Physician Incentives

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American Recovery and Reinvestment Act of 2009

The Medicare and Medicaid EHR incentive program will provide incentive payments to eligible professionals (EP) that are meaningful users of certified EHRs. EPs who meet the eligibility requirements for both the Medicare and Medicaid incentive programs may participate in only one program and must designate the program in which they would like to participate. EPs are allowed to change their program selection only once after the initial incentive payments have been made.

Eligibility Requirements:

• Incentive payments for physicians are based on individual practitioners. If you are part of a practice, each eligible professional may qualify for an incentive payment if each eligible professional successfully demonstrates meaningful use of certified EHR technology.
• Each EP is eligible for one incentive payment per year, regardless of how many practices or locations they provide services at.
• Hospital-based eligible professionals are not eligible for incentive payments. A physician is considered hospital-based if 90% or more of their services are performed in either hospital inpatient or emergency room settings.

Medicare Incentive Program:

The Medicare incentive program allows for up to $44,000 per eligible provider. An EP under the Medicare program includes a Doctor of Medicine (MD), Doctor of Osteopathy (DO), Doctor of Podiatric Medicine (DPM), Doctor of Optometry, Chiropractor, Doctor of Oral Surgery, and Doctor of Dental Medicine who is legally authorized to practice under state law.

Medicare Eligible Professionals have until 2014 to register for the incentive program without retribution. After 2015, Medicare will start a payment reduction at 1% that increases each year to a maximum of 5%. To qualify, Medicare EPs must successfully demonstrate Meaningful Use for each year of participation in the program. The incentive payments are made based on the calendar year. The reporting period for the first year is any 90 continuous days during the calendar year, and the reporting period for all subsequent years is an entire calendar year.

Maximum Total Amount of EHR Incentive Payments for a Medicare EP is outlined in the table below. To receive the maximum EHR incentive payment, Medicare EPs must begin participation by 2012.

For complete information on the Medicare Incentive Program Click Here

Medicaid Incentive Program:

The Medicaid Incentive Program allows for up to $63,750 per eligible provider. Medicaid EPs include 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 Dietician, Nutrition Professional, Audiologists, Physical Therapist, Occupational Therapist, and Qualified Speech-Language Therapist. No enrollment is allowed after 2016.

To qualify for incentive payments under the Medicaid EHR incentive program, an EP must meet one of the following criteria:

• Have a minimum 30% Medicaid patient volume
• Have a minimum 20% Medicaid patient volume and is a pediatrician
• Practice predominantly in a Federally Qualified Health Center or Rural Health Center and have a minimum 30% patient volume attributable to needy individuals.

Payment Scenarios for Medicaid EPs Who Begin Adoption in the First Year

EPs may qualify for both the Medicare and Medicaid incentive programs, but must choose between which incentive program when they register. They will be allowed to switch only ONCE once the initial incentive payment has been made, if the provider wishes. The best way to maximize incentive payments is by participating in the Medicaid EHR Incentive Program.

Registration for EHR Incentive Programs

The registration page for Medicare and Medicaid EHR incentives are located at https://www.cms.gov/EHRIncentivePrograms/20_RegistrationandAttestation.asp, as noted before. The registration is completely online, and allows for the option of choosing between either the federal Medicare incentive program, or the state Medicaid incentive program. The sooner you are registered, the better your chances of maximizing your incentive payments. You are allowed to register before having a system installed.

Checklist for Medicare EHR Incentive Program:

• Make sure you are an eligible, either as a professional or as a hospital.
• See if you are eligible for the Medicaid EHR Incentive program, where you could possibly recieve higher incentive payments. EPs are only allowed to switch between programs only once after the first incentive payment is initiated.
• Get Registered! Registration began on January 3, 2011.
• Use Certified EHR technology
• Successfully demonstrate "meaningful use" for a consecutive 90-day period in your first year of participation.
• Attest for incentive payments through the registration portal with Medicare. You can access the secure attestation website starting in April 2011.

Checklist for Medicaid EHR Incentive Program:

• Make sure you are eligible
• See if you are eligible for the Medicare EHR Incentive program, and see if it would be more beneficial.
• Get registered! Visit https://www.cms.gov/EHRIncentivePrograms/40_MedicaidStateInfo.asp find out if your state is participating. If your state has not yet begun to participate, you can still register for the Medicare EHR Incentive Program.
• Use Certified EHR technology.
• Get qualified, by either adopting certified EHR technology, implement certified EHR technology already purchased, upgrade your current system to certified EHR technology, or demonstrate meaningful use for a 90-day period with the certified EHR.
• Invest in the certified EHR technology. The spending requirements are defined through the state's Medicaid agency web site.
• Attest for incentive payments. Details on this will also be found on the state's Medicaid agency web site.