EHR Incentives Program Simplified

Medicare and Medicaid incentives are given as a reward for meaningful use of qualified, certified EHRs. The use of certified EHRs will also increase accuracy, reduce errors, help providers in decision-making and support features like E-Prescribing. Eligible professionals (EPs) and hospitals can receive incentives under the Medicaid, Medicare, and Medicare Advantage programs.

Medicaid Program

Medicaid EHR incentives are voluntarily offered by states and teritories to eligible professionals and hospitals for adoption, implementation, upgradation, and demonstration of meaningful use of certified EHR technology. Incentives will be offered in the first year of participation and demonstration of meaningful use and also upto the five subsequent years.

Starting 2011, the Medicaid EHR Incentive Programs will allow providers to receive upto $63,750 over a period of six years. To qualify for Medicaid EHR incentives, providers or hospitals must begin participation atleast by 2016.

Medicare Program

With the Medicare EHR Incentives Program, providers can receive as much as $44,000 over a period of 5 years. Medicare EHR Incentives are available to providers who demonstrate meaningful use of certified EHR technology. Participation in the program begins in 2011. Eligible Professionals (EPs) serving Health Provider Shortage Areas (HSPAs) will receive additional incentives.

Medicare Advantage Program

This program provides incentives to Medicare Advantage Organizations (MAOs) whose affiliated professionals and hospitals  demonsrate meaningful use of certified EHR technology.

Certified EHR

In order to qualify for EHR incentives, providers will have to use certified EHR technology. The Office of the National Coordinator for Health Information Technology (ONC) establishes the standards for certifying EHRs. The standards and rules are not finalized yet.

Providers do not need certified EHRs to register for the incentive programs. However, they receive incentives only when they demonstrate meaningful use of certified EHR technology.

NPI, NPPES and PECOS

To qualify for incentives, eligible providers must have a National Provider Identifier (NPI), be enrolled in CMS Provider Enrollment, Chain and Ownership System (PECOS). An active user account in the National Plan and Provider Enumeration System (NPPES) is also required.

An eligible professional who is participating in only the Medicaid EHR Incentives Program need not be enrolled in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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