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Government Incentives & Stimulus FAQs
Q: What is the Stimulus Act’s official name?
A: The American Recovery and Reinvestment Act of 2009 (or ARRA).
Q: What is required, system-wise, in order to obtain the incentives?
A: Eligible professionals will have to “meaningfully use” a “certified” EHR.
Q: When would incentives be paid?
A: The bonus (or incentive) payments from CMS will begin as early as May 2011, if those eligible have completed the necessary tasks to achieve meaningful use, and registered through the CMS website. For the first year of implementation, the EHR reporting period will be 90 days for any continuous period beginning and ending within the calendar year. (For example, the EHR reporting period can be January 1, 2011 to April 1, 2011, March 13, 2011 to June 13, 2011, etc.). For every year after the first payment year, the EHR reporting period will be for the entire calendar year. The reporting year began as early as October 1, 2010 for eligible hospitals and CAHs, and January 1, 2011 for eligible professionals. Therefore, 2011 is the first year that payments will be made. Eligible professionals who have been using a certified EHR in the approved format since before the ARRA was developed will also be entitled to the maximum incentive, with payment at the beginning May 2011.
Q: How much can physicians be paid?
A: Payments are substantial especially if an eligible professional participates in the program starting in 2011. Eligible professionals using an EMR/EHR right now based upon what the specified criteria will be will have already ensured maximum reimbursement for themselves. The payment for specified EMR/EHR usage in 2011 (or for current EMR/EHR usage) is $18,000 in 2011. Over the course of the five year reimbursement program, a total of $44,000 will have been paid. The later usage starts, the less the payments will be.
The table below details total potential payments to eligible professionals under the program, as reimbursable by Medicare:
Note: This is per physician provider in a qualifying medical practice. A practice with 3 physicians would be eligible for a total of $132,000 in reimbursements.
Maximum Total Amount of EHR Incentive Payments for a Medicare EP who does not Predominantly Furnish Services in a HPSA Calendar Year First CY in which the EP Receives an Incentive
Calendar Year |
First CY in which the EP Receives an Incentive Payment |
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2011 |
2012 |
2013 |
2014 |
2015 and subsequent years |
|
2011 |
$18,000 |
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2012 |
$12,000 |
$18,000 |
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2013 |
$8,000 |
$12,000 |
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2014 |
$4,000 |
$8,000 |
$12,000 |
$12,000 |
|
2015 |
$2,000 |
$4,000 |
$8,000 |
$8,000 |
$0 |
2016 |
$2,000 |
$4,000 |
$4,000 |
$0 |
|
TOTAL |
$44,000 |
$44,000 |
$39,000 |
$24,000 |
$0 |
Q: What is the formula for paying Medicare eligible professionals?
A: Medicare eligible professionals will be incentivized based upon 75% of their Medicare payments for the year. Thus, in order to obtain the maximum $18,000 in the first year, at least $24,000 in Medicare payments must have been paid to the eligible professional in 2010 ($24,000 x 75% = $18,000). The same formula applies for the ensuing years.
Q: What about Medicaid eligible professionals?
A: If you meet any of the following criteria with Medicaid patient volume as estimated in accordance with a method established by the HHS Secretary, your incentive can be as much as $63,750 as an eligible professional who:
1. Is not hospital-based and who has at least 30% of his / her patient volume attributable to individuals receiving medical assistance under this title.
2. Is not hospital-based and has at least 20% of his / her patient volume attributable to individuals receiving medical assistance under this title.
3. Practices predominantly in a federally qualified health center or rural health clinic and has at least 30% of his / her patient volume attributable to needy individuals.
If you are in any of these three categories, Stimulus legislation calls for up to $63,750 in federal contributions toward the “meaningful usage” of a certified EHR, as opposed to the maximum of $44,000 for Medicare eligible professionals.
Payment Scenarios for Medicaid EPs Who Begin Adoption in the First Year
Q: Can eligible professionals benefit by Medicare and Medicaid incentives?
A: No. ARRA incentives apply to one or the other, but not both.
Q: Are incentives paid per eligible professional or per practice?
A: Per eligible provider! If a practice has more than one eligible professional, each one individually is eligible for their own incentives.
Q: What about “Meaningful Usage?”
A: Overview: The American Recovery and Reinvestment Act of 2009 (Recovery Act) authorizes the Centers for Medicare & Medicaid Services (CMS) to provide reimbursement incentives for eligible professionals and hospitals who are successful in becoming "meaningful users" of certified electronic health record (EHR) technology. The Medicare EHR incentive program will provide incentive payments to eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) that are meaningful users of certified EHR technology. The Medicaid EHR incentive program will provide incentive payments to eligible professionals and hospitals for efforts to adopt, implement, or upgrade certified EHR technology or for meaningful use in the first year of their participation in the program and for demonstrating meaningful use during each of five subsequent years.
The Medicaid EHR incentive program will provide incentive payments to eligible professionals and hospitals for efforts to adopt, implement, or upgrade certified EHR technology or for meaningful use in the first year of their participation in the program and for demonstrating meaningful use during each of five subsequent years.
Who qualifies as an Eligible Provider (EP)
Medicare: Doctor of Medicine (MD), Doctor of Osteopathy (DO), Doctor of Podiatric Medicine (DPM), Doctor of Optometry, Doctor of Oral Surgery, Doctor of Dental Medicine
Medicaid: Doctor of Medicine (MD), Doctor of Medicine (MD), Doctor of Osteopathy (DO), Doctor of Podiatric Medicine (DPM), Doctor of Optometry, Doctor of Oral Surgery, Doctor of Dental Medicine, Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist, Certified Registered Nurse Anesthetist (and Anesthesiologist Assistant), Certified Nurse Midwife, Clinical Social Worker, Clinical Psychologist, Registered Dietitian, Nutrition Professional, Audiologists, Physical Therapist, Occupational Therapist, Qualified Speech-Language Therapist
Q: Where do I register for the Medicare and Medicaid Incentive Programs?
A: Registration is done completely online at https://ehrincentives.cms.gov/hitech/login.action. There you sign up for the program you wish to participate in, either Medicare or Medicaid.There also are registration user guides for EPs and EHs for both the Medicare and Medicaid programs.
Q: What information do I need to register?
A: Eligible Professionals will need their NPI, NPPES User ID and Password, payee tax ID (if you are reassigning benefits), and payee NPI (also if you are reassigning your benefits). Hospitals need their CMS Identity and Access Management (I&A) User ID and Password, CMS Certification Number (CCN), NPI, and Hospital tax ID number. You do not need to provide information on the certified EHR technology you are using when you register. This information is required when you attest.
To learn more about the EHR Incentives program, go to:
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