HITECH EHR Incentives
The HITECH Act (the Act) was signed into law on February 17, 2009. The Act included Medicare and Medicaid incentives for healthcare providers to adopt Electronic Health Records (EHR). Further, $17 billion was set aside for incentive payments to promote effective adoption of EHR and adopts both "carrots" and "sticks" as incentives for adoption.
Begining in 2011, eligible providers who make "meaningful use" of EHR prior to 2014 ("qualified providers") may receive extra Medicare and Medicaid payments. However, eligible professionals who do not adopt EHR by 2015 will face payment reductions. Professionals participating in the Medicare program who do not demonstrate meaningful use will incur reimbursement reductions that start as 1% and increase each year that meaningful use is not achieved. The maximum reduction goes up to 5%.
To encourage adoptions of EHR quickly, HITECH provides for declining incentive payments beginning in 2011 and ending in 2015. There are 5 (five) types of non-hospital based doctors eligible for EHR incentives under the Medicare program:
(i) doctors of medicine or osteopathy;
(ii) doctors of dental medicine or dental surgery;
(iii) doctors of podiatric medicine;
(iv) doctors of optometry; and
Incentives under the Medicaid program are available to: physicians (primarily doctors of medicine and doctors of osteopathy); nurse practitioners; certified nurse-midwives; dentists; and physician assistants who furnish services in a federally qualified health center or rural health clinic that is led by a physician assistant. These professionals are collectively called Eligible Professionals/EPs.
Medicare incentive payments for EPs who implement EHR in 2011 or 2012 can be up to $18,000.00. The incentive is reduced to $15,000.00 for physicians who implement systems in 2013 and reduced further for those who do so in 2014. Eligible Professionals who make "meaningful use" of EHR starting in 2011 stand to collect $44,000.00 over 5 years, while EPs who begin in 2013 are limited to extra payments of $27,000.00 over 3 years. The amount of incentive is based upon 75% of total Medicare reimbursement paid to an EP during a billing period and, therefore, the maximum level of payments will be available only to EPs who serve a sufficient volume of Medicare Patients.
Alternatively, EPs with high volumes of Medicaid patients (30% or higher) can receive incentive payments through the Medicare program. However, physicians may not receive incentive payments under both programs. LIke the Medicare incentives, the Medicaid incentives will be eliminated for providers who do not adopt EHR prior to 2016, but there are no penalty provisions for non-adoption.
The Act called for use of certified EHR technology in a "meaningful manner" including electronic prescriptions; to provide for electronic exchange of information to promote health quality; and to allow for submission of information on clinical quality. The Act also requires the Secretary to promote "the use of electronic health records and healthcare quality over time by requiring more stringent measures of meaningful use."
The next article will discuss how CMS has explained its objectives for the three stages of meaningful use criteria.
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