What is the Stimulus Act's official name?
The American Recovery and Reinvestment Act of 2009 (or ARRA).
What is required, system-wise, in order to obtain the incentives?
Eligible professionals will have to "meaningfully use" a "certified" EHR.
When would incentives be paid?
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.
How much can physicians be paid?
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
What is the formula for paying Medicare eligible professionals?
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.
What about Medicaid eligible professionals?
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.
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