/31/13. I don't attest again until 1/1/14 for my $12000. Guess I should have gotten on it earlier last yr but such is life. Hope this info helps someone else.

Year 1 is 90 days. It doesn't matter if you start in January or in October. Year 2 requires you to attest for the entire year. So for people that are attesting year one, you can wait until October to start or you can just get it out of the way now.

Adam,

If you are willing to share your thoughts on this issue, I would be interested in your rationale. whether you decide to or not.

@ Jimmie

my rationale for un-enrolling in medicare if I decide to do it:

1) reimbursement barely covers my per-patient minimum required income to cover office over-head expenses, and when the
SGR cuts finally come to fruition I will no longer afford to see medicare patients.
2) threats of SGR-related cuts and proven history of congressional and presidential failure to fix the broken formula. They will eventually stop delaying the cuts and we won't get paid anything worth our efforts and educational training to accept their "payment." This may be a moot point under the ACO model of payments, in which case I won't be able to see these patients anyway because our local ACO is open ONLY to the local hospital owned practices. I'm not allowed to participate unless they own me, thus I would have to subscribe (pay) to belong to a national ACO billing service and I refuse to sell my soul to this type of "health plan."
3) CMS lies and tricks to get us involved in programs by 1st "incentivizing" us to participate then "requiring" us to participate under threats of payment reduction for non-participation. Examples include: PQRI/PQRS, ERx, Meaningful Use. Like many other docs I know, when PQRI/PQRS was offered in 2008 (+/- a year), I predicted successfully that within a few years they would penalize us for non-participation. Starting 2014, this becomes reality.
4) Stage 2 and 3 of MU requirements that are EXPONENTIALLY more challenging and time consuming to meet. Coupled with incentive pay that is not even close to covering my expenditures to meet the requirements (for me stage 2 will reimburse $,4000 and $2,000 in my final 2 years of the 5 year MU incentive) thus resulting in a return on investment (ROI) of NEGATIVE DOLLARS when you consider my time and my paid staff time to meet their "measures of good practice."
5) 2014 represents the year in which failure to participate and produce data for PQRS/PQRI and MU will result in 1-2% penalty for non-participation. It's already happening for ERx.
6)threats of audit and the risk of getting falsely accused of inappropriate billing practices by the governmental gestapo called the General Accounting Office (GAO) are at ALL TIME U.S. HISTORICAL HIGHS. If you subscribe to CMS email alerts, you know that in January they proudly released 2012 reclaims data in which the GAO spent 1 Billion dollars (with a B) on reclaiming Medicare payments, and for the 1st time in U.S. history turned a profit. They raked in over 3 Billion (with a B) and prosecuted over 1,200 people and about 200 institutions. Let me be clear, I do not commit fraud. But I know a doctor in Maine who was falsely accused by the GAO and he WENT OUT OF BUSINESS AND INCURRED MASSIVE DEBT DEFENDING HIMSELF. This is not fair. This is not just. This is fascism in practice, right here in the good-ole U.S. of A. The home of the brave, and land of the free. I LOVE MY COUNTRY but I HATE these governmental practices that have NO REGARD for the personal debt we all incurred getting our career training and PERSONAL SACRIFICES we all made to learn doctoring and care for others, giving of ourselves DAILY. And the government comes around and F's us over. Mark my words, the GAO will not stop. They will spend more this year and more next year to get more reclaims payments.
7) inconsistency in government sponsored health plans

The down-side: i will feel sad and guilty that many of my medicare patients won't be able to afford to see me for cash payments (I will offer them reduced fees of $40-75 office visits), people I've cared years for. But even with my lowered fees many won't be able to afford it. When the ACO model of payment fully kicks in 2014 for Medicare this may be a moot point because they will end up getting assigned a participating provider (which won't be me). I know CMS says Medicare patients will have the right to choose......but you and I know damn well that with their track records of lies and deception this choice will turn into a choice to see "participating providers," and later that "choice" will no longer be offered. Instead they will be assigned to doctors without choice.

I say the following not to be offensive, rather somewhat in jest and somewhat with serious undertones: If any of you readers think I'm being paranoid, then you are foolishly drinking the cool-aid and need to undergo psychiatric testing. The government will come after us in the form of audits and "reclaims reviews." Be scared, be terrified. On the one hand they say "we need more primary care doctors and are increasing their reimbursements." On the other hand they just cut our payments by failure to agree on the Sequestration bill, and will eventually cut via the SGR formula, and they are putting us in chains and screwing us over for the YEARS of sacrifices we made.

For these reasons which I believe to be rational and thought-out for many months/years are the reasons I am making plans to withdraw from medicare in 2014.

respectfully submitted.

P.s. my use of capital letters is not "yelling," but simply for emphasis.

Adam,

Thank you for your insight. This is the part of the equation that is kicking my butt. Unfortunately, the average salary here in Montana is quite low, and the Medicare % is higher than a lot of other areas in the country, and the out of pocket cost will be quite formidable to the Medicare group as a whole.

However, reading your post does reinforce the idea, for my practice, that the status quo will have to change.

Here is a link to a simple explanation of the options for physicians in dealing with Medicare: Medicare options

There are 3 options, Par, Nonpar and Opt Out

super, thank you for that info!

@todd

It depends on where you are on the board, but if you have just opened ACUB, then:

1. Choose a forum under Discussions --> Forums (such as General Discussion)
2. You will see a New Topics tab just to the right of Most Recent Posts
3. If you are in a thread and can't see the forums, the easiest method is to click on Forum List, which will bring you to the list of forums.

Bill,

We are in the same boat as we got our 90 days in year 2012. Now we will have to attest in 2014 for our first full year 2013.
Are the requirements exactly the same for the first full year as the 90 days. In other words, still use the Meaningful Use Wizard just like we did for the 90 days to receive our $12,000?

Thanks

Take this amount and assuming a 50% practice overhead and then a 50% total tax rate for a business and personal income, that will be $6000 personal down to $3000 after taxes. Divide by how many hours it took - cumulative adding up the actual extra hours plus extra minutes with each patient and you will get how much you made on this. (Yes, I did it too and realized the government was taking back 50% off the top in taxes from the start! I figured the office overhead because the staff did a bunch of work for this and I gave them a bonus). Then consider how much more work it will be over a year long endeavor. Just doing this increases our chance of a third party audit from the henchmen they have hired as has been explained above.

Adam: would you mind explaining what is required for the withdrawal, at least what you have discovered? I too am planning a retreat in 2014 when penalties kick in. I understand I have to send them a letter at least a month in advance in 2013. I DO think you patients can afford 40 to 70 dollars: put a better value on yourself! They pay twice that for cable TV and cell phones. (But I don't know your patients. I just see the cars that mine drive). I may just let them pay what the gov't was paying me 68-50% off) or go to some kind of Senior concierge model where they pay a yearly fee. They are already paying $160 deductible and $26 co-pays, so a few hundred a year should buy a couple of visits and labs, along with continued care.

No, in the second year, you have to attest the full year. You have until March 31, 2014 to complete the attestation for 2013. E.g. running the wizard from 1/1/2013 to 12/31/2013 to receive the second payment. Third, Fourth, and Fifth are the same.

Thanks Sandeep,

I knew I had to attest for a full year, but is this still considered stage 1 and the Core requirements are all the same? Only difference is a longer period?

Okay, there appears to be some confusion. Let me break down the timline. Starting in 2014, Stage 2 is in effect. At that point, we are back to the 90 day requirement for people who attested in 2011 and 2012.

So if you filed for Calendar Year 2011, you would be in Stage 1 for 3 years (2011,2012,2013) until 2014, then you would have to submit 90 days under stage 2 for the fourth year. Lastly, you would do the full year for 2015 with Stage 2 requirements.

So if you filed for Calendar Year 2012, you would be in Stage 1 for 2 years until 2014 (2012,2013), then you would have to submit 90 days under stage 2 for the third year. 1 Full Calendar Year for Stage 2 in 2015. Then, 1 year for Stage 3 in 2016.

Basically ever year after 2011 gets 2 years to be in Stage 1 before finally moving to Stage 2. 2011 people have the "benefit" of being in Stage 1 for 3 years having only 2 years to go. The timeline is summarized below:


Source: CMS

Sandeep,

So for 2012 mu submitters... Can be in stage 1 for 2013. When can one resubmit and for how long a time is needed?

Thanks.

Yes, if you submitted for the first time in 2012 (90 days), then you must submit for the entire calendar year of 2013 meeting Stage 1 requirements. So starting Jan. 1, 2014 until March 31, 2014, you will submit your data for the entire year of 2013. March 31, 2014 is the deadline to submit for the calendar year 2013. You will need to re-register for 2013 between now and the day before your attestation. No one is on Stage 2 until 2014.

And therefore, can submit January 1, 2014, MU 1 requirements?

Thanks Sandeep,
It is now crystal clear.
Now I wish I would have started one year earlier.

Simple Answer: Yes


No one should be submitting Stage 2 on January 1, 2014. The people who are on Stage 2 in 2014 are the ones who started in 2011 or 2012. They would be the first ones to demonstrate meaningful use at Stage 2. The earliest anyone would be able to attest to 90 days of a Stage 2 system will be April 1, 2014.