Meaningful Use FAQs

What is ARRA and what does it mean for medical providers?

The HITECH provisions of the American Recovery and Reinvestment Act of 2009 (ARRA), also known as the “economic stimulus plan,” provide significant financial incentives to assist physicians in the purchase, implementation, and meaningful use of a certified electronic health records (EHR) system.

Am I eligible for Stimulus Dollars?

The ARRA outlines two separate EHR incentive programs for Medicare and Medicaid. Each has its own set of eligibility requirements under the proposed rules.

Medicare

According to the Medicare program, EHR incentive payments will be available for eligible professionals that are paid under the physician fee schedule. For Medicare purposes, eligible professionals are those professionals who qualify as “physicians” under the Medicare statute. This includes doctors of medicine and osteopathy and, for certain limited purposes, dentists, podiatrists, optometrists, and chiropractors. A qualifying eligible professional must demonstrate meaningful use of an EHR as defined by CMS during the specified reporting period.

Click here for the Medicare payment schedule

Medicaid

Under the Medicaid program, eligible professionals include physicians (defined as MDs and osteopaths and, in some limited cases, optometrists), dentists, certified nurse-midwives, nurse practitioners, and physician assistants who are practicing in Federally Qualified Health Centers (FQHCs) or Rural Health Clinics (RHCs) led by a physician assistant. A qualifying eligible professional must demonstrate Meaningful Use through a means determined by the state and meet Medicaid volume percentages—20 percent for pediatricians, 30 percent for others.

Click here for the Medicaid payment schedule

Eligible for Both Programs?

Eligible professionals may not receive incentives from both Medicare and Medicaid, as participants can only choose to participate in one program. Before 2015, an eligible professional may switch programs only once after the first incentive payment is initiated. Most eligible professionals will maximize their incentive payments by participating in the Medicaid EHR Incentive Program.

I belong to a group practice, and we bill under the same tax ID. Who gets the check?

The payments are made per eligible professional, not per practice.

Do all the providers in a practice need to participate at the same time or through the same program?

No, the HITECH legislation allows physicians and other eligible healthcare professionals to participate in the incentive program at the speed they want. Providers within a single organization can begin proving and attesting to Meaningful Use at different times and as best matches their patient mix. For example, one partner with a lot of Medicaid patients may participate under that program, while the others choose Medicare.

Does a provider need to be using an EHR for all of 2013 to be eligible for a 2014 incentive payment?

No. According to the EHR reporting period for Medicare and Medicaid incentive payments, the first year of demonstration means any continuous 90-day period within the payment year. Eligible professionals must successfully demonstrate Meaningful Use of certified EHR technology during this time. Therefore, the EHR reporting period can be any continuous 90-day period beginning and ending within the relevant payment year.

  • An example of an unallowable EHR reporting period would be for an eligible professional to begin on November 1, 2013 and finish on January 31, 2014 because it overlaps into the next payment year.
  • Starting with the second payment year (and any subsequent payment years), the EHR reporting period for eligible professionals or hospitals will be the entire payment year.

When will the EHR Stimulus Funding be available to physicians and in what form?

A single, consolidated incentive payment will be made on a rolling basis when CMS determines that a provider has demonstrated Meaningful Use for the applicable reporting period (i.e., 90 days for the first year or a calendar year for subsequent years) and reached the threshold for maximum payment.