CMS Incentive Programs and Meaningful Use of EHR Technology...
There are rules as to who qualifies for the CMS incentive payments, when the payments will be made, and
under what circumstances. Generally, qualifying ambulatory medical practices that adopt an EHR system and
subsequently meet the "Meaningful Use" MU criteria can elect to receive
reimbursement through (a) the Medicare program or (b) the Medicaid program (you may only choose one - although
there is a one time opportunity to switch programs).
Medicare Guidelines:
- Eligible physicians are those who practice in an ambulatory setting. Hospital-based physicians are
not eligible
- The EHR MU incentive program is in addition to the existing CMS ePrescribing and PQRI incentive
programs
- Physicians who already have an installed EHR system will also receive incentives if they meet
the MU requirements
- To receive the maximum reimbursement bonus of $44,000 per provider, the provider must be a
“meaningful” user of certified EHR technology in 2011 or 2012
- The Medicare incentive amount is calculated as 75% of the allowable Part B charges for the payment
year with an annual cap as shown in the table below
- Failure to adopt an EHR and/or achieve MU by 2015 will result in:
- (1) No incentives will be paid, and
- (2) Penalties will be applied as follows:
- 2015=1% of qualifying reimbursements
- 2016=2%...
- 2017=3%...
- 2018=HHS may decide to increase penalties to a maximum of 5%...
Medicare Incentive Payment Schedule
|
"Pay for Performance" Year |
| Starting Year |
2011 |
2012 |
2013 |
2014 |
2015 |
2016 |
Total |
| 2011 |
$18K |
$12K |
$8K |
$4K |
$2K |
$0 |
$44K |
| 2012 |
|
$18K |
$12K |
$8K |
$4K |
$2K |
$44K |
| 2013 |
|
|
$15K |
$12K |
$8K |
$4K |
$39K |
| 2014 |
|
|
|
$12K |
$8K |
$4K |
$24K |
| 2015 |
|
|
|
|
$0 |
$0 |
- 1% |
| 2016 |
|
|
|
|
|
$0 |
- 2% |
| 2017 |
|
|
|
|
|
|
- 3% |
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