Unfortunately, the notion of being fashionably late does not apply to EHR incentive programs. It pays to be on time for this party. If you haven’t yet attested for the Medicare or Medicaid EHR Incentive Programs, you’ve still got some time. Eligible professionals must begin their consecutive 90-day reporting period by October 3rd in order to attest to meeting meaningful use and be qualified to receive an incentive payment for 2012. Nuesoft has prepared a video guide to help walk you through some of the program’s more complex meaningful use requirements. Don’t let this opportunity pass you by. Follow our guide and prepare your practice to receive the maximum incentive payments available.
By now, I’m sure you’ve heard of the HITECH Act. This act allocates $19 billion in government funds to encourage the healthcare industry to adopt information technology in the way of electronic health records.
Integrating this technological advance will help medical practices prevent medical errors, limit unnecessary costs, decrease paperwork and improve the quality of healthcare across the nation.
Both the Medicare and Medicaid EHR Incentive Programs provide financial incentives to eligible professionals who are able to demonstrate meaningful use of certified EHR technology. So, what does “meaningful use” really mean?
- Use of a certified EHR in a meaningful manner, such as e-prescribing.
- Use of certified EHR technology for electronic exchange of health information to improve the quality of health care.
- The use of certified EHR technology to submit clinical quality measures (CQM) and other quantifiable markers.
Simply put medical professionals must show that they are using certified EHR technology in ways that can be significantly measured in quality and in quantity. We’d like to help you become more comfortable by taking you through the certification process, making it easier to for you to start receiving incentive payments.
For the Medicare program, eligible professionals include: Doctors of medicine or osteopathy, Dentists, Podiatrists, optometrists, and chiropractors.
Eligible professionals under the Medicaid program include physicians, nurse practitioners, certified nurse-midwives and dentists. Physician assistants who provide services in federally qualified health centers or rural health clinics led by a physician assistant are also included.
Both the Medicare and Medicaid EHR incentive programs currently exclude clinical psychologists, clinical social workers, physical therapists, occupational therapists, dieticians, diabetes nurse educators and “hospital-based” physicians. CMS defines hospital-based physicians as those who provide 90 percent or more of their services in a hospital inpatient or outpatient setting.
Those who wish to qualify for the Medicaid EHR Incentive Program must meet one of the following requirements:
- A minimum of 30 percent Medicaid patient volume
- For pediatricians, a 20 percent minimum Medicaid patient volume
- Or practice predominately in a federally qualified health center or rural health center with a 30 percent minimum patient volume attributable to needy individuals.
Incentive payments for eligible professionals are based on individual practitioners and not the practice as a whole. The number of individual incentive payments will not exceed one per year, regardless of how many practices or locations at which the individual provides service.
Eligible professionals cannot participate in both the Medicare and Medicaid incentive programs. They must choose which program is more beneficial to them. Before 2015, an eligible professional may only switch programs once after the first incentive payment is made. If a provider chooses the Medicaid incentive program, they will also have to choose an individual state from which to receive payment, even if they provide care across state borders.
So, if you’ve met these eligibility requirements, here’s how to get started:
Eligible Professionals must first register for the program using the CMS Registration and Attestation System. You may register before you have a certified EHR in place or even if you don’t have an enrollment record in the Medicare.
Provider Enrollment, Chain and Ownership System (PECOS), which is required for all Medicare eligible professionals.
To help the registration process go smoothly, be sure to have the following information available:
- NPPES User ID and Password.
- Payee Tax ID
- Payee National Professional Identifier
Not all states are ready to participate in the Medicaid EHR Incentive Program. If you choose to receive payments for the Medicaid EHR incentive program, be sure to check your state’s status on the CMS website since you won’t be able to register until your state’s program has started and their site has opened.
Choosing a certified EHR technology is critical to qualifying for EHR incentive payments. Eligible professionals must choose an EHR technology that has been tested and certified by an Office of the National Coordinator (ONC) Authorized Testing and Certification Body (ATCB). If you currently have an EHR in place, verify that it has been tested and certified by an ONC-ATCB , specifically for the Medicare and Medicaid EHR Incentive Programs.
In addition, be certain that the EHR provider has a system that will enable you to easily and seamlessly track data that must be measured in order to meet meaningful use criteria.
Meeting Meaningful Use Criteria
To demonstrate meaningful use, eligible professionals must use a certified EHR to meet defined objectives and report clinical quality measures.
To qualify for incentive payments, meaningful use requirements must be met in the following ways:
- For the Medicare EHR Incentive Program, eligible professionals must successfully demonstrate meaningful use of certified EHR technology every year they participate in the program by meeting defined objectives and clinical quality measures.
- For the Medicaid EHR Incentive Program, eligible professionals have the option of adopting, implementing, upgrading or demonstrating meaningful use of certified EHR technology in their first year of participation.
So you may wonder what’s the key difference between qualifying for Medicare or Medicaid incentive payments. For Medicare, eligible professionals must successfully demonstrate meaningful use of certified EHR technology every year, starting the first year of participation.
Those who wish to qualify for Medicaid have more options in Year One. After Year One, they too must demonstrate meaningful use every year.
As I mentioned before, demonstrating meaningful use requires meeting what CMS calls “Defined Objectives and Clinical Quality Measures” Defined objectives spell out the requirements for qualification. They are currently scheduled to be rolled out in 3 stages over five years.
To qualify for 2012 payments, eligible professionals must meet 15 of the Stage 1 Core objectives and 5 of the Menu Set objectives. You'll find these objectives in our accompanying paper: Making Sense of Meaningful Use: How to Qualify for EHR Incentive Programs. The remaining 5 objectives may be chosen from a list of 10 menu set objectives. These objectives can also be found in the paper.
In addition to meeting the objectives, you will also need to report on six “Clinical Quality Measures” that measure healthcare processes, outcomes, patient perceptions and organizational systems associated with the ability to provide quality health care.
Since it can be difficult to keep track of what meaningful use criteria have been met over a 90 day period, check with your EHR provider to see if they provide the ability to print a report for meeting meaningful use requirements. This report will greatly help in determining if you have met all of your meaningful use criteria.
Attesting Meaningful Use
After meeting the meaningful use objectives and clinical quality measures for 90 days, you’re almost there. You will need to return to the Web-based CMS Registration and Attestation System to legally attest that you have met the meaningful use criteria for the Medicare Incentive Program.
To attest for the Medicare EHR Incentive Program in subsequent years, you will need to have met meaningful use for a full year. The reporting period for eligible professionals must fall within the calendar year.
In the first year of participation in the Medicaid EHR Incentive Program, eligible professionals have the option to adopt, implement, upgrade or demonstrate meaningful use of their certified EHR technology. Medicaid EHR Incentive Program participants should check with their state to find out when they can begin participation.
A certified EHR system will assist you in the attestation process by providing you with a report of the numerators, denominators and other information needed to successfully report on meaningful use objectives and clinical quality measures.
Professionals must identify their certified EHR by giving its CMS EHR Certification ID. This unique ID can be found on the Certified Health IT Product List on the ONC website.
Immediately after submitting your results, you will see a summary of your attestation and if it was accepted. If accepted, incentive payments should be distributed approximately four to eight weeks following your submission.
Eligible professionals may also use third parties to register and attest on their behalf. If you elect to go this route, keep in mind that users working on your behalf must have an Identity and Access Management System, Web user account, and be linked to the Eligible Professional’s National Provider I.D.
The maximum total Medicare incentive payment for eligible professionals is $44,000 over a five-year period. The incentive payment is equal to 75% of Medicare fee-for-service allowable charges for covered services provided by an eligible professional in a payment year.
To receive the maximum incentive payment, you must begin participation by 2012. To receive any Medicare incentive payments, you must qualify and enroll by 2014. If you fail to demonstrate meaningful use by 2015, you will be subject to a reduction in Medicare payments (1 percent penalty in 2015, 2 percent penalty in 2016, 3 percent penalty in 2017, and up to a 5 percent penalty in 2018 and beyond).
Under Medicaid, the maximum incentive payment is $63,750 per eligible professional, paid over 6 years. The first year payment is $21,250 , and $8,500 per year for subsequent years. States have their own timelines for implementing programs, but you must enroll by 2016 to receive the maximum amount of incentive payments, since the program is only scheduled to run through 2021.
We at Nuesoft hope this video has helped in your understanding of the HITECH Act, meaningful use guidelines and how you may qualify to receive government funds. For more detailed information on how to qualify for the Medicaid or Medicare EHR Incentive Programs, download our guide. Our trainers and support staff here at Nuesoft are also available to help you understand the new Meaningful Use benchmarks and assist you in meeting the requirements.