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Meaningful Use FAQ
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The Recovery Act specifies three main components of meaningful use:
-The use of a certified EHR in a meaningful manner (e.g.: e-Prescribing);
-The use of certified EHR technology for electronic exchange of health information to improve quality of health care;
-The use of certified EHR technology to submit clinical quality and other measures.
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What is the purpose of certified electronic health record (EHR) technology?
Certification of EHR technology will provide assurance to purchasers and other users that an EHR system or product offers the necessary technological capability, functionality, and security to help them satisfy the meaningful use objectives for the Medicare and Medicaid EHR Incentive Programs.
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Under the Medicare EHR Incentive Program, EPs who demonstrate meaningful use of certified EHR technology can receive up to a total of $44,000 over 5 consecutive years. Additional incentives are available for Medicare EPs who practice in a Health Provider Shortage Area (HPSA) and meet the maximum allowed charge threshold. Under the Medicaid EHR Incentive Program, EPs can receive up to a total $63,750 over the 6 years that they choose to participate in program. EPs may switch once between programs after a payment has been made and only before 2015.
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When do the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs start?
Participation in the Medicare EHR Incentive Program can begin as early as 2011; The incentive program ends in 2016. Registration for the Medicare EHR Incentive Program is expected to begin in January 2011, with attestation beginning in April 2011.The earliest incentive payments to eligible professionals (EPs) and eligible hospitals are expected to be made in May 2011.
Medicaid EHR Incentive Program is voluntarily offered by individual states and may begin as early as 2011 and will end in 2021. Registration for the Medicaid incentive program is expected to begin in January 2011. Participants in the Medicaid EHR Incentive Program should consult their State for specific information regarding attestation and payment.
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Hospitals and eligible professionals (EPs) are expected to be able to register for the program in January 2011. The registration process will be the same for the Medicare and Medicaid programs. You will be able to find registration and other program information at http://www.cms.gov/EHRIncentivePrograms when it becomes available.
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Information on registration for EHR incentive programs will be available toward the end of 2010 on the CMS website at http://www.cms.gov/EHRIncentivePrograms. Registration for the Medicare EHR Incentive Program will begin in January 2011 and will be available online. Registration for the Medicaid EHR Incentive Program may also begin in January 2011, but the timing will vary by state.
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No. All EHR systems and technology must be certified specifically for this program.
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For demonstrating meaningful use through both the Medicare and Medicaid EHR Incentive Programs, the EHR reporting period for an EP's first year is any continuous 90-day period within the calendar year. In subsequent years, the EHR reporting period for EPs is the entire calendar year. Under the Medicaid program, there is also an incentive for the adoption, implementation, or upgrade of certified EHR technology, which does not have a reporting period.
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EPs cannot receive a payment under both the MIPPA E-Prescribing Incentive Program and the Medicare EHR Incentive Program for the same year. However, EPs may receive payments from both the MIPPA E-Prescribing Incentive Program and the Medicaid EHR Incentive Program for the same year.
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To receive an EHR incentive payment, the provider (eligible professional (EP), eligible hospital or critical access hospital (CAH)) is responsible for demonstrating meaningful use of certified EHR technology under both the Medicare and Medicaid EHR incentive programs.
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The incentives are not a reimbursement of costs, and maximum payments have been set.
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Not for the same year. If an EP meets the requirements of both programs, they must choose to receive an EHR incentive payment under either the Medicare program or the Medicaid program. After a payment has been made, the EP may only switch programs once before 2015.
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Medicare payment adjustments will begin in 2015 for EPs and eligible hospitals that do not demonstrate meaningful use of certified EHR technology.
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There are 16 measures for EPs and 14 measures for eligible hospitals that require the collection of data to calculate a percentage, which will be the basis for determining if the Meaningful Use objective was met according to a minimum threshold for that objective.
Objectives requiring a numerator and denominator to generate this calculation are divided into two groups: one where the denominator is based on patients seen, and a second group where the objective is not relevant to all patients for these objectives; the denominator is based on actions related to patients whose records are maintained using certified EHR technology. This grouping is designed to reduce the burden on providers.
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How do I know if my electronic health record (EHR) system is certified?
Once a product is certified, the name of the product will be published on the ONC web site. It is expected that the first EHRs will be certified and listed on the ONC web site in fall 2010.
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EPs are not excluded from reporting clinical quality measures, but zero is an acceptable value for the CQM denominator. If there were no patients who met the denominator population for a CQM, then the EP would report a zero for the denominator and a zero for the numerator. For the core measures, if the EP reports a zero for the core measure denominator, then the EP must report results for up to three alternate core measures (potentially reporting on all 6 core/alternate core measures). For the menu-set measures, we expect the EP to report on measures which do not have a denominator of zero. If none of the measures in the menu set applies to the EP, then the EP must report on three of such measures, reporting a denominator of zero, and then attest that the remainder of the menu-set measures have a value of zero in the denominator.
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Yes. Medicare and Medicaid incentive payments are made on a per EP basis, not by practice.
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No, if EPs report data on all three clinical quality measures from the core set, they would not report on any from the alternate core set. The three additional clinical quality measures must come from the menu set.
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For a Medicare EP's first payment year, the EHR reporting period is a continuous 90-day period within a calendar year; so an EP must satisfy the meaningful use requirements for 90 consecutive days within their first year of participating in the program to qualify for an EHR incentive payment. In subsequent years, the EHR reporting period for EPs will be the entire calendar year. With regard to the Medicaid EHR Incentive program, EPs must have adopted, implemented, upgraded, or meaningfully used certified EHR technology during the first calendar year. If the Medicaid EP adopts, implements, or upgrades in the first year of payment, and demonstrates meaningful use in the second year of payment, then the EHR reporting period in the second year is a continuous 90-day period within the calendar year; subsequent to that, the EHR reporting period is then the entire calendar year.
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In this case, EPs should base both the numerators and denominators for meaningful use objectives on the number of unique patients in the clinic setting, since this setting is where they are eligible to receive payments from the Medicare and Medicaid EHR Incentive Programs.
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Physicians who furnish substantially all, defined as 90% or more, of their covered professional services in either an inpatient (POS 21) or emergency department (POS 23) of a hospital are not eligible for incentive payments under the Medicare and Medicaid EHR Incentive Programs.
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Yes. As long as an eligible professional (EP) or eligible hospital meets all necessary requirements for qualifying for incentive payments, they will receive the maximum incentive payment amount, regardless of the purchase or implementation costs of their EHR system.
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Under the Medicare EHR Incentive Program, the annual incentive payment limit for each payment year will be increased by 10 percent for eligible professionals (EPs) who predominantly furnish services in a Health Professional Shortage Area (HPSA) and meet the maximum allowed charge threshold. Critical access hospitals (CAHs) can receive an incentive payment amount equal to the product of its reasonable costs incurred for the purchase of certified EHR technology and the Medicare share percentage. Under Medicaid, there are no additional incentives for rural providers, beyond the incentives already available.
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This is correct.
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States should make clear to providers when they attest for AIU what documentation they must maintain, and for how long, in case of audit. If States determine that certain provider types are a high risk for potential fraud/abuse for AIU, then they can ask for some verification of adoption, implementation or upgrade.
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Yes. EPs in the U.S. Territories can receive EHR incentive payments under both the Medicare and Medicaid EHR Incentive Programs, as long as they meet the applicable requirements. EPs must choose whether to participate in the Medicare or Medicaid EHR Incentive Program.
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Yes. EPs in the District of Columbia can receive EHR incentive payments under the Medicare or Medicaid program, as long as they meet the program's requirements. EPs in D.C. are subject to the same requirements as EPs in the 50 States, and thus may not concurrently receive payments from both the Medicare and Medicaid EHR Incentive Programs.