This year will have many challenges and one of them is keeping up with important dates to be met. Here is an overview of the most pertinent dates and a way to download a handy calendar of these dates to keep nearby.

1. Important Events & Dates
in Healthcare in 2014
By Mary Pat Whaley, FACMPE, CPC

2. DATE: NEW for 2014
MEANINGFUL USE FOR ALL
2014 is the last year that Medicare Eligible Providers (EPs)
can begin participation and earn an incentive.
In 2014, all providers -- regardless of where they are (which
stage) with Meaningful Use -- are required to demonstrate
Meaningful Use for a 3-month reporting period - allowing
time to upgrade to 2014 certified EHR technology.
Also in 2014, all participants, regardless of the stage of
Meaningful Use they are in, must have an electronic patient
portal.

3. DATE: NEW for 2014
EVALUATION/MANAGEMENT UPDATE
The Centers for Medicare and Medicaid Services (CMS)
now allows "the status of three or more chronic or
inactive conditions" to qualify as an extended
History of Present Illness (HPI.)
What does this mean?
Physicians that care for patients with chronic illness can
now be reimbursed for a justifiable higher level of office
visit using the 1995 documentation guidelines.
Physicians have two options: status of at least three
chronic or inactive conditions OR document at least four
elements of the HPI.

4. DATE: NEW for 2014
CHANGES TO HIPAA
Although HIPAA Omnibus Rules were in effect late in 2013,
many practices have not caught up. Don’t forget to:
• Give new patients the new NPP.
• Post the new NPP in your reception area.
• Have vendors that “create, receive, maintain or
transmit PHI” sign a new BAA (it protects the practice!)
• Be ready to provide patients with their medical
records electronically.
• Update your policies to reflect the new law and train all
staff to understand the requirements of HIPAA!

5. DATE: NEW for 2014
EFT & ERA COMPLIANCE
In 2014, all payers are required to provide
Electronic Remittance Advice (ERA) and Electronic
Funds Transfer (EFT.) If a payer sends paper
Remittance Advice or paper payments, call them
and tell them they are required to send everything
electronically.

6. DATE: NEW for 2014
EXCHANGE ENROLLMENT
Important dates for Health Insurance Exchange
(HIX) are as follows:
• March 31, 2014: Open enrollment for 2014
ends
• November 15, 2014: Proposed date for 2015
open enrollment to start
• January 15, 2015: Proposed date for 2015
open enrollment to end

7. DATE: NEW IN 2014
VALUE-BASED MODIFIERS
CMS will apply a value-based payment modifier (VBPM) to physician
payment in all groups of 10 or more eligible professionals (EPs)
starting in 2016. The VBPM program aligns with the Physician Quality
Reporting System and includes a payment adjustment based on
PQRS reporting. The scoring methodology for the VBP modifier will
assess quality of care furnished compared to cost during the
performance period (CY 2014) to calculate an adjustment to
payments under the physician fee schedule during the payment
adjustment period (CY 2016).
CMS will assess the size of the group of physicians based on a query
of PECOS within 10 days of the close of the QRS selfnomination/registration process during the relevant performance year.
For groups with 10 or more eligible providers, PQRS registration ends
September 30, 2014).

8. DATE: Extended Into 2014
EHR SUBSIDIES
CMS extends the sunset date on the Stark
exception to December 31, 2021. The
decision will allow hospitals to continue to
finance EHR implementations for referring
physician practices without breaking antikickback laws.

9. DATE: January 2014
PQRS
The Physician Quality Reporting System (PQRS)
data collection period begins for 2014 PQRS in
January.
Physicians must begin PQRS reporting to avoid the
-2.0% penalty in 2016 to their Medicare
reimbursements.

10. DATE: January 1, 2014
DMEPOS FEE
Physicians, non-physician practitioners,
physician groups, and non-physician
practitioner groups that are enrolling as a
Durable Medical Equipment, Prosthetics,
Orthotics and Supplies (DMEPOS) supplier
via the CMS-855S application must pay the
required application fee. The fee for January
1, 2014, through December 31, 2014 is
$542.00.

11. DATE: January 1, 2014
CHANGES IN RVUs
Relative Value Units (RVUs) are multiplied by a conversion
factor to get a reimbursement amount. For 2014 Medicare’s
conversion factor is $35.8228.
RVU changes can have a big impact on your practice. States
RVU Guru Frank Cohen, “For 2014, CPT code 37227
(cardiology) had the largest overall loss in non-facility RVUs;
from 470.33 in 2013 to 420.53 for 2014. The biggest gain (with
% change) for total RVUs was 43220 (GI), going from 3.80 to
28.49 total RVUs, an increase of 650%.” To do your own
impact analysis (free), visit www.frankcohen.com.

12. DATE: January 6, 2014
CMS CLAIM DENIALS
Claims submitted that identify an
ordering/referring provider of items or services
who is not enrolled in Medicare will be denied.
This includes Part B providers and suppliers of
Durable Medical Equipment, Prosthetics,
Orthotics, and Supplies (DMEPOS.)

13. DATE: February 28, 2014
MU ATTESTATION FOR 2013
If you are an Eligible Provider participating in the Medicare
EHR Incentive Program, you have until February 28, 2014, to
attest to demonstrating meaningful use of the data collected
during the reporting period for the 2013 calendar year. You
must attest by 11:59 p.m. Eastern Standard Time on February
28 to demonstrate meaningful use. If you are participating in
the Medicaid EHR Incentive Program, refer to your state’s
deadlines for attestation.
You must attest to demonstrating meaningful use every year
to receive an incentive and avoid a payment adjustment. Need
MU help? Contact David Zetter at www.zetter.com, our MU
Guru!

14. DATE: March 3 -7, 2014
ICD-10 TESTING
CMS will conduct national ICD-10 testing for
current direct submitters (providers and
clearinghouses) from March 3 through 7, 2014.
This will give trading partners access to the
Medicare Administrative Contractor's (MACs) and
Common Electronic Data Interchange (CEDI) for
testing with real-time help desk support. The
event will be conducted virtually and registration is
required.

15. DATE: March 31, 2014
END of SGR “PATCH”
The three-month SGR "patch” expires. It
is hoped that lawmakers will repeal the
SGR permanently and replace it with an
improved Medicare physician payment
system.

16. DATE: March 31, 2014
SUNSHINE ACT REPORTING
March 31st is the last day of reporting in the first
year of the Physician Payments Sunshine Act.
By this time, pharmaceutical manufacturers and
group purchasers will report to the Centers for
Medicare and Medicaid Services information on
payments and other "transfers of value" made
to doctors. The information on the first year is to
be published in September 2014.

17. DATE: April 1, 2014
NEW 1500 CLAIM FORM
Start using Version 02/12 1500 Health Insurance
Claim Form (1500 Claim Form) that will accommodate
reporting needs for ICD-10.
The new form addresses two priorities that were
included in the revisions to the 1500 Claim Form. The
first was the addition of an indicator in Item Number
21 to identify the version of the diagnosis code set
being report, i.e., ICD-9 or ICD-10. The second priority
was to expand the number of diagnosis codes that
can be reported in Item Number 21, which was
increased from 4 to 12.

18. DATE: October 1, 2014
ICD-10 IN EFFECT
ICD-10 is one of two things that is keeping practice
managers up at night. Practices should be already
starting to train, although most billing/EMR systems
will not be ready to handle ICD-10 until late spring or
early summer. (By the way, the other thing is money.)
Shameless self-promotion: we help practices with ICD-10 training
and that money thing.

19. DATE: October 1, 2014
PQRS
For Eligible Professionals (EPs) in first year of
participation, any 90-day period can be used,
but attestation must be concluded before
October 1 to avoid the penalty in 2015.

20. DATE: October 3, 2014
START MU REPORTING
October 3rd is the last day for Eligible
Professionals (EPs) to begin their 90-day
reporting period for stage 1 of Medicare's
Meaningful Use program. Providers that fail to
do so will face a 1% cut in Medicare
reimbursement starting in 2015.

21. NEXT STEPS
For a downloadable schedule of
all the dates in this program, click
on the download link below to go
to the Manage My Practice site.
DOWNLOAD

22. We’re here to help solo
and small practices survive
2014. Call us at (919) 3700504 or email us at
marypat@managemypractice.com