Eligible physicians (“EPs”) and eligible hospitals (“EHs”) will soon be able to receive incentive payments based on their “Meaningful Use” of electronic health records (“EHR”). The Centers for Medicare and Medicaid Services (“CMS”) recently released screen shots of the Attestation which EPs and EHs will need to complete in order to qualify for these incentive payments. The Attestation website will become active on April 18, 2011, and those who register for the Attestation at this time may begin receiving payments as early as May 2011.
Requirements for Achieving Stage 1 Meaningful Use
The Attestation walks EPs and EHs through a series of questions whereby EPs and EHs can demonstrate that they have achieved “Meaningful Use” of their EHR systems. In order to demonstrate Stage 1 “Meaningful Use,” EPs and EHs must meet all of the Core Objectives (15 for EPs, 14 for EHs), and at least half of the Menu set Objectives. A list of Core and Menu set Objectives can be found here. These objectives cover the three overarching goals of “Meaningful Use” – (1) use of certified EHR in a meaningful manner; (2) use of certified EHR technology for electronic exchange of health information; and (3) use of certified EHR technology to submit clinical quality measures and other measures determined by CMS. In the first year an EP or EH attests to “Meaningful Use,” only 90 days of EHR use is actually required for participation. However, failure to maintain “Meaningful Use” in a following year will jeopardize an EPs or EHs ability to collect all of the available incentive because the payment for any year that “Meaningful Use” is not achieved will be forfeited.
Medicare Incentive Payments
EPs attesting to “Meaningful Use” in 2011 or 2012, and who maintain “Meaningful Use” status throughout the term of the EHR Incentive Program through Medicare, will receive up to $18,000 in Year 1, up to $12,000 in Year 2, up to $8,000 in Year 3, up to $4,000 in Year 4 and up to $2,000 in Year 5, for a total maximum incentive of $44,000 per physician over this five year period. EPs who wait until 2013 will only be eligible to receive $39,000 over 4 years, and EPs who wait until 2014 will only be eligible to receive $24,000 over 3 years. Physicians will not be able to participate in the EHR Incentive Program if they fail to attest to Meaningful Use after 2014.
EHs receive incentive payments based on a formula that equates to the Initial Amount, multiplied by the Medicare Share, multiplied by the Transition Factor (which reduces each year). A more detailed explanation of the EH Incentive Formula can be found here.
Medicaid Incentive Payments
In the alternative, EPs can enroll in the EHR Incentive Program through Medicaid and receive up to $63,750 over a period of 6 years. EPs will be eligible for an amount calculated based on the “average allowable cost” for purchasing and maintaining an EHR system, which shall be determined by CMS. EHs can enroll in the EHR Incentive Program through both Medicare and Medicaid. Providers enrolling in the EHR Incentive Program through Medicaid will be required to meet all of the requirements for “Meaningful Use” and must also provide additional information regarding their patient volume.
Stages of “Meaningful Use”
The current objectives for achieving “Meaningful Use” only encompass the requirements to meet Stage 1 of “Meaningful Use.” EPs and EHs will eventually need to demonstrate achievement of both Stage 2 and Stage 3 “Meaningful Use” requirements in order to continue to participate in the EHR Incentive Program. EPs and EHs who intend to participate in the EHR Incentive Program must work with their EHR vendors to ensure that their EHR systems are capable of meeting the Core and Menu set Objectives necessary to accomplish Stage 1 “Meaningful Use.” In addition, EHR vendors must be able to represent and warrant that their EHR Systems will be able to meet the Stage 2 and Stage 3 Objectives which are scheduled to be implemented in future years. Regulations are expected within the next year to determine the Objectives which will need to be met in order to qualify for Stage 2 and Stage 3 of “Meaningful Use,” as well as the timing of when the new requirements will be implemented.
Your Houston Harbaugh attorneys are here to assist you in determining whether you are eligible to participate in the EHR Incentive Program and to help you work with your EHR vendors to maximize your incentive payments.