In 2015, the electronic health records meaningful use, physician quality reporting system and value-based modifier reporting programs become punitive in nature.

That means that this year and previously, physicians could participate in the programs and earn incentives while avoiding penalties. Next year, however, failure to participate will result in reduced Medicare reimbursements. The payments may be lower by 1 or 2 percent to start, but all three combined programs could have a cumulative reimbursement penalty of 11 percent by 2017 based on regulations already in the pipeline, says Jeb Shepard, senior government affairs representative at the Medical Group Management Association.

Shepard and government affairs colleague Jennifer McLaughlin will host a Washington Update session at the MGMA Annual Conference, Oct. 26-29 in Las Vegas. On the table in addition to the quality reporting programs will be the latest news on implementation of the Affordable Care Act, including changes for Medicaid and the health insurance exchanges. For instance, ACA-mandated Medicaid payment parity with Medicare during 2013 and 2014 goes away next year unless pending legislation in Congress is passed and/or some states fund it themselves. Neither option, Shepard cautions, can be counted on.

Shepard and McLaughlin also will walk through HIPAA operating rules requiring insurers to support electronic funds transfers and electronic remittance advice, and will address payer use of controversial “virtual” credit cards for reimbursement and how providers can fight back. They also will explain the work of the government affairs unit of MGMA and the need for members to use the resources available to them.

The session, Washington Update, is scheduled on Oct. 27 10:15 a.m. in Room N255/N257.

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