Meaningful Use Basics
The Medicare and Medicaid EHR Incentive Programs were created under the American Recovery and Reinvestment Act (ARRA) of 2009 to provide financial incentives to providers and hospitals who adopt and demonstrate Meaningful Use of electronic health records (EHRs). The three main components of MU are:
- The use of a certified EHR in a meaningful manner, such as 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 document clinical quality data and other measures
Medicaid EHR Incentive Program Basics
The Medicaid EHR Incentive Program provides incentive payments for Medicaid eligible professionals (EPs) who adopt, implement, or upgrade EHR technology in their first year of participation in the program, and successfully demonstrate meaningful use in subsequent years.
For the Medicaid EHR Incentive Program, an EP must be one of the following five types of Medicaid professionals: physicians, dentists, certified nurse-midwives, nurse practitioners, and physician assistants practicing in a Federally Qualified Health Center (FQHC) or a Rural Health Center (RHC) led by a physician assistant.
To qualify for an EHR incentive payment, a Medicaid EP must not be hospital-based and must meet one of the following criteria:
- Have a minimum 30% Medicaid patient volume,
- Have a minimum 20% Medicaid patient volume, and is a pediatrician,
- Practice predominantly in an FQHC or RHC where 30 percent of the patient volume is derived from needy individuals.
The last year to begin participating in the Medicaid EHR Incentive Program is 2016. EPs may receive Medicaid EHR incentive payments for up to $63,750 over six years; 2021 is the final year for Medicaid EHR incentive payments. Participation years do not have to be consecutive.
Note: The total for pediatricians who meet the 20 percent patient volume but fall short of the 30 percent patient volume is $14,167 in the first year and $5,667 in subsequent years. This adds up to a maximum Medicaid EHR incentive payment of $42,500 over a six-year period.
Medicaid Meaningful Use (Year 1) - Adopt, Implement, or Upgrade (AIU)
Eligible professionals can receive an incentive payment for adopting implementing, or upgrading (AIU) certified EHR technology in their first year of participation. To qualify for AIU, an EP must meet the following criteria:
- Supply documentation that their EHR technology is certified to the 2014 Edition or the 2015 Edition, or a combination of the two. The documentation must also show that they have or plan to adopt, implement, or upgrade such system at their practice.
- Meet certain Medicaid patient volume thresholds.
- % Medicaid patient volume = (Medicaid Encounters / Total Encounters)*100
- To calculate your patient volume, please review our guide
- Supply auditable proof for meeting patient volume qualifications and retain the proof for at least six years.
The last year to begin AIU is 2016. Providers are encouraged to submit if they are close to the patient volume requirement. Medicaid will validate actual Medicaid patient volume seen by the provider during attestation review. Whichever method is the most favorable to the provider will be the method employed to make eligibility determinations.
Steps to Register for the Program
- Prepare for registration by following this checklist to make sure you are ready to register.
- Determine certification of your EHR system. To determine if an EHR system is currently certified, view the ONC Certified Health IT Product List (CHPL)
- Register with CMS to participate in the Medicaid EHR Incentive Program. Eligible Professionals must first register with CMS online and signal their intent of registering with Maryland Medicaid.
- Upon receipt of a welcome email from Maryland's Registration and Attestation System, eMIPP, you may prepare to attest.
- Obtain or verify the correctness of your eMedicaid username and password. These credentials are what you will use to login to the attestation website, eMIPP.
- Retain proper documentation in caase of an audit. Note: You may be audtied prior to receiving payment.
Introduction to Incentive Programs
|Medicaid EHR Incentive Program|
|Run by your State Medicaid Agency|
|Maximum incentive amount is $63,750|
|Payments over 6 years, does not have to be consecutive|
|No payment adjustment for providers who are only eligible for the Medicaid program|
|In the first year providers can receive an incentive payment for adopting, implementing, or upgrading EHR technology. Providers must demonstrate meaningful use in the remaining years to receive incentive payments|
The links provided here provide introduction to the Medicaid and Medicare EHR Incentive Programs, and what is required of Eligible Professionals to meet the requirements under Meaningful Use. See the Step-by-step Guide on registering for the Medicaid EHR Incentive Program. If you have questions about patient volume calculation, see our guide to Calculating Your Meaningful Use Patient Volume.
If you are ready to get started, you must first determine what program you want to apply for. Use the assessment tool linked here to help you determine where you land. Determining What Program I Qualify For
For more information on completing the steps for Meaningful Use, please see our EHR Incentive Program page.