DrFirst Healthcare Technology Blog

Part 1: Medicare EHR Incentive Program

September 3, 2010

As we rapidly approach the beginning of the anticipated meaningful use incentives, it is becoming increasingly important to clearly define all of the details surrounded eligibility, attestation and MU requirements.  To begin, the MU incentives are based on individual providers – therefore, if you are part of a group practice, each eligible professional can individually qualify for the incentive payments if they demonstrate meaningful use.

Under the Medicare EHR Incentive Program, an eligible provider (EP) must be one of the following:

  • Doctors of Medicine or Osteopathy
  • Doctors of Dental Surgery or Dental Medicine
  • Doctors of Podiatric Medicine
  • Doctors of Optometry
  • Chiropractors

***Note: A doctor is considered ‘hospital based’ and will not qualify as an EP if they perform 90% or more of their services in a hospital inpatient or emergency room setting.

The first step towards becoming eligible is to purchase a certified technology system.  This system must allow you to meet 15 of the core and 5 of the 10 menu requirements to allow you to attest meaningful use of your system.  Once this has been completed, there are a few requirements that must be met to register to take place in the program:

  • All EPs must have a National Provider Identifier (NPI)
  • All EPs must be enrolled in the CMS Provider Enrollment, Chain and Ownership System (PECOS)
    • The PECOS system will also be used to attest MU compliance, but the exact details of this build-out are still being developed.
    • Most EPs will need to have an active user account in the National Plan and Provider Enumeration System (NPPES)

**Note: If you are an EP that does not have an NPI and/or an NPPES user account, click here to apply.

Medicare EPs that meet the necessary MU criteria will receive an incentive payment equal to 75% of their Medicare allowable charges for covered professional services – with a maximum payment of $44,000.  It is important to get started by Jan. 1, 2011 to ensure that you will receive the first round of payment checks.

EPs can participate in the Medicare EHR incentive program as soon as the Federal program launches in 2011.  To be eligible for the first round of payments around May, 2011 providers must demonstrate meaningful use for a minimum of 90 consecutive days to receive the full year’s credit.  With this stated, it is clear that no providers will be able to attest to compliance prior to April.

Those that plan to meet the Medicare ARRA incentive criteria will be allowed to receive both the meaningful use payments and the PQRI payments in the same year, but will not be allowed to receive the MU payments during the same year as the MIPPA e-prescribing payments.

Coming up next: Part 2: Medicaid EHR Incentive Program

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About the Author

Irene Froehlich

Ms. Froehlich has been with DrFirst since its inception in 2000. In her role as Director of Marketing, she oversees the planning, directing, and coordinating all marketing and public relations efforts at DrFirst. Ms. Froehlich has a B.S. in Communications from the University of Illinois, Champaign-Urbana.

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