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Medicare and Medicaid Provider Program

What are the requirements to register for the Medicare and Medicaid Provider Incentives?

  1. Name of the EP, eligible hospital, or qualifying CAH
  2. National Provider Identifier (NPI)
  3. Business address and business phone
  4. Taypayer Identification Number (TIN) to which the provider would like their incentive payment made
  5. CMS Certification Number (CCN) for eligible hospitals
  6. Medicare or Medicaid program selection (may only switch once after receiving an incentive payment before 2015) for EPs
  7. State selection for Medicaid providers

What are the notable differences between the Medicare and Medicaid EHR programs?

Medicare Medicaid
Federal Government will implement (will be an option nationally) Voluntary for States to implement (may not be an option in every State)
Payment reductions begin in 2015 for providers that do not demonstrate Meaningful Use No Medicaid payment reductions
Must demonstrate Meaningful Use in Year 1 A/I/U option for 1st participation year
Maximum incentive is $44,000 for EPs (bonus for EPs in HPSAs) Maximum incentive is $63,750 for EPs
Meaningful Use definition is common for Medicare States can adopt certain additional requirements for meaningful use
Last year a provider may initiate program is 2014; last year to register is 2016; payment adjustments begin in 2015 Last year a provider may initiate program is 2016; last year to register is 2016
Only physicians, subsection (d) hospitals and CAHs 5 types of EPs, acute care hospitals (including CAHs) and children's hospitals

What is the EHR Incentive Program Timeline?

  • January 2011 - Registration for the EHR Incentive Program begins
  • January 2011 - For Medicaid providers, States may launch their programs if they so choose
  • April 2011 - Attestation for the Medicare EHR Incentive Program begins
  • May 2011 - EHR incentive payments begin
  • November 30, 2011 - Last day for eligible hospitals and CAHs to register and attest to receive an incentive payment for FFY2011
  • February 29, 2012 - Last day for EPs to register and attest to receive an incentive payment for CY 2011
  • 2015 - Medicare payment adjustments begin for EPs and eligible hospitals that are not meaningful users of EHR technology
  • 2016 - Last year to receive a Medicare EHR Incentive payment; last year to initiate participation in Medicaid EHR
  • 2021 - Last year to receive Medicaid EHR incentive payment

 

Last Updated 8/31/2010
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