Over the years there have been significant changes with the transition to electronic health records (EHRs). In an effort to offset the initial costs and to incentivize providers to make the transition to EHRs, the Center for Medicare and Medicaid Services (CMS) was authorized by federal legislation to create the Medicare and Medicaid EHR Incentive Program. These programs provide eligible professionals and hospitals with incentive payments for using EHRs in ways that positively impact patient care. Since Medicare does not typically have a dental benefit, the Medicaid EHR Incentive Program will be most applicable to dental offices.
What is it?
The Medicaid Incentive Program is currently being offered in 43 states, including Washington, and provides incentive payments to eligible healthcare professionals during their first year of participation and continued demonstration of “meaningful use” for up to five subsequent participation years. “Meaningful use” is being defined by the CMS as “use of EHRs in a way that positively affects patient care.”
Am I eligible?
In order to be eligible for the Medicaid EHR Incentive Program, providers must have at least a 30 percent Medicaid patient volume. Patient volume is calculated by dividing the number of billed Medicaid encounters during a continuous 90-day period in the preceding calendar year by the total number of billed encounters in that same period. Providers must also be enrolled and billing through ProviderOne.
What are the incentives?
Eligible participants can receive up to $63,750 over a six year period should they choose to participate all six years; years of participation do not have to be consecutive. In their first year of participation providers can receive an initial incentive payment of $21,250.00 for the adoption, implementation or upgrading of EHR technology (AIU process). Following their first year of implementation, providers can receive incentive payments of $8,500.00 per year for up to five years, so long as they continue to demonstrate and report their meaningful use.
What are the requirements?
In their first year of participation, providers can adopt, implement, or upgrade their current EHR technology to demonstrate “meaningful use” (AIU process). In order for providers to remain eligible for EHR incentive payments they must meet the meaningful use criteria each year. The EHR program consists of 3 stages of meaningful use; Data Capture and Sharing, Advanced Clinical Processes and Improved Outcomes.
Providers can participate in the program for three years under Stage 1 regardless of when they begin the Medicaid EHR program. After three years, providers will begin Stage 2. There are currently no rules or requirements written for Stage 3. CMS anticipates releasing proposed rulemaking for Stage 3 in the fall of 2014, with a final rule with requirements for Stage 3 following in the first half of 2015. Eligible providers who have completed at least two years of Stage 2 would then begin Stage 3 in January 2017.
Under Stage 1 providers must complete 14 core objectives, 5 menu set objectives and 9 total clinical quality measures. Click here
to view Stage 1 core and menu set objectives.
Under Stage 2 providers must complete 17 core objectives, 3 menu set objectives and 9 clinical quality measures. Click here
to view Stage 2 core and menu set objectives.
to view the complete list of Clinical Quality Measures for 2014 CMS EHR Incentive Programs for Eligible Professionals.
When and where do I report?
Participants report for the Medicaid EHR Incentive Program by attesting through their state Medicaid website. The reporting period is 90 days for the first year of participation in the EHR program and 1 year subsequently. The reporting period for the first year must be 90 consecutive days within a calendar year (January 1st – December 31st) and the following reporting period must be the entire calendar year. There will be a special reporting period in 2014, meaning that regardless of a provider’s stage of meaningful use, they will only be required to demonstrate meaningful use for a 90 day EHR reporting period. This is due to the fact that in 2014 all participating providers must upgrade or adopt a 2014 certified version of EHR software.
Where can I find 2014 certified EHR software?
A complete list of certified EHR technology can be found on the Office of the National Coordinator for Health Information Technology’s website. Click here
to access their website.
Washington state EHR Incentive Program Resources
to access Washington state’s Eligible Professional Training Guide for Meaningful Use
to access Washington state’s white paper regarding the AIU process
to learn how to get paid correctly as a servicing provider in a group practice in Washington
to access Washington state’s white paper on EP Patient Volume Calculations
to access Washington state’s white paper on Special Issues for EPs at FQHCs and RHCs
to access Washington state’s white paper on EHR Appeal Process