Dr. Sam:
Well, the electronic health records is actually separately. General, when you do electronic health records, you probably are compliant with PQRS because it's part of it, but PQRS can be done without electronic health records. With Medicare, there's actually two reductions. If you didn't comply with what they call meaningful use for electronic health records, you get 2% off for that. In addition, if you didn't comply with the PQRS, there's an additional 2%, so potential a provider has as much as 4% reduction on their claim based on non-reporting of electronic health records and PQRS, but they're separate. A doctor can say, “Well, you know what, I don't want to spend the money or the time to do electronic health records, but can I do PQRS without electronic health records,” and you absolutely may. Okay and that was exactly what I was referring to, I just couldn’t think of what it was considered, so thank you. Can you share with the audience a little bit about what that documentation would look like? Well, thanks Stu, so let's do that. This PowerPoint that you see, certainly you can download it, I believe there’s going to be a way for you to print it, but let's just make PQRS reporting simple. Part of the reason that this PQRS is happening is that of course as noticed here from the journal of The American Board of Family Medicine, it is determined that chiropractic is reducing some 83.5 million in savings to Medicare. Part of that is due to the effectiveness of Medicare and I think this is where PQRS can help us. PQRS, what does it stand for, Physician Quality Reporting System. This PQRS is something that all providers of Medicare have to do, so this includes medical doctors, not just chiropractors, whether you are participating or non-participating, this still must be reported because all providers do have to include this in their billing and all providers are required to bill. This started back in 2007 and it actually started as an incentive program, where a provider who did PQRS was actually given a 1% increase in fees. However, in 2013, they transitioned from an incentive program to one of a penalty. That penalty is something that allows us to have that 2% reduction. PQRS though is technically not mandatory, so when someone says, “Well, is it mandatory?” It is and it isn’t. Not mandatory refers to that if you don't do it, you get the reduction. If you do do it, you do not get the reductions. In other words, there’s no extra money, but it means you're not getting a reduction for it. What is this all about, how hard is it? Well, they began applying this reduction in 2015, meaning the last year and the reduction last year was 1.5%. This year, it's 2%. What's confusing though is some people might say, “Hey, Sam last year, I did PQRS, how come they're reducing my fee?” If you look at the second bullet here, you’ll notice the payment adjustment for 2015 was related to 2013, so in the fourth bullet, notice that 2014 is what counts for this year, if you do this year accounts to 18, so it's a little confusing because it's every other year. If you began doing it last year, you will not get a reduction next year and remember it’s 2%. Good news, it will not increase. Dr. Stu had mentioned about electronic health records, by not having electronic health records that does increase 1% per year, so though this year electronic health records is only 2%, it will increase to 3 - 4 and then cap out at 5% in 2025, but PQRS ...
Dr. Stu:
Dr. Sam:
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