Each EP can receive up to $63,750 in Medicaid incentives over a six-year period with a maximum payment of $21,250 for the first payment year and $8,500 for each of the payment years two through six. The Medicaid EHR Incentive Payment Program runs from 2011 through 2021, but eligible professionals and hospitals must receive their first incentive payment by 2016 in order to qualify for the program.

Medicaid Incentive Payment Schedule for Eligible Professionals

Calendar
Year


2011


2012


2013


2014


2015


2016

2011

$21,250

2012

$8,500

$21,250

2013

$8,500

$8,500

$21,250

2014

$8,500

$8,500

$8,500

$21,250

2015

$8,500

$8,500

$8,500

$8,500

$21,250

2016

$8,500

$8,500

$8,500

$8,500

$8,500

$21,250

2017

$8,500

$8,500

$8,500

$8,500

$8,500

2018

$8,500

$8,500

$8,500

$8,500

2019

$8,500

$8,500

$8,500

2020

$8,500

$8,500

2021

$8,500

Total

$63,750

$63,750

$63,750

$63,750

$63,750

$63,750

Note:

  1. Pediatricians with a minimum 20% patient volume may qualify for up to a maximum of $14,167 in the first incentive payment year and to up a maximum of $5,667 in each of the five subsequent incentive payment years for no more than a total of $42,500 over the maximum six-year period.
  2. If a pediatrician meets or exceeds the 30% patient volume threshold, he or she is eligible for the full incentive payment amounts.

The aggregate EHR incentive calculation for Medicaid-eligible hospitals is represented mathematically as follows, to be paid over three-to-six years.

{(Overall EHR Amount) X (Medicaid Share)}

For more information about Medicaid EHR Incentive Payment schedules, please go to:

http://www.cms.gov/EHRIncentivePrograms/35_Basics.asp#BOOKMARK4.

What must an eligible provider do to qualify for a Medicaid EHR Incentive Payment?

In order to receive a Medicaid EHR incentive payment, EPs and eligible hospitals must adopt, implement, upgrade, or demonstrate meaningful use of a certified EHR system during their first payment year. The list of certified EHRs can be found on the Health and Human Services' Office of the National Coordinator (ONC) Web site at:

http://onc-chpl.force.com/ehrcert.

Definitions of "adopt," "implement," and "upgrade":

  • Adopt -acquire, purchase, or secure access to a certified EHR system
  • Implement -commence utilization (for example, staff training, data entry of patient demographic information into EHR)
  • Upgrade -expand the available functionality of certified EHR technology capable of meeting meaningful-use requirements at the practice site or upgraded from existing EHR technology to certified EHR technology per the ONC EHR certification criteria

Beyond the first payment year, EPs and eligible hospitals must successfully demonstrate "meaningful use" of their certified EHRs in order to qualify for the Medicaid incentive payments.

Eligible Professionals (EP) Stage 1 Meaningful Use Criteria: There are a total of 25 meaningful-use objectives. To qualify for an incentive payment, the EP must meet 20 out of 25 of these objectives.

  • 15 Required Core Objectives -Examples include computerized provider order entry (CPOE) for medication orders, implementing of drug/drug and drug/allergy interaction checks, maintaining up-to-date problem lists of current and active diagnoses, generating and transmitting permissible prescriptions electronically (eRX), reporting six total Clinical Quality Measures, etc.
  • The remaining five objectives may be chosen from the list of 10 menu set objectives -Examples include implementing drug-formulary checks, incorporating clinical lab test results as structured data, generating lists of patients by specific conditions, etc.

Eligible Hospitals Stage 1 Meaningful Use Criteria: There are a total of 24 meaningful-use objectives. To qualify for an incentive payment, the eligible hospital must meet 19 of these 24 objectives.

  • 14 Required Core Objectives include the use of CPOE for medication orders, implementing drug/drug and drug/allergy interaction checks, maintaining up-to-date problem lists of current and active diagnoses, meeting all 15 of the clinical quality measures, etc.
  • The remaining five objectives may be chosen from the list of 10 menu set objectives : Examples include implementing drug-formulary checks, incorporating clinical lab test results as structured data, generating lists of patients by specific conditions for quality improvement, etc.

For more information about meaningful use, please go to the CMS Web site at Meaningful Use EHR Incentive Programs.


This information is provided by MassHealth .