Impact of Proposed SGR Repeal Bill on Meaningful Use Program

Fact sheet on health IT and meaningful use impacts of H.R. 4015, the SGR Repeal and Medicare Provider Payment Modernization Act of 2014, released February 6, 2014, and its companion Senate bill S. 2000 (previous versions were S. 1871 and H.R. 2810).

Read an Excerpt: 

Impact of the Proposed SGR Repeal Bill on the Meaningful Use Program

RE: H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act of 2014, released February 6, 2014, and its companion Senate bill S. 2000 (previous versions were S. 1871 and H.R. 2810).

  • The Medicare Electronic Health Records (EHR) Incentive Program and attestation by eligible providers and hospitals will not be impacted by this legislation. The Medicare EHR Program requirements and certified systems will also continue under the new Merit-Based Incentive Payment System (MIPS). Professionals who report quality measures through certified EHR systems for the MIPS quality category are deemed to meet the meaningful use clinical quality measure component.
  • All EHRs would be required to have achieved interoperability by 2017.
  • The Medicare EHR Incentive Program (Meaningful Use) will continue as currently structured through 2017 and then will be incorporated into MIPS, along with the Physician Quality Reporting System (PQRS) and Value-Based Modifier (VBM), beginning with 2018 and beyond.
  • The Medicare EHR Program’s penalty for non-attesting eligible providers (1% penalty each year not to exceed 5%) to begin in 2016, will end with 2017 and be replaced by the MIPS starting with 2018.
  • The MIPS positive and negative provider payment incentives will be based on four areas including meaningful use (25 percent), quality (30 percent), resource use (30 percent), and clinical practice improvement (15 percent).  Incentive payments will be based on each provider’s relative standing to the annual threshold and to all other providers.  The Secretary of HHS will determine the annual MIPS thresholds based on previous year’s performance.
  • Under MIPS, composite payment penalties will be limited to not more than four percent in 2018, five percent in 2019, seven percent in 2020, and nine percent in 2021. Positive incentive payments will be paid to achievers above the annual threshold and will be subject to additional bonuses.
  • Medicaid will not be impacted, as the MIPS program will only affect the Meaningful Use program penalties, which never were in place for the Medicaid program.
  • Incentives will be available to participate in "alternative payment models" (APMs; i.e., ACOs, patient-centered medical homes, etc.) and APM participating providers will be exempt from MIPS.
  • The Secretary of HHS will publish a list of qualified clinical decision support (CDS) mechanisms, at least one of which must be free of charge, that could be used by ordering professionals and a study on the feasibility of establishing aggregated result of EHRs uses on the functional of certified EHR products.

Richard M. Hodge, HIMSS Senior Director Congressional Affairs, 703-562-8847 or rhodge@himss.org.

Sources: H.R. 4015 draft legislation and Congressional Committees’ Summary.  

Keywords: 
Congress, SGR, Meaningful Use, MIPS