Stimulus FAQs
For the 2011 payment year, how and when will incentive payments for the Medicare Electronic Health Record (EHR) Incentive Programs be made?
Bonus payments for EPs who practice predominantly in a geographic Health Professional Shortage Area (HPSA) will be made as separate lump-sum payments no later than 120 days after the end of the calendar year for which the EP was eligible for the bonus payment.
Please note that the 90-day reporting period an EP selects does not affect the amount of the EHR incentive payments. The Medicare EHR incentive payments to EPs are based on 75% of the estimated allowed charges for covered professional services furnished by the EP during the entire payment year. If the EP has not met the $24,000 threshold in allowed charges at the time of attestation, CMS will hold the incentive payment until the EP meets the threshold as described above. Medicare EHR incentive payments to eligible hospitals and critical access hospitals (CAHs) will also be made approximately four to eight weeks after the eligible hospital or CAH successfully attests to having demonstrated meaningful use of certified EHR technology. Eligible hospitals and CAHs will receive an initial payment and a final payment. Eligible hospitals and CAHs that attest in April can receive their initial payment as early as May 2011. Final payment will be determined at the time of settling the hospital cost report. Please note that the Medicaid incentives will be paid by the States, but the timing will vary according to State. Please contact your State Medicaid Agency for more details about payment. For more information about the Medicare and Medicaid EHR Incentive Program, please visit http://www.cms.gov/EHRIncentivePrograms. |
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What if you're an eligible professional (EP) who has successfully attested for the Medicare Electronic Health Record (EHR) Incentive Program, but haven't received an incentive payment yet?
For EPs, incentive payments for the Medicare EHR Incentive Program will be made approximately four to eight weeks after an EP successfully attests that they have demonstrated meaningful use of certified EHR technology. However, EPs will not receive incentive payments within that time frame if they have not yet met the threshold for allowed charges for covered professional services furnished by the EP during the year.
The Medicare EHR incentive payments to EPs are based on 75% of the estimated allowed charges for covered professional services furnished by the EP during the entire payment year. Therefore, to receive the maximum incentive payment of $18,000 for the first year of participation in 2011 or 2012, the EP must accumulate $24,000 in allowed charges. If the EP has not met the $24,000 threshold in allowed charges at the time of attestation, CMS will hold the incentive payment until l the EP meets the $24,000 threshold in order to maximize the amount of the EHR incentive payment the EP receives. If the EP still has not met the $24,000 threshold in allowed charges by the end of calendar year, CMS expects to issue an incentive payment for the EP in March 2012 (allowing 60 days after the end of the 2011 calendar year for all pending claims to be processed).
Payments to Medicare EPs will be made to the taxpayer identification number (TIN) selected at the time of registration, through the same channels their claims payments are made. The form of payment (electronic funds transfer or check) will be the same as claims payments.
Bonus payments for EPs who practice predominantly in a geographic Health Professional Shortage Area (HPSA) will be made as separate lump-sum payments no later than 120 days after the end of the calendar year for which the EP was eligible for the bonus payment.
For more information about the Medicare and Medicaid EHR Incentive Program, please visithttp://www.cms.gov/EHRIncentivePrograms.
The Medicare EHR incentive payments to EPs are based on 75% of the estimated allowed charges for covered professional services furnished by the EP during the entire payment year. Therefore, to receive the maximum incentive payment of $18,000 for the first year of participation in 2011 or 2012, the EP must accumulate $24,000 in allowed charges. If the EP has not met the $24,000 threshold in allowed charges at the time of attestation, CMS will hold the incentive payment until l the EP meets the $24,000 threshold in order to maximize the amount of the EHR incentive payment the EP receives. If the EP still has not met the $24,000 threshold in allowed charges by the end of calendar year, CMS expects to issue an incentive payment for the EP in March 2012 (allowing 60 days after the end of the 2011 calendar year for all pending claims to be processed).
Payments to Medicare EPs will be made to the taxpayer identification number (TIN) selected at the time of registration, through the same channels their claims payments are made. The form of payment (electronic funds transfer or check) will be the same as claims payments.
Bonus payments for EPs who practice predominantly in a geographic Health Professional Shortage Area (HPSA) will be made as separate lump-sum payments no later than 120 days after the end of the calendar year for which the EP was eligible for the bonus payment.
For more information about the Medicare and Medicaid EHR Incentive Program, please visithttp://www.cms.gov/EHRIncentivePrograms.
What if the electronic health record (EHR) system costs much more than the incentive the government will pay? Can you request additional funds?
The Medicare and Medicaid EHR Incentive Programs provide incentives for the meaningful use of certified EHR technology. Under the Medicaid program, there is also an incentive for the adoption, implementation, or upgrade of certified EHR technology in the first year of participation. The incentives are not a reimbursement of costs, and maximum payments have been set.
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When will the Centers for Medicare & Medicaid Services (CMS) begin to pay Medicare and Medicaid electronic health record (EHR) incentives to eligible professionals (EPs) and hospitals the demonstration of meaningful use of certified EHR technology?
CMS expects that Medicare incentives will begin to be paid in May 2011. Medicaid incentives will be paid by the States and will also begin in 2011 but the timing will vary by State. Under the Medicaid EHR Incentive Program, incentives can also be paid for the adoption, implementation, or upgrade of certified EHR technology.
Some have already received or are in the process of receiving their first Medicare ARRA incentive payment check (click here to see the list). If your name is not on this list you need to request a demo of SuiteMed IMS today. We can help you obtain these funds, but time is running out to claim your share for 2011.
Some have already received or are in the process of receiving their first Medicare ARRA incentive payment check (click here to see the list). If your name is not on this list you need to request a demo of SuiteMed IMS today. We can help you obtain these funds, but time is running out to claim your share for 2011.
Why “meaningful use” requirements?
EHRs do not achieve these benefits merely by transferring information from paper form into digital form. EHRs can only deliver their benefits when the information and the EHR are standardized and “structured” in uniform ways, just as ATMs depend on uniformly structured data. Therefore, the “meaningful use” approach requires identification of standards for EHR systems. These are contained in the ONC Standards and Certification regulation announced on July 13, 2010.
EHRs cannot achieve their full potential if providers don’t use the functions that deliver the most benefit – for example, exchanging information, and entering orders through the computer so that the “decision support” functions and other automated processes are activated. Therefore, the “meaningful use” approach requires that providers meet specified objectives in the use of EHRs, in order to qualify for the incentive payments.
EHRs cannot achieve their full potential if providers don’t use the functions that deliver the most benefit – for example, exchanging information, and entering orders through the computer so that the “decision support” functions and other automated processes are activated. Therefore, the “meaningful use” approach requires that providers meet specified objectives in the use of EHRs, in order to qualify for the incentive payments.
How will the CMS EHR incentive program registration process work?
Hospitals and eligible professionals can register for the program starting in January 2011. Once the programs begin, a link on the Registration web page of CMS will be available. Providers can use this central website to get information about the program and link to the programs’ online registration system.
How will providers demonstrate that they have achieved the “meaningful use” objectives required by the regulation?
For 2011, CMS will accept provider attestations for demonstration of all the meaningful use measures, including clinical quality measures. Starting in 2012, CMS will continue attestation for most of the meaningful use objectives but plans to initiate the electronic submission of the clinical quality measures. States will also support attestation initially and then subsequent electronic submission of clinical quality measures for Medicaid providers’ demonstration of meaningful use.
When will the Centers for Medicare & Medicaid Services (CMS) begin to pay Medicare and Medicaid electronic health record (EHR)?
CMS expects that Medicare incentive will begin to be paid in May 2011. Medicaid incentives will be paid by the States and will also begin in 2011 but the timing will vary by State. Under the Medicaid EHR Incentive Program, incentives can also be paid for the adoption, implementation, or upgrade of certified EHR technology.
Can multiple software applications be used to achieve Meaningful Use?
Meaningful Use can be achieved using any combination of systems. However, every application and module used to achieve meaningful use must be certified (or the combination of systems in use at the site must achieve site certification).
The Meaningful Use Rule identifies 15 Core Set required criteria and 10 Menu Set optional criteria (from which eligible professionals and hospitals must choose 5). Can any 5 be chosen?
Any 5 can be selected. The Meaningful Use final rule notes “all EPs and hospitals must choose at least one of the population and public health measures to demonstrate as part of the menu set. This is the only limitation placed on which five objectives can be deferred from the menu set."
Can a paper copy of the visit summary or discharge summary to the patient be provided?
EHRs and Hospital Information Systems must have the capability of producing a human readable summary AND a computable summary that adheres to the Standards Final Rule (CCR or CCD). The Standards Rule requires a CCR/CCD at a minimum plus optional human readable PDF, Text, DOC etc.
The EP could choose any of the listed means from the proposed rule of PHR, patient portal (web site delivery), secure email, electronic media such as CD or USB or printed copy. If the EP chooses an electronic media, they would be required to provide the patient a paper copy upon request. Both forms electronic and paper can be produced by SuiteMed IMS EHR technology.
The EP could choose any of the listed means from the proposed rule of PHR, patient portal (web site delivery), secure email, electronic media such as CD or USB or printed copy. If the EP chooses an electronic media, they would be required to provide the patient a paper copy upon request. Both forms electronic and paper can be produced by SuiteMed IMS EHR technology.
Do Rural Health Clinics qualify for Medicare incentives?
According to the CMS website, "An eligible hospital for Medicare incentive payments is a 'subsection (d) hospital' that is paid under the hospital inpatient prospective payment system."
According to an Issue Brief released by the American Hospital Association "The payment incentives in the American Recovery and Reinvestment Act of 2009 (ARRA) are available to each hospital that is a meaningful user of a certified electronic health record (EHR); ARRA defines a hospital as a Medicare subsection (d) hospital, which is a general, acute care, short-term hospital."
According to an Issue Brief released by the American Hospital Association "The payment incentives in the American Recovery and Reinvestment Act of 2009 (ARRA) are available to each hospital that is a meaningful user of a certified electronic health record (EHR); ARRA defines a hospital as a Medicare subsection (d) hospital, which is a general, acute care, short-term hospital."
For a large medical practice with many physicians, is the ARRA reimbursement allowed per physician, or just for the medical group?
The reimbursement is permitted per "eligible professional," as long as the eligible professional demonstrates "meaningful use of an EHR" and participates in Medicare. An eligible professional means physician, as defined in section 1861(r) of the Social Security Act -- this says "The term 'physician', when used in connection with the performance of any function or action, means (1) a doctor of medicine or osteopathy legally authorized to practice medicine and surgery by the State in which he or she performs such function or action". One important exception is if the physician is employed by a hospital; in that case, the hospital, not the physician, is eligible for the reimbursement.
Are radiologists eligible for stimulus funds?
According to the CMS incentive fact sheets, a Medicare Eligible Professional (EP) "is a doctor of medicine or osteopathy, a doctor of dental surgery or dental medicine, a doctor of podiatric medicine, a doctor of optometry, or a chiropractor, who is legally authorized to practice under state law." Based on this definition, radiologists, whom are MDs, qualify for incentives.
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