EHR Incentives

Collect your EHR Incentives!!

As per the American Recovery and Reinvestment Act (ARRA) of 2009, every Eligible Professional (EP) must demonstrate the Meaningful Use of EHR system in order to receive Medicare and Medicaid Incentive payments. An EP cannot be entitled for EHR incentive payment from both Medicare and Medicaid in the same year. The EPs can switch between the two programs “only once” after receiving their first incentive payment.

EHR Incentives Payment – Medicare

In Medicare, EPs can receive incentive amounts to a maximum of $44,000 (if their first year of demonstrating Meaningful Use of EHR system was 2011). The incentives are paid for a period of 5 years starting from 2011 through 2015. In the first year, the EP’s must demonstrate the Meaningful Use of EHR system for any 90-day period. For the remaining years, they must demonstrate a full year of Meaningful Use.

Who qualifies to be an EP to receive Medicare Incentives?

An EP can be one of the following to be eligible to receive the Medicare Incentives:

• Doctor of medicine
• Dentist
• Doctor of podiatric medicine
• An optometrist
• Chiropractor

Payment Adjustments/Penalties – Medicare

By 2015, if the EPs do not demonstrate the Meaningful Use of the EHR system, the physician fees schedule amount will be adjusted and only the adjusted values would be paid to EPs. The adjustments, beginning in 2015, will be as follows:

• 2015 – 99% of physician fees schedule amount
• 2016 – 98% of physician fees schedule amount
• 2017 – 97% of physician fees schedule amount
• 2018 – 96% of physician fees schedule amount (if less than 75 percent of EPs use EHR systems)
• 2019 – 95% of physician fees schedule amount (if less than 75 percent of EPs use EHR systems)

First Year of Meaningful Use demonstration of EHR
	2011	2012	2013	2014	2015
2011	$18,000	0	0	0	0
2012	$12,000	$18,000	0	0	0
2013	$8,000	$12,000	$15,000	0	0
2014	$4,000	$8,000	$12,000	$12,000	0
2015	$2,000	$4,000	$8,000	$8,000	Penalty of 1% of Medicare fees schedule
2016	$0	$2,000	$4,000	$4,000	Penalty of 2% of Medicare fees schedule
TOTAL	$44,000	$44,000	$39,000	$24,000	$0

Table 1: Maximum Incentive Payments for EP

As per the data from the table, the EPs still can aim to receive $44,000 as incentive amount by demonstrating Meaningful Use of their EHR system by October 3, 2012.

For physicians practicing in Health Professional Shortage Area (HPSA), they are eligible for an additional 10% over the maximum incentive amount (i.e.) $48,400 for a period of 5 years.

Table 2: Maximum Incentive Payments for EP practicing in HPSA

EHR Incentives Payment – Medicaid:

In Medicaid, EPs can receive incentive amounts to a maximum of $63,750. The incentives are paid for a period of 6 years starting from 2011 through 2016. To receive incentives through Medicaid, EPs need not demonstrate the Meaningful Use of EHR system.

To participate in the Medicaid program, the EP must have a practice that is 30% Medicaid based on the number of patient encounters, where 20% is for pediatricians. Also, there is no penalty if the EPs do not participate in the Medicaid program as in the case of Medicare.

Who qualifies to be an EP to receive Medicaid Incentives?

An EP can be one of the following to be eligible to receive the Medicaid Incentives:

• A physician
• Nurse Practitioners
• Dentists
• Physician Assistants practicing in a Rural Health Clinic (RHC) or a Federally Qualified Health Center (FQHC) led by a physician

Table 3: Maximum Incentive Payments for Medicaid program

Significant dates to Remember:

October 1, 2011 – Reporting period begins for eligible hospitals (EH) and Critical Access Hospitals (CAHs)
January 1, 2012 – Reporting period begins for EPs
May 2012 – Payment of EHR incentives commences
July 3, 2012 – Last day for EHs to begin the 90-day period to demonstrate Meaningful Use of EHR system for Medicare Incentive program
September 30, 2012 – Reporting period ends for EHs and CAHs
October 3, 2012 – Last day for EPs to begin the 90-day period to demonstrate Meaningful Use of EHR system for Medicare Incentive program
November 30, 2012 – Last date of EHs and CAHs to register and attest in order to be able to receive the incentive payment for 2012 for Medicare Incentive program
December 31, 2012 – Reporting period ends for EPs
February 28, 2013 – Last date of EPs to register and attest in order to be able to receive the incentive payment for 2012 for Medicare Incentive program

To know more about Meaningful Use Consulting and EHR certification, please contact us by email at [email protected] or call us at +1 (408) 850 2243..