The incentive value is to be 75% of allowed Medicare charges for professional services for a payment year with yearly maximums as described in the below table if the EP is a meaningful EHR user. The program begins in 2011 and will continue through 2016. EPs can participate for up to five years throughout the duration of the program. The last year to begin participation in the Medicare EHR Incentive Program is 2014. To receive the maximum EHR incentive payment, Medicare EPs must begin participation by 2012.
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Education Center - Incentives
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Webinar Recordings
54 minutes
- recorded Tuesday, October 2, 2012
65 minutes
- recorded Tuesday, February 8, 2011
57 minutes
- recorded Tuesday, February 22, 2011
Resources
Medicare Incentives for Eligible Professionals
Medicaid EHR Incentives for Eligible Hospitals
Each state must approve the demonstration of meaningful use for their state. Eligible hospitals will qualify for Medicaid incentive payments if they adopt, implement, upgrade, or demonstrate meaningful use of certified EHR technology during the first participation year or successfully demonstrate meaningful use of certified EHR technology in subsequent participation years. Medicaid hospitals that qualify for EHR incentive payments may begin receiving payments in any year from FY 2011 to FY 2016. While the law defines a payment year in terms of federal fiscal year (FY) beginning with FY 2011, a hospital does not have to begin receiving incentive payments in FY 2011.
Medicaid Incentives for Eligible Professionals
Medicaid EPs are defined as those professionals who are:
- Not hospital-based provider with at least 30% Medicaid patient volume;
- Not hospital-based pediatrician with at least 20% Medicaid patient volume; or,
- An EP who practices in a FQHC or RHC with at least 30% patient volume attributable to needy individuals.
Hospital-based is defined as a professional (such as a pathologist, anesthesiologist, or emergency physician) who furnished substantially all services in a hospital setting (whether inpatient or outpatient) and through the use of the facilities and equipment, including EHR, of the hospital. Determination of hospital-based status is made on the basis of site of services and without regard to any employment or billing arrangement made between the professional and any other provider.
Medicaid EHR Incentive Payments to Non Hospital-based Providers with at Least 30% Medicaid Patient Volume
Such professions include:
- Physicians (Doctor of Medicine, Doctor of Osteopathy, and in some states optometrists)
- Dentists
- Certified Nurse Mid-wives
- Nurse Practitioners
- Physician Assistants (PAs) who practice in a FQHC or RHC that is led by a PA. The PA would be leading a FQHC or RHC if:
- The PA is the primary provider in a clinic (i.e., when there is a part-time physician and full-time PA, the PA would be considered the primary provider);
- The PA is a clinical or medical director at a clinical site of practice; or,
- The PA is an owner of a RHC.
Medicaid EHR Incentive Payments to Non Hospital-based Pediatricians with at Least 20% Medicaid Patient Volume
Medicaid incentive payments to these EPs cover up to two-thirds of 85% of the net allowable costs for EHR technology, support services, maintenance, and training for a provider to adopt and operate the EHR technology. Allowable costs for Year 1 payments are the average costs, from studying EPs, for the purchase and initial implementation or upgrade of EHR technology, including support services for training for adoption and initial operation of the technology. The net average for Year 1 cannot exceed $25,000 so if the net average cost of an EP is $25,000, they would receive a payment in Year 1 of $14,166.67 (2/3 x (85% x $25,000) = $14,166.67). Year 1 cannot be after 2016.
Medicaid EHR Incentive Payments to EPs who practice in a FQHC or RHC with at Least 30% Patient Volume Attributable to Needy Individuals
Needy individuals are defined as those individuals:
- Receiving Medicaid;
- Receiving assistance under Title XXI;
- Who is furnished uncompensated care by a provider; or
- Who receive reduced charges by the provider on a sliding scale basis used on the individual’s ability to pay.
Minnesota Medicaid
Health care providers and other stakeholders can receive information about Minnesota's Medicaid EHR Provider Incentive Program online at www.dhs.state.mn.us/EHRincentives. The Minnesota Department of Human Services is administering the federal program that provides incentives to eligible providers and hospitals that implement and demonstrate meaningful use of certified EHR technology. If you have questions about Minnesota Medicaid HIT issues, contact Bob Paulsen, MN Medicaid Health Information Technology Coordinator, (651) 431-5827.
Medicare EHR Incentives for Prospective Payment System Hospitals
The formula for the calculation of the Medicare incentive payment to prospective payment system (PPS) hospitals is as follows:
($2M + Discharge Amount) x Medicare Share x Transition %
North Dakota Medicaid
Health care providers and other stakeholders can receive information about Minnesota's Medicaid EHR Provider Incentive Program online at ND Medicaid HIT Website. The North Dakota Medicaid HIT Office is administering the federal program that provides incentives to eligible providers and hospitals that implement and demonstrate meaningful use of certified EHR technology. If you have questions about North Dakota Medicaid HIT issues contact, Nancy R. Willis, State Medicaid HIT coordinator, (701) 328-1715.
Medicare EHR Incentives for Critical Access Hospitals
Critical access hospitals (CAHs) that are meaningful EHR users by 2011 are eligible for four years of enhanced Medicare payment with immediate full depreciation of certified EHR costs, including undepreciated costs from previous years.
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