Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

Policy & Regulation News

EHR Incentive Program Deadline Rapidly Approaching

By Ryan Mcaskill

The deadline for providers to receive payments from the Medicare and Medicaid EHR Incentive Program is February 28.

- The healthcare industry is just about one month away from the February 28 Eligible Professional attestation Medicare EHR Incentive Program deadline. This is a yearly incentive where physicians, hospitals and critical access hospitals to show that they have adopted, implemented or upgraded their systems and can demonstrate the meaning use and certified EHR technology. Currently, the industry is in the middle of the 90-day reporting period where they must “attest” that they used a certified EHR and meet Stage 1 criteria for meaningful use objects and clinical quality measures.

There are two different EHR Incentive Programs, one for Medicare that the Centers of Medicare and Medicaid Services is in-charge of and one for Medicaid which is run by individual state agencies. The two programs are similar but do have a few key differences.

The Medicare program has a maximum incentive of $44,000 that can be paid out over five consecutive years. Payment adjustments started at the beginning of 2015 for eligible parties that did not participate. Providers are also required to demonstrate meaningful use every year to receive the incentive payments. Eligible providers have until 11:59 P.M. Eastern Standard Time on February 28 to attest any time to 2014 data.

The Medicaid program has a maximum incentive of $63,750 that can be paid out over six years which do not have to be consecutive. Eligible providers that choose not to participate are not subject to payment adjustments. Furthermore, in the first year, providers can receive an incentive payment for adopting, implementing or upgrading EHR technology. Regardless, providers must demonstrate meaningful use in the remaining years to receive incentive payments.

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  • There are some caveats to the payment adjustments for Medicare eligible professionals. The 2015 adjustment started on January 1 for any provider that did not successfully demonstrate meaningful use in 2013 (for long-time participants of the program), 2014 (for first timers) or have not received a 2015 hardship exception.

    For providers that are not able to demonstrate meaningful use by the deadline or do not receive the 2016 hardship exception (the application process is already live) will have the payment adjustment applied January 1, 2016. Providers that are eligible for both Medicare and Medicaid incentives, only need to prove meaningful use under one program to avoid the payment adjustment.

    It is possible that any incentive payment through these programs could be reduced through a sequestration, as required by the Budget Control Act of 2011. Under these reductions, eligible professionals and hospitals will be reduced by 2 percent.

    There is a large list of eligible professionals on the CMS website, and in some instances, a provider can be eligible for both Medicare and Medicaid EHR incentive programs.

     

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