Speaking of learned helplessness...

January 21, 2012

So, CMS has kicked me twice this week. First, I realized that the meaningful use

money that I was thinking was going to save me this year can't possibly come

until the very end of the year, regardless of how soon I attest. I just learned

that I need $24,000 in CURRENT year Medicare payments before they will pay me

the maximum year 1 amount of $18,000, and it takes me all year to generate that

much in Medicare payments. And, I may not even generate that much in payments

this year, because I was borderline before and many of my MC patients are

switching over to Medicare Advantage plans, which don't count. Great!

Second, I just got my first Medicare payment with a 1% penalty for not having

been a " successful " e-prescriber in 2011, even though I was doing it full-time

and putting the proper codes on all my claims by October. The requirement was

to be doing it by the end of June, which I could not do because

hardware/software incompatibilities prevented me from starting to use the

necessary, updated version of my EHR by the required date. I could have used a

stand-along eRX product, but decided I couldn't do the extra work. I was

resigned to the penalty until I heard news that I could file a hardship

exemption that seemed to be designed for docs in exactly my situation. I filed

for the exemption by the required date. About a month later, I got an e-mail

from them saying that their information revealed that I would not be subject to

the penalty, so they were not going to proceed with my processing my exemption.

I knew in the pit of my stomach that smelled like danger, but was too swamped

with other garbage to spend a lot of time questioning it. I decided to trust

that they knew what they were doing... MISTAKE! Just got my first payment with

1% penalty, which will last all year. We are definitely going to appeal, but,

as you all know, DO NOT HAVE TIME FOR THIS GARBAGE! I know, I should drop them,

but I would lose all of my over- 65 patients, and they are my favorites!

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