Medicare Promoting Interoperability Program Participants Can Apply for Payment Adjustment Reconsideration by December 3, 2021
The American Recovery and Reinvestment Act of 2009 requires critical access hospitals (CAHs) and eligible hospitals (EHs) participating in the Medicare Promoting Interoperability Program to successfully demonstrate meaningful use of certified electronic health record (EHR) technology (CEHRT) during the applicable reporting period to avoid a downward payment adjustment for a CAH or EH applicable payment year. CAHs who are not meaningful users will receive a 100% instead of a 101% reimbursement of reasonable costs for their 2020 cost reports.
CMS applies a reduced annual payment update to the Inpatient Prospective Payment System (IPPS) for subsection (d) hospitals that aren’t meaningful EHR users or haven’t been granted a hardship exception. The applicable percentage increase to the IPPS payment rate will be adjusted downward for those eligible hospitals that aren’t meaningful EHR users. For eligible hospitals that aren’t meaningful EHR users, the percentage increases will be reduced by 75% in FY 2017 and subsequent years.
CAHs and EHs that did not successfully demonstrate meaningful use of CEHRT recently received a letter from CMS notifying them they will be subject to a negative payment adjustment. However, if you received a letter from CMS stating your CAH is subject to a negative fiscal year (FY) 2020 Medicare EHR payment adjustment, or your EH is subject to a negative FY 2022 Medicare EHR payment adjustment, and you believe this determination was reached in error, you may apply for a payment adjustment reconsideration.
Applications must be attached to an email and sent to qnetsupport@hcqis.org with the subject line “2022 Eligible Hospital Hardship Reconsideration Request” or “Critical Access Hospital FY2020 Reconsideration request” by December 3, 2021. If approved, this payment adjustment reconsideration is valid for the relevant year’s payment adjustment only.
Both application forms are available below for hospitals wishing to apply for a reconsideration. Please review the instructions and fill out your form completely before submitting.
- 2020 Medicare Promoting Interoperability Program CAH Payment Adjustment Reconsideration Application
- 2022 Medicare Promoting Interoperability Program EH Payment Adjustment Reconsideration Application
For More Information
View more information about payment adjustments and hardship information. For more information on the Promoting Interoperability Programs, visit the Promoting Interoperability Programs website.