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Which professionals are eligible for the EHR/EMR Stimulus Incentives?
This depends upon whether the eligible professionals qualify for their
incentives through Medicare or Medicaid.
Under Medicare, eligible professionals include DCs, DDSs, DPMs, DOs, MDs
and ODs who are office-based (not hospital-based such as pathologists,
anesthesiologists or ER physicians). Physical therapists, psychologists,
nurses, nurse practitioners, physician assistants, medical assistants and
social workers are examples of non-eligible professionals through Medicare.
Medicaid eligible professionals are those providers named under Medicare,
as well as Certified Nurse Midwives, Nurse Practitioners, and under certain
circumstances, Physician Assistants. All must also not be hospital based,
and to qualify for Medicaid's incentives, medical treatment must be provided
to at least a 30% Medicaid patient population (20% for pediatrics).
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How much is available to Medicare providers?
The maximum amount available to eligible professionals through Medicare is $44,000.
See the explanation beneath the Medicare Incentives Schedule below for Medicare Part
B amounts needed to qualify for the maximum incentives.
Medicare Incentives Schedule
|
Year
|
Eligible in 2011
|
Eligible in 2012
|
Eligible in 2013
|
Eligible in 2014
|
Eligible in 2015
and Beyond
|
|
2011
|
$18,000a
|
$0
|
$0
|
$0
|
$0 incentive
|
|
2012
|
$12,000b
|
$18,000a
|
$0
|
$0
|
$0 incentive
|
|
2013
|
$8,000c
|
$12,000b
|
$15,000f
|
$0
|
$0 incentive
|
|
2014
|
$4,000d
|
$8,000c
|
$12,000b
|
$12,000b
|
$0 incentive
|
|
2015
|
$2,000e
|
$4,000d
|
$8,000c
|
$8,000c
|
No incentive,
1% Mcare cut
|
|
2016
|
$0
|
$2,000e
|
$4,000d
|
$4,000d
|
No incentive,
2% Mcare cut
|
|
Total
|
$44,000
|
$44,000
|
$39,000
|
$24,000
|
No incentive,
3%-5% Mcare cut
|
Annual Part B charges required to obtain maximum Stimulus Act incentives:
a $24k Part B for $18k max
b $16k Part B for $12k max
c $10,667 Part B for $8k max
d $5,334 Part B for $4k max
e $2,667 Part B for $2k max
f $20k Part B for $15k max
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How much is available to Medicaid Providers?
Under Medicaid, eligible professionals can receive up
to $63,750 over six years and must qualify by 2016 to
receive maximum incentives. To qualify, an eligible provider's
patient population must be comprised of at least 30% Medicaid
patients and 20% for pediatricians. Requires proving Meaningful
Use in year 2; year 1 can be for adoption only.
Medicaid Incentives Schedule
|
Year
|
2011-2016 30% provider
|
2011-2016 20% pediatrician
|
|
1st year
|
$21,250a
|
$14,167b
|
|
2nd year
|
$8,500c
|
$5,667d
|
|
3rd year
|
$8,500
|
$5,667
|
|
4th year
|
$8,500
|
$5,667
|
|
5th year
|
$8,500
|
$5,667
|
6th year
(up to 2021)
|
$8,500
|
$5,667
|
|
Total
|
$63,500
|
$42,500
|
Allowable costs:
a $25k (1st year only) = $21,250 or b $14,167
c $10k = $8,500 or d $5,667 & $5,666
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Are incentives paid per practice or per eleigible provider?
They are paid per eligible provider, not per practice. This
means that practices with more than one eligible provider
would obtain the maximum amount of benefit to which each eligible
provider is entitled for implementing an EHR/EMR certified for the
Stimulus Act.
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Can an eligible provider claim both Medicare and Medicaid benefits?
Eligible professionals can opt for the Medicare or Medicaid incentive,
but cannot derive benefits of both. An EP may change his/her selection
one time during the course of the incentive program
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Can elgible professionals who do not accept Medicare or Medicaid benefit
from Stimulus Act Incentives?
Eligible professionals who do not accept Medicare or who do not have at
least a 30% Medicaid population (20% for pediatricians) cannot benefit
from Stimulus Act incentives available for implementing a certified EHR/EMR.
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What about the 2% Incentive right now for using e-Rx?
Physicians who currently e-prescribe can receive (and have been receiving)
a 2% incentive. This will continue until Stimulus Act funds begin. At that
point, the 2% e-Rx incentive is cancelled
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What must we do to obtain Stimulus Act Incentives?
In order to obtain these financial incentives, eligible professionals must
"meaningfully use" their certified EHR/EMR. In other words, a provider cannot
just buy an EHR or EMR system and expect to obtain incentives. The EHR or EMR
needs to actually be used – meaningfully used.
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How long must meaningful use be proven to qualify for Stimulus Act Incentives
Reporting Period: The reporting period for the EHR Incentive program using a
certified EHR is any continuous 90 day period during the first payment year.
Please note that although the measure specifications assume a full calendar
year you should only calculate the denominator and numerator from the first
day of the 90 day reporting period to the last day of the 90 day reporting period.
