EMR / EHR Adoption Incentives (Stimulus)

Here's How it Works:

There are two ways you can qualify for the incentive. Qualified providers can qualify under either incentive, but not both. You can qualify either under Medicare or Medicaid. Physicians qualifying under the Medicare portion can receive up to $44,000 and those qualifying under the Medicaid incentive can qualify for up to $64,000. You can receive your incentive payments starting in January of 2011. Physicians who do not implement EHR technology by 2015 will suffer from a 1% reduction in Medicare Payments (reductions will continue to increase after 2015 up to 5%).

Medicare EMR / EHR Incentive:

Physicians qualifying under the Medicare provision are eligible for up to $44,000. The total amount that you receive is based on how early you adopt and your Medicare Part B billings. (You must submit Medicare Part B claims to qualify.) You will receive the lesser amount of either 75% of your Medicare Part B charges or $44,000 over a five year period from 2011 to 2015. You can also qualify for an early adopter incentive of $3,000 (if you qualify for either 2011 or 2012.) Remember, to receive your maximum payment, you must start now.

Who is eligible?

Physicians, Dentists, Podiatrists, Optometrists, and Chiropractors.

Meaningful use year:

Elegibility begins 01/01/2011. What does this mean to you? Implementation of a small practice should ideally start no later than September of 2010 to ensure 'Meaningful Use' can be demonstrated by 2011 - as it takes time to train, install, and begin to demonstrate and report on 'Meaningful Use'. Please visit our 'Meaningful Use' page to learn more about Meaninugful Use and what it means to your practice.

What Happens to Medicare Fee Schedules for Non-Adopters?

Providers who do not demonstrate 'Meaningful Use' of a certified EHR system by 2014 will see a decrease of 1% in their Medicare fee schedules for 2015. Medicare fee payment reductions will continue annually, up to a maximum of 5% if it is determined that total EHR adoption is under 75% of eligible providers by 2018.

The earliest adopters that begin the transition to an EHR immediately and demonstrate 'meaningful' use of the EHR will realize the highest possible financial incentive through the stimulus. Physician practices that elect not to utilize an EHR system by 2015 may see Medicare/Medicaid reimbursement penalties starting at 1% in increasing up to 5%.

Medicaid EMR / EHR Incentive

Providers qualifying under Medicaid are eligible for up to $63,750 over six years. Your payment is calculated as 85% of the EHR cost (up to $25,000 for the first year), and 85% of annual cost (up to $10,000) over the following five years. To qualify for the Medicaid provision, at least 30% of your cases must be attributable to Medicaid. For pediatricians, the minimum percentage of Medicaid patients is reduced to 20%. However, office-based pediatricians are only eligible to receive up to two thirds of the maximum payment.

Who is eligible?

Physicians, dentists, certified nurse mid-wives, nurse practitioners, and physician assistants practicing in a rural health clinic or Federally Qualified Health Clinic (FQHC)can take advantage. Eligible professionals cannot be hospital based, and patient volume must be comprised of at least 30% Medicaid patients. Pediatricians (again, non-hospital based) are eligible for Medicaid incentives with 20% Medicaid patient volume.

Meaningful use year:

Elegibility begins 01/01/2011. What does this mean to you? Implementation of an EHR for Medicaid providers should begin immediately to ensure to be eligible for the earliest payments - as it takes time to train, install, and begin to demonstrate and report on 'Meaningful Use'. Please visit our 'Meaningful Use' page to learn more about Meaninugful Use and what it means to your practice.