MU Penalties: ASC Ophthalmologists Get a Pass…For Now

If you are an ophthalmologist who performs a lot of ASC procedures, you’ve likely been sweating the onset of Meaningful Use penalties more than most. Sweat no more

Relief is in sight and (surprise!) it’s coming from Congress.

Why You Were Worried: A Quick Reminder

Although there are some complicated exceptions, the HITECH Act of 2009 requires many physicians to be using certified EHR in 50 percent of their patient encounters by now. Those who don’t comply face Medicare reimbursement cuts of up to 5 percent between now and 2018. Many ophthalmologists who perform a lot of Medicare-reimbursable procedures face significant pay cuts if they haven’t adopted EHR by now.

The Problem

According to data presented at the ASCA annual meeting, 82 percent of ASCs aren’t using EHR yet. Most ASCs use either paper records or digital scans of paper records—not EHR that meets MU, according to Mary Hibdon, an ASCA presenter.

Why? Lawmakers overlooked ASCs in the original HITECH legislation. ASCs were not listed among eligible providers (EPs) and did not get the first wave of MU incentives. So it’s no surprise that there’s no certified EHR available for ASCs. As a result, most ophthalmologists can’t use EHR in their ASC work yet, and they risk not meeting their MU requirements if they perform a lot of procedures at ASCs.

Why You’re Getting a Breather

The Senate has passed the Electronic Health Fairness Act of 2015, which exempts ASC procedures from MU obligations. A bill containing a similar exemption passed the House earlier this summer. Once President Obama signs the bill, the MU exemption for ASC encounters is official. The exemption lasts until three years after HHS determines, “through notice and comment rulemaking, that certified EHR technology is applicable to the ambulatory surgical center setting,” the newly passed legislation says.

The MU exemption applies to ophthalmologists who have ownership interests in ASCs, as well as ophthalmologists who don’t have ownership interests, says Kay Tucker of ASCA, which supported the legislation. Currently, 30 percent of specialists who perform procedures in ASCs are ophthalmologists, according to CMS data. That percentage could decrease as CMS contemplates moving uncomplicated cataract surgeries into in-office surgical suites.

Photo Credit: Gage Skidmore. CC BY-SA

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