Reporting EHR Meaningful Use for Medicare Bonus Begins Monday

April 15, 2011

April 15, 2011 — Physicians hoping to qualify for an $18,000 incentive payment from Medicare this year for using an electronic health record (EHR) system in a "meaningful" way can begin to tell the government that they have met the requirements starting Monday, April 18.

The Centers for Medicare and Medicaid Services (CMS) will cut the first Medicare incentive checks this May.

The money is courtesy of the economic stimulus legislation of 2009 called the American Recovery and Reinvestment Act (ARRA). It authorizes up to $44,000 under Medicare over 5 years, and almost $64,000 under Medicaid over 6 years, to physicians who demonstrate "meaningful use" of an EHR system. "Meaningful use" is CMS shorthand for improving and streamlining patient care with digital technology. Physicians can choose to receive incentive payments under Medicare or Medicaid, but not both.

The report that physicians can file as of Monday is called an "attestation." Submitted online at the CMS Web site, the attestation documents that physicians have satisfied a long list of meaningful use requirements, such as electronically transmitting prescriptions to pharmacies and giving patients electronic access to their records, during a 90-day period. Physicians who have not previously registered to participate in either the Medicare or Medicaid incentive programs can do so at the same Web site.

Physicians Still Using Paper Charts in 2015 Will Get Docked

Under Medicare, physicians who satisfy meaningful use requirements for the first time in either 2011 or 2012 will receive $18,000 that year. Annual payments decrease over the next 4 years, adding up to $44,000. To receive the maximum amount, physicians must continue to attest each year to CMS that they are meaningful EHR users. After the first year, the reporting period changes from a span of 90 days to the entire calendar year.

Physicians who begin participating in either 2013 or 2014 will receive less money from Medicare over the term of the program. All incentive payments cease after 2016.

Failure to demonstrate meaningful use of an EHR system starting in 2015 will have financial consequences: a 1% reduction in Medicare reimbursement. This cut deepens to 2% in 2016, and 3% in 2017 and beyond.

The EHR incentive program under Medicaid, administered by state Medicaid programs, pays out $63,750 over 6 years to qualifying physicians, with the first-year payment being $21,250. Physicians can enter the program as late as 2016 and still qualify for the entire $63,750. These payments cease after 2021. State Medicaid programs will not penalize physicians who fail to become meaningful users of EHRs.

Individual state Medicaid programs have different schedules for launching their EHR incentive program. CMS expects the vast majority to roll out before year's end. In some states, physicians have already begun to receive their initial payment. Each state has its own system for registration and attestation. For more information on state Medicaid programs, including their timetables, visit the CMS Web site.

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