Updated: March 12th, 2010
In the coming months, the Department of Health and Human Services and the Office of the National Coordinator for Health Information Technology (ONCHIT) will be finalizing a range of guidelines and requirements relating to the HITECH Act and economic stimulus programs. To stay up to date, request notifications by email. If you have questions not covered here, email your questions to stimulus@micromd.com or register for one of our upcoming webinars, “ Economic Stimulus and Your Practice”.
Eligibility for Incentive Payments
Who is eligible for Medicare Stimulus Reimbursements?
Office-based physicians who demonstrate meaningful use of an electronic medical record (EMR) system — including dentists, podiatrists, optometrists and chiropractors — are eligible. Physical therapists and hospital-based physicians—such as pathologists, anesthesiologists, ER physicians or hospitalists—are not.
Who is eligible for Medicaid Stimulus Reimbursements?
Those allowed to submit for incentives include physicians, dentists, certified nurse mid-wives, nuse practitioners and physician assistants.
Are HITECH Act incentive payments per provider or per practice?
The incentives are paid on a per provider basis.
Can some physicians in a group demonstrate "Meaningful Use" and receive payments while some do not?
Remember that the incentive payments go to the individual physicians delivering the care and are not distributed at a practice/group level. Although to earn payments, the physicians must demonstrate "Meaningful Use", which includes interoperability with other outside systems; practices that are not fully operational are less likely to have clarified their connectivity strategy and so may present a problem to those physicians who are using EHR. This is an issue that practices will need to work through in order for their physicians to collect the incentive payments.
How do the Medicare incentive payments work?
If an eligible provider is using a qualified EHR in 2011 or 2012, they can receive up to 75 percent of their allowable charges (maximum of $44,000 over 5 years). Physicians practicing in "health professional shortage areas" can receive a 10 percent additional payment. Penalties for not meeting meaningful use begin in 2015 and start with a one percent reduction in payments and increase to three percent in 2017.
How do the Medicaid incentive payments work?
Healthcare professionals with 30 percent or more Medicaid enrollees among their patient load (20 percent for pediatricians), FQHCs and Rural Health Clinics can receive reimbursements based on EMR costs. Incentive reimbursements represent up to 85 percent of the cost of the technology. The maximum benefit is $25,000 in the first year for implementation, and $10,000 each year following (up to four years) that the EMR is operating and maintained.
Will stimulus payments be in addition to regular reimbursements?
Yes, the payments are separate from the Medicare or Medicaid claims paid to your practice.
How will the payments be disbursed to the doctors?
Most will receive payments in 2012 if Meaningful Use is demonstrated in 2011.
Can a provider receive incentives for both Medicare and Medicaid?
No. Providers will have to choose one. We encourage you to review your Medicare and Medicaid patient volumes and associated revenues to determine the best option.
Can a provider receive both the MIPPA e-prescribing bonus and HITECH Act stimulus payments?
No. Providers will have to choose one. Your participation in the MIPPA e-prescribing bonus program for 2009 and 2010, however, will not be affected because the economic stimulus program will not begin until 2011.
Certified EMRs and Meaningful Use
What is “Meaningful Use?”
According to HITECH, providers must demonstrate "Meaningful Use" of a certified EMR system. Meaningful Use will involve three stages of reporting requirements with increasing requirements over time. Stage 1 requirements will be applied in 2011 and 2012; Stage 2 requirements will be applied in 2013 and 2014 and Stage 3 requirements will be applied in 2015. The specifics will be forthcoming, but Meaningful Use is expected to encompass e-Prescribing, interoperability with other outside systems and quality reporting.
What is meant by the term “certified” EMR?
The legislation requires that physicians use an EMR (or EHR) that has been evaluated to ensure that its software features and functionality meet a certain standard of performance. Though the method of certification has not been finalized, it is expected to be similar to the process offered by the Certification Commission for Healthcare Information Technology (CCHIT). MicroMD EMR 7.0 is already CCHIT-certified for 2008.