Health Information Technology (HIT) & E-Rx Incentive Programs
The Medicare and Medicaid EHR Incentive Programs provide financial incentives for the “meaningful use” of certified EHR technology to improve patient care. To receive an EHR incentive payment, providers have to show that they are “meaningfully using” their EHRs by meeting thresholds for a number of objectives. CMS has established the objectives for “meaningful use” that eligible professionals (including those working in post-acute and long-term care facilities), eligible hospitals, and critical access hospitals (CAHs) must meet in order to receive an incentive payment.
The Medicare and Medicaid EHR Incentive Programs are staged in three steps with increasing requirements for participation. All providers begin participating by meeting the Stage 1 requirements for a 90-day period in their first year of meaningful use and a full year in their second year of meaningful use. After meeting the Stage 1 requirements, providers will then have to meet Stage 2 requirements for two full years. Eligible professionals participate in the program on the calendar years, while eligible hospitals and CAHs participate according to the federal fiscal year.
Incentive Payments
The Medicare and Medicaid EHR Incentive Programs provide incentive payments to eligible professionals, eligible hospitals and critical access hospitals (CAHs) as they adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology. Eligible professionals can receive up to $44,000 through the Medicare EHR Incentive Program and up to $63,750 through the Medicaid EHR Incentive Program.
2017 Milestones
| Important 2016 EHR participation dates to keep in mind: | |
| 2017 EHR Incentive Programs Reporting Period | January 1- December 31, 2017 |
| 2017 EP Payment Adjustment Reconsideration Application Deadline | February 28, 2017 |
| CY 2016 EHR Incentive Program Attestation and eCQM Submission Deadline | March 13, 2017 |
| Deadline for Appeal Filing for eCQM Reporting/Eligibility/Failed Reporting Meaningful Use | March 28, 2017 |
| EHR Incentive Program Hardship Exception for Payment Adjustment Year 2018 | July 1, 2017 |
| CY 2017 EHR Incentive Programs Attestation Deadline for First-Time Participants | October 1, 2017 |
For more specific information, including schedule of amount of incentive payments, please see:
Payment Adjustments
In the American Recovery and Reinvestment Act of 2009 (ARRA), Congress mandated that payment adjustments should be applied to Medicare eligible professionals and eligible hospitals who are not meaningful users of Certified Electronic Health Record (EHR) Technology under the Medicare EHR Incentive Program.
If a provider is eligible to participate in the Medicare EHR Incentive Program, they must demonstrate meaningful use to avoid a payment adjustment in either the Medicare EHR Incentive Program or in the Medicaid EHR Incentive Program, depending on their eligibility. Medicaid providers who are only eligible to participate in the Medicaid EHR Incentive Program are not subject to these payment adjustments.
Hardship Exceptions
Eligible professionals and eligible hospitals may be exempt from payment adjustments if they can show that demonstrating meaningful use would result in a significant hardship. To be considered for an exception, an eligible professional (this includes clinicians who practice in nursing facilities) or eligible hospital must complete a Hardship Exception application along with proof of the hardship. If approved, the hardship exception is valid for 1 payment year only. A new application must be submitted if the hardship continues for the following payment year. In no case may a provider be granted an exception for more than 5 years.
In early 2016, CMS announced new streamlined hardship applications reduce the amount of information that eligible professionals (EPs), eligible hospitals, and CAHs must submit to apply for an exception. The new applications and instructions for a hardship exception from the Medicare Electronic Health Records Incentive Program 2017 payment adjustment are available below.
This new, streamlined application process is the result of PAMPA, which established that the Secretary may consider hardship exceptions for “categories” of EPs, eligible hospitals, and CAHs that were identified on CMS’ website as of December 15, 2015. Prior to this law, CMS was required to review all applications on a “case-by-case” basis.
Important Notice – eligible professionals must submit the CMS Hardship Exemption Application by July 1, 2017 to avoid payment adjustment in 2018.
Clinicians practicing in post-acute and long-term care settings that do not have the necessary technology to participate in CMS’ EHR Incentive Program can fill out Section 2.3 Lack of control over the availability of Certified EHR Technology to be eligible for the exemption.
For more information visit the CMS Payment Adjustments & Hardship Information website.
EHR Incentive Programs Tipsheet for Eligible Professionals Practicing in Multiple Locations
Are you an eligible professional practicing in multiple locations? Review the new Multiple Locations Tip Sheet for information on how to successfully demonstrate meaningful use in the Medicare and Medicaid EHR Incentive Programs.
The tip sheet includes guidance on determining if a location is equipped with certified EHR technology, calculating patient encounters, and what to do when different menu objectives and clinical quality measures (CQMs) are chosen across locations.
Guidance for Multiple Locations
Here are some key points to keep in mind if you are practicing in multiple locations:
- To demonstrate meaningful use, 50 percent of patient encounters must take place at locations with certified EHR technology during the reporting period.
- A location is equipped with certified EHR technology if you have access to the certified EHR at the beginning of the EHR reporting period.
- You can add numerators and denominators from each certified EHR system for an accurate total.
- You should report on menu objectives and CQMs from the location with the most patient encounters if different locations chose different measures.
For More Information:<
Visit the CMS EHR Incentive Programs website for more resources to help you successfully participate.