8. Show Me the Incentive Money
Incentive payments totaling $44,000 are calculated as $18,000 for 2011
$12,000 for 2012
$ 8,000 for 2013
$ 4,000 for 2014
$ 2,000 for 2015
9. Can a physician be penalized for not utilizing an EHR by 2015?
Yes. Failure to adopt a “meaningful use” EMR beginning in 2015 will have doctors facing penalties in the form of reductions to their Medicare fees schedule reimbursement rates. The penalty will equal 1% in 2015, 2% in 2016, and 3% in 2017 and each subsequent year. Under the bill, the Secretary can increase the penalty to 5% if fewer than 75% of eligible physicians are not utilizing an EMR by 2018.
10. Under Medicaid who is eligible to receive incentive payments and what is the timeline for payments?
The intended Medicaid program offers up to $64,000 to providers who see more than 30% of patients paying with Medicaid, (20% for pediatricians). Beginning in 2011, the Medicaid incentive payment will be based on a calculation that includes the provider’s Medicaid mix and qualifying IT related expenses. Payments could amount up to $25,000 the initial year and $10,000 each subsequent year for a total period of five years. The eligible professional under Medicaid must first demonstrate certified EHR usage by 2015 to be eligible for payments and after 2021 will not be eligible for payments. Pediatricians, who only meet the lower threshold of 20% Medicaid patients, would be eligible for 66% or the payments described above. The current bill also provides a cap for total payments under the Medicaid Plan. Once the funds have been depleted, payments will no longer be available under the Medicaid plan.
11. So my group has 5 physicians. Will the group qualify for total incentive payments of $220,000 under the Medicare incentive program?
Yes. If each of the physicians meets the ability to demonstrate meaningful use of a certified EMR system by 2012, the group could be entitled to a total of $220,000 in incentive payments under the Medicare program (5 x $44,000=$220,000).
13. What constitutes a “Certified” EHR system?
What constitutes a “certified” EHR is to be determined. However, many believe that CCHIT will be instrumental in the certification process and that HHS will likely be basing much of their standards on the current work of CCHIT. Private certification groups should serve as an option to CCHIT.
To view a list of current CCHIT certified companies, visit www.myEMRchoice.com
14. Are NPs/RNs/MAs covered by the incentive programs?
Nurse practitioners and nurse mid-wives should be able to file for incentive payments under the Medicaid program. Physician Assistants may qualify if the PA is practicing in a rural health clinic that is led by the PA or who is practicing in a FQHC. Mid-level providers do not qualify under the Medicare portion of the incentives.
15. Is there a separate bonus payment for hospitals that utilize an EMR?
Yes. The Stimulus Bill includes a separate Medicare incentive payment for hospitals efficiently utilizing an EMR. The calculation is much more complicated. It includes a $2 million base payment plus an amount from a formula including various factors such as the discharge volume, inpatient-bed-days for different Medicare patients and total patients, and total hospital charges.
16. My practice has been utilizing an EMR system since prior to the date the Stimulus Bill was signed into law. Can the providers in my practice still qualify for the incentive payments?
Yes. Only 20%-30% of practices had implemented an EMR prior to the enactment of HITECH. Because of the relatively short time frame and the sheer number of practices that still need to implement an EMR, it may be a challenge for some of these non-early adopters to qualify for the maximum payments. If your system is certified and you can demonstrate meaningful use of the system prior to 2012 you should generally qualify for the incentive payments under the Medicare Plan
17. My existing EMR system was only $12,000. If I qualify, will my incentive payment be limited to $12,000 under the Medicare Plan?
No. Under the Medicare Plan, the requirement to receive the maximum incentive payments is a utilization standard and is not dependent upon the actual cost or purchase method of the EMR system. If you meet all qualifications for the incentive payment, you should receive the maximum payment regardless of the actual cost or purchase method of your EMR system.
18. My practice does not currently utilize an EMR. When is the right time to start planning for an EHR implementation?
Now. Why leave money on the table? And if you are retiring or selling, buy the cheaqpest EMR you can, earn the stimulus funds and ad 20% to your selling price for a medical practice that has a fully implemented, productive and trained EMR staff!
19. Is there any benefit for early adoption of the certified EMR system?
Yes. Early adopters would stand to gain, as about 70 percent of the Medicare payments would be received in the first two years.
20. Is there any additional benefit for PQRI and electronic prescribing?
Those engaged in Physician Quality Reporting Initiative (PQRI) and electronic prescribing can earn an additional $ 6000 – $ 8000 per year, beginning now.
21. How will the EHR Stimulus payments actually be distributed to the physicians?
The timing and distribution process for the incentive payments is to be determined and finalized by the Secretary of the Health and Human Services and the federal rule making process.
22. Will the public know whether or not I practice with a qualified meaningful EHR?
Real possible. CMS will post the names, addresses, and phone numbers of eligible professionals who are meaningful EHR users and group practices receiving incentive payments.