Show Media Item - Who Qualifies for the HITECH Act Rebate?
Monday, November 01, 2010
Who qualifies for the Meaningful Use government incentives? The following information was taken from CMS' final rule on the Medicare and Medicaid Electronic Health Record Incentive Programs, as set forth by the 'American Recovery and Reinvestment Act of 2009.'
Reimbursement Eligibility:
There are three requirements that must be met to qualify for incentivepayments. First, you must be an Eligible Professional. Second, you must adopt EHR software that is certified to the 2011 standards set forth by the ONC. And finally, you must demonstrate Meaningful Use. This document addresses each of these three requirements in further detail.
Medicare Eligibility:
Eligible professionals (EPs) for Medicare incentive payments are doctors of medicine or osteopathy, dentists or dental surgeons, podiatrists, optometrists, or chiropractors.
Hospital-based physicians who furnish at least 90% of their professional services in a hospital setting (inpatient or emergency room) in the year preceding hte payment year are not eligible.
Hospital- based EPs practicing predominantly in a Federal Qualified Health Center, Rural Health Clinic, or those who provide services in outpatient setting are eligible for incentives.
Medicaid Eligibility:
Eligible professionals (EPs) for Medicaid incentive payments are physicians, pediatricians, dentists, nurse practitioners, certified nurse midwives, and physician assistants practicing ina Federally Qualified Health Center or Rural Health Clinic that is led by a physician assistant.
Note: Pediatricians have distinct eligibility and payment rules. If you are a Pediatrician, contact your EHR partner or visit the CMS.gov website for more information.
Hospital-based physicians who furnish at least 90% of their professional services in a hospital setting (inpatient or emergency room) in the year preceding hte payment year are not eligible.
Hospital- based EPs practicing predominantly in a Federal Qualified Health Center, Rural Health Clinic, or those who provide services in outpatient setting are eligible for incentives.
Note: Patient volume criteria for clinics and group practices effect eligibility and, consequently, incentive payments. Contact your EHR partner or visit the CMS.gov website for more information.
EHR Certification 2011:
Use of an Office of the National Coordinator- Authorized Testing and Certification Body (ONC-ATCB) certified EHR technology is required in order to qualify for incentive payments. To view a list of ONC-ATCB Certified EHR Technology, visit http://www.cchit.org/products/onc-atcb.
Demonstrating Meaningful Use:
Reporting must be done for 'core set' objectives, 'menu set' objectives, and clinical quality measures in order to fully demonstrate meaningful use. Detailed charts of each of the measures discussed below can be found on page 2-5 at the following link: http://alnmm.com/_library/2010/9/final_rules_90710.pdf
As of Stage One final rules, EPs must report on 15 'core set' objectives which represent tasks that are essential to creating any medical record; such as vital signs, demographics, and active medications.The core set is also intended to demonstrate the potential of an EHR, such as prescription verification that can increase efficiency and avoid preventable errors.
As of Stage One, EPs must report on 5 out of 10 'menu set' objectives. These objectives begin to introduce an interactive EHR, between patients, other providers, insurance providers, etc; however, all 10 of the menu objectives are predicted to be required objectives in Stage Two.
CMS defines Clinical Quality Measures as “measures of processes, experience, and/or outcomes of patient care, observations or treatment that relate to one or more of the Institute of Medicine domains of health care quality (e.g., effective, safe, efficient, patient-centered, equitable and timely).” EPs must report on three core/alternate core measures and three alternate measures.
Medicare Payment Periods: Payments will begin in 2011 and continue throughout 2016. Payments are based on meaningful use reporting, which is on an annual schedule beginning with 90 days of reporting in 2011 and entire calendar year reporting in all subsequent years. Incentives are calculated at 75% of allowable charges up to a maximum $44,000 over 5 years.
Medicaid Payment Periods:
Payments will begin in 2011 and continue throughout 2016.Medicaid EPs have no reporting period in the first payment year and a 90 day reporting period in their second year. EPs must also report for 12 months in their second year of demonstrating meaningful use. Incentives are calculated at 85% of allowable charges up to a maximum $63,750 over 6 years.
How to choose between Medicare and Medicaid incentives:
If your practice happens to qualify for both Medicare incentives and Medicaid incentives, you have a decision to make. EPs are only able to participate in one program, however, if you qualify for both incentives you will have the option to switch programs after receiving your first incentive payment prior to 2015.
Disclaimer:The content of this page is for general information purposes only and does not constitute advice.ALN tries to provide content that is true and accurate as of the date of writing. TheHITECH Act is in the early stages and information is being updated and clarified daily.
Show Media Item - Who Qualifies for the HITECH Act Rebate?
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