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Meaningful Use and PQRS -- and medicare fraud.


Meaningful use, or MU, is a government program, supposedly designed to force physicans into buying electronic medical record systems. Here we develop our impression that actually, the goal of the "MU" program is actually to reduce payments to physicians and reduce the government's expenses.

In MU, the government promised to pay physicians an incentive if they proved that they complied with a set of criteria, that they claimed were correlated with "quality". They also implemented a "penalty" for physicians that did not comply with their criteria. The penalties (for Medicare) have been gradually accumulating, and it is anticipated that they will eventually encompass about 10% of medicare payments. Lots of money. PQRS is another government mandate similar to MU. The goal of PQRS is to also to exert penalties on physicians, and again to put the blame on physicians who do not comply with the impossible requirements.

We adopted an EMR so we could "comply" with meaningful use. We were doing fine prior to this, so the US government forced us to buy software that we didn't or need. We hired another full time staff member to click the buttons in the EMR required to comply with meaningful use. There are innumerable silly things like "sending records to portals" (few patients want a portal), and going through complicated menu after menu. This is expensive.

After doing this, the government then implemented constantly changing criteria for "compliance", claiming that if we didn't comply, the practice was not providing quality care. Then the government implemented "audits", with yet another set of impossible requirements, and "took back" incentive payments.

Overall, in retrospect, it is clear that the US government constructed an impenetrable MU/PQRS labyrinth of cross-referenced rules, and mysterious bureaucracy. When it is impossible to comply, the government claims that the medical practice has not complied with their "quality" rules. The goal is to reduce the medicare costs. We think this is cheating -- it is Medicare fraud. We would prefer that the government would just say "We are going to pay you less". But they they would have to accept responsibilty for their decisions.

It took us several years to find out that the Government was "gaming us". As it is just another expense for us, we have decided to stop all "meaningful use" effort. We accept that our Medicare payments will be less, and if necessary, we will adjust our practice structure to discourage Medicare patients. If Medicare becomes financially infeasible for us, we will drop out.



© Copyright May 4, 2016 , Timothy C. Hain, M.D. All rights reserved.
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