CMS Announces EHR Incentive Appeals extension to April 30

CMS is extending the March 30 deadline for EPs to submit eligibility appeals for the CMS EHR Incentive Program 2011 payment year. Protesting under the eligibility appeal allows the EP to show they have met all the requirements for the EHR Incentive Program but they could not receive a payment because of “circumstances outside of the provider’s control.”

There are three types of appeals in the EHR incentive program which include either an informal review or a request for reconsideration process.

1. In an Eligibility Appeal a provider has met all the program requirements and should have received an EHR incentive but could not because of a circumstance outside the provider’s control. The deadline for this appeal is 30 days after the 2 month period following the payment year. This means March 30, 2012 for EPs.
2. In a Meaningful Use Appeal a provider has shown that he or she used certified EHR technology and met the meaningful use objectives and associated measures after a successful attestation. The deadline for this appeal is 30 days from the date of the demand letter or other finding that could result in the recoupment of an EHR incentive payment.
3. In an Incentive Payment Appeals it is for Medicare EPs only and a provider has shown that he or she provided claims data not used in determining the incentive payment amount. The deadline for this appeal is 60 days from the date the incentive payment was issued or 60 days from any Federal determination that the incentive payment calculation was incorrect.

For general questions and for information on how to file an EHR incentive program appeal, eligible professionals (EPs), eligible hospitals, critical access hospitals, Medicare Advantage Organizations, and Medicaid eligible hospitals may contact OCSQ’s designated appeal support contractor by phone or email. Office hours are Monday through Friday 9am to 5pm ET.

• Toll-free number: 855-796-1515
• Email: OCSQAppeals@provider-resources.com

You can also find general information on the Appeals page on the EHR Incentive Program web site.