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EHR Incentive Program

Earn incentive payments and avoid penalties by participating in the Medicare Electronic Health Records (EHR) Incentive Program.

Stay Informed

  • The Centers for Medicare and Medicaid Services (CMS) extends EHR attestation deadline for Medicare eligible professionals to March 20, 2015. 
  • CMS recently announced that they intend to make changes to the EHR Incentive Program for 2015. 
Program basics

The Medicare and Medicaid Electronic Health Records Incentive Programs provide incentive payments for demonstrating meaningful use of EHR technology.

Medicare payment schedule
Review the Medicare Payment Schedule
Medicaid Payment Schedule
Review the Medicaid Payment Schedule
Eligibility

Eligible professionals (EP) include:

  • Doctor of medicine or osteopathy
  • Dentist
  • Podiatrist
  • Optometrist
  • Chiropractor

Eligible Hospitals include:

  • "Subsection (d) hospitals" paid under the Inpatient Prospective Payment System (IPPS)
  • Critical Access Hospitals (CAHs)
  • Medicare Advantage (MA-Affiliated) Hospitals

For more information visit the CMS website.

Medicare patient volume

Consider patients from all payers to be counted in both the numerator and denominator.

The maximum incentive payment, based on 75 percent of allowed charges, comes after accumulating $24,000 in Medicare charges.

There is a minimum number of patient volume for Medicaid, but not Medicare:

  • A minimum 30 percent Medicaid patient volume
  • A minimum 20 percent Medicaid patient volume, and is a pediatrician
Earning incentive payments
  1. Make sure you are eligible.
  2. Register.
  3. Use certified EHR technology.
  4. Demonstrate meaningful use for 90 consecutive days in the first year.
  5. Attest that you have used certified EHR technology.
Attesting for meaningful use

Contact the EHR Information Center at 1-888-734-6433 (open Monday through Friday from 7:30 a.m. -6:30 p.m. CT) if you need assistance with any registration and attestation system inquiries.

Clinical quality measures

Beginning in 2014, reporting of CQMs changes for all providers regardless of whether they are participating in Stage 1 or Stage 2 of meaningful use.

  • Eligible professionals must report on 9 of 64 approved CQMs (CMS has made recommendations for core CQMs for both the adult population and the pediatric population)
  • All Medicare-eligible providers beyond their first year of meaningful use must electronically report their CQM data to CMS.

View the annual update of the 2014 electronic clinical quality measures.

Clinical decision support

Some examples of clinical decision support rules specific to neurology are:

  • Checking if patients with ischemic stroke are being treated with aspirin
  • Checking if a patient with atrial fibrillation and a stroke is receiving warfarin for anticoagulation
EHR Incentive program resources
Meaningful use stage 2

Stage 2 becomes effective in 2014. This is for those who began participating in 2011 or 2012.

Under Stage 2 you must:

  • Meet 20 total objectives: 17 core objectives and three menu objectives from a list of six
  • Report on 9 out of 64 total CQMs
  • Select CQMs from at least three of six key health care policy domains:
    • Patient and Family Engagement
    • Patient Safety
    • Care Coordination
    • Population and Public Health
    • Efficient Use of Healthcare Resources
    • Clinical Processes/Effectiveness

For more information, check the Stage 2 Toolkit.

Information on EHR Incentive Program Audits

Eligible providers, eligible hospitals, and critical access hospitals attesting in either the Medicare or Medicaid Electronic Health Record (EHR) Incentive Program may be subject to an audit.

States will be performing audits on Medicaid providers participating in the Medicaid EHR Incentive Program.

Available resources include:

Hardship Exceptions

Hardship exceptions are granted under specific circumstances as determined by CMS. The submission period for applications has been reopened. All applications for 2015 hardship exemptions must be submitted no later than 12:00 a.m. ET on November 30, 2014.

Eligible professionals can apply for hardship exceptions in the following categories:

  • Infrastructure: Must demonstrate that you are in an area without sufficient internet access or face insurmountable barriers to obtaining infrastructure (e.g. lack of broadband)
  • New Eligible Professionals: Newly practicing EPs can apply for a 2-year limited exception to payment adjustments. For example, a newly practicing neurologist who begins in CY 2015 would receive an exception to penalties in 2015 and 2016, but would need to begin demonstrating MU in CY 2016 to avoid a penalty in 2017.
  • Unforeseen Circumstances: Examples include natural disaster or other unforeseeable barrier.
  • Lack of Patient Interaction:
    • Lack of face-to-face or telemedicine interaction with patients
    • Lack of follow-up need with patients
  • Multiple Locations: Lack of control over the availability of certified EHR technology for more than 50% of patient encounters.
  • NEW! 2014 EHR Vendor Issues: The EP's EHR vendor was unable to obtain 2014 certification or the eligible professional was unable to implement MU due to 2014 EHR certification delays.

Access the CMS Payment Adjustments & Hardship Exceptions website for more information and to access the EP Hardship Exception Application.

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