1. My group has 10 physicians. Would the group qualify for total incentive payments of $440,000 under the Medicare incentive program?
Yes. If each of the physicians meets the criteria including the ability to demonstrate meaningful use of a certified EHR system by 2012, the group could be entitled to a total of $440,000 in incentive payments under the Medicare program.
Yes. If each of the physicians meets the criteria including the ability to demonstrate meaningful use of a certified EHR system by 2012, the group could be entitled to a total of $440,000 in incentive payments under the Medicare program.
2. What Is “Meaningful Use” defined in the legislation?
“Meaningful Use” is described initially in the legislation includes the following: The use of a certified EHR with ePrescribing capability as determined appropriate by the Secretary of HHS.
“Meaningful Use” is described initially in the legislation includes the following: The use of a certified EHR with ePrescribing capability as determined appropriate by the Secretary of HHS.
- The ability to report on clinical quality measures as specified by the Secretary.
- The use of EHR technology that allows electronic exchange of patient health information.
- Further information with regard to required standards, reporting and connectively levels will be determined by the Secretary of Health and Human Services.
3. My practice has been utilizing an EHR system prior to the date the Stimulus Bill was signed into law. Can the providers in my practice still qualify for the incentive payments?
Yes. In fact you are probably ahead of the curve. Only 20%-30% of practices have implemented an EHR prior to the enactment of HITECH. If your system is certified and you can demonstrate meaningful use of the system prior to 2012 you should be able to qualify for the incentive payments.
Yes. In fact you are probably ahead of the curve. Only 20%-30% of practices have implemented an EHR prior to the enactment of HITECH. If your system is certified and you can demonstrate meaningful use of the system prior to 2012 you should be able to qualify for the incentive payments.
4. The cost of my EHR system was only $15,000. If I qualify, will my incentive payment be limited to $15,000?
No. The requirement to receive the maximum incentive payments is a utilization standard and is not dependent upon the actual cost or purchase method of the EHR system. If you meet all qualifications for the incentive payment, you should receive the maximum payment regardless of the actual cost or purchase method of your EHR system.
No. The requirement to receive the maximum incentive payments is a utilization standard and is not dependent upon the actual cost or purchase method of the EHR system. If you meet all qualifications for the incentive payment, you should receive the maximum payment regardless of the actual cost or purchase method of your EHR system.
5. Are there any additional benefits for PQRI and electronic prescribing?
Those engaged in Physician Quality Reporting Initiative (PQRI) and electronic prescribing can earn an additional $ 6000 - $ 8000 per year, beginning immediately.
Those engaged in Physician Quality Reporting Initiative (PQRI) and electronic prescribing can earn an additional $ 6000 - $ 8000 per year, beginning immediately.
6. How will the EHR Stimulus payments actually be distributed to the physicians?
The timing and distribution process for the incentive payments is to be determined and finalized by the Secretary of the HHS and the federal rule making process.
The timing and distribution process for the incentive payments is to be determined and finalized by the Secretary of the HHS and the federal rule making process.
7. Will my patients or the public know whether or not my practice qualifies as meaningful EHR user?
Yes. CMS will post the names, addresses, and phone numbers of eligible professionals who are meaningful EHR users and group practices receiving incentive payments.
Yes. CMS will post the names, addresses, and phone numbers of eligible professionals who are meaningful EHR users and group practices receiving incentive payments.
8. What are the Medicare and Medicaid incentive options?
The HITECH Act (part of the American Recovery and Reinvestment Act) outlines two separate and distinct incentive payment programs, one through Medicare and one through Medicaid. Providers can only receive incentive payments from one of the programs and will need to determine where they stand to benefit most.
The Medicaid program offers up to $64,000 to physicians who see more than 30% of patients paying with Medicaid, (20% for pediatricians). The Medicare program offers individual physicians up to $44,000 in incentive payments.
The HITECH Act (part of the American Recovery and Reinvestment Act) outlines two separate and distinct incentive payment programs, one through Medicare and one through Medicaid. Providers can only receive incentive payments from one of the programs and will need to determine where they stand to benefit most.
The Medicaid program offers up to $64,000 to physicians who see more than 30% of patients paying with Medicaid, (20% for pediatricians). The Medicare program offers individual physicians up to $44,000 in incentive payments.
9. Are all physicians eligible for incentive payments from Medicare and Medicaid?
Physicians that do not accept Medicare or those that do not have a patient payor mix of greater than 30% Medicaid (20% for pediatricians) will not qualify for the HITECH incentive payments. Furthermore, physicians operating solely in a hospital environment, such as pathologist, anesthesiologist, or emergency physicians are not eligible.
Physicians that do not accept Medicare or those that do not have a patient payor mix of greater than 30% Medicaid (20% for pediatricians) will not qualify for the HITECH incentive payments. Furthermore, physicians operating solely in a hospital environment, such as pathologist, anesthesiologist, or emergency physicians are not eligible.
10. Are groups that do Medicare Advantage also eligible for the stimulus dollars?
Yes, those organizations and their providers are eligible for the incentives as long as the provider delivers a minimum of twenty hours a week of patient care services and the organization furnishes at least 80 percent of the services of the individual professional to clients of their organization.
Yes, those organizations and their providers are eligible for the incentives as long as the provider delivers a minimum of twenty hours a week of patient care services and the organization furnishes at least 80 percent of the services of the individual professional to clients of their organization.
11. How are Pediatricians and Family Physicians going to be able to participate?
If a physician does not meet the Medicaid payor mix threshold and does not accept Medicare, they will be able to apply for grants and/or loans to offset the upfront costs of the purchase of an EHR but will not be eligible for incentives as described in the Stimulus Bill.
Additionally, the Secretary of HHS will be assessing utilization levels beginning in 2011, to see if there is a need to offer other incentives for the prompt adoption among those populations of providers.
If a physician does not meet the Medicaid payor mix threshold and does not accept Medicare, they will be able to apply for grants and/or loans to offset the upfront costs of the purchase of an EHR but will not be eligible for incentives as described in the Stimulus Bill.
Additionally, the Secretary of HHS will be assessing utilization levels beginning in 2011, to see if there is a need to offer other incentives for the prompt adoption among those populations of providers.
12. Can a physician be penalized for not utilizing an EHR by 2015?
Beginning in 2015, physicians not demonstrating meaningful use of an EHR will face penalties in the form of reductions to their Medicare fees schedule reimbursement rates. The penalty will equal 1% in 2015, 2% in 2016, and 3% in 2017 and each subsequent year. Under the bill, the Secretary can increase the penalty to 5% if fewer than 75% of eligible physicians are not utilizing an EHR by 2018.
Beginning in 2015, physicians not demonstrating meaningful use of an EHR will face penalties in the form of reductions to their Medicare fees schedule reimbursement rates. The penalty will equal 1% in 2015, 2% in 2016, and 3% in 2017 and each subsequent year. Under the bill, the Secretary can increase the penalty to 5% if fewer than 75% of eligible physicians are not utilizing an EHR by 2018.
13. Under Medicaid who is eligible to receive incentive payments and what is the timeline for payments?
The Medicaid program offers up to $64,000 per providers who see more than 30% of their patients paying with Medicaid, (20% for pediatricians). Beginning in 2011, the Medicaid incentive payment will be based on a calculation that factors the provider’s Medicaid mix in combination with up to $25,000 the first year and $10,000 each subsequent year for a total period of five years.
The eligible professional under Medicaid must first demonstrate certified EHR usage by 2015 to be eligible for payments and after 2021 will not be eligible for payments. Pediatricians, who only meet the lower threshold of 20% Medicaid patients, would be eligible for 66% or the payments described above.
The Medicaid program offers up to $64,000 per providers who see more than 30% of their patients paying with Medicaid, (20% for pediatricians). Beginning in 2011, the Medicaid incentive payment will be based on a calculation that factors the provider’s Medicaid mix in combination with up to $25,000 the first year and $10,000 each subsequent year for a total period of five years.
The eligible professional under Medicaid must first demonstrate certified EHR usage by 2015 to be eligible for payments and after 2021 will not be eligible for payments. Pediatricians, who only meet the lower threshold of 20% Medicaid patients, would be eligible for 66% or the payments described above.