We have compiled answers to the most frequently asked questions about the REC, its services and incentive payment requirements. If you have questions you would like answered, please email us!
Who is eligible for assistance from the REC?
As defined by the HITECH Act, eligible providers are primary care physicians (Internal Medicine, Family Practice, OB/GYN, Pediatrics, General Surgery) and other healthcare professionals (PA, NP, Nurse Midwife) with prescribing privileges. The REC makes assistance available to all primary care providers, but with priority given to the following settings:
• Small group practices (10 or less providers)
• Ambulatory clinics connected with public or critical access hospitals
• Community Health centers and Rural Health clinics
• Other ambulatory settings that predominantly serve uninsured, underinsured, and medically underserved populations
What services will the REC provide?
An overview of the services includes but is not limited to:
• Determining eligibility for HIT incentive programs
• Selecting the most cost-effective EHR for your practice
• Planning a successful EHR implementation
• Enhancing administrative and clinical workflows
• Assessing and meeting training needs for your staff
• Achieving meaningful use of HIT
• Maximizing HIT incentive payments
• Connecting for Health Information Exchange (HIE)
• Improving the value and quality of patient care
What Medicare and Medicaid incentives are available under the ARRA stimulus?
Medicaid: Pays up to $63,750 per provider over a 6 year period (2011 – 2021)
What must I do to be eligible for the incentives?
Eligible providers must:
1. Medicaid requires 30% of the practice patient population be Medicaid (20% if pediatrics). Medicare requires that you see Medicare patients and will reimburse up to 75% (not to exceed $44,000 over 5 years) of Medicare allowable charges.
2. The practice must use a certified EHR
3. The practice must meet meaningful use criteria.
How can my practice meet the meaningful use criteria?
Under the meaningful use rule, providers will need to prove that they have met a set of proposed objectives with their EHR product to be considered “meaningful users”. Providers will need to prove meaningful use of their EHR for at least 90 continuous days in 2011 in order to earn an incentive, and then for the entire year each subsequent year. The final definition for meaningful use has not been finalized as of May 2010. Please check this link see the most updated info on meaningful use.
Clinical quality measures will need to be submitted by a provider on a core set of measures, as well as a specialty-specific subgroup; providers will be able to file for an exception if none of the proposed measures match with their specialty.
I am interested in learning more about the EHR incentive payment what should I do next?
First, you can get additional information by clicking here (Link to tnREC Home Page) and registering your interest. After your information is processed, a provider representative in your area will contact you. If you would like to contact us by phone, please call 866-514-8595.
I am currently participating in the eprescribing initiative. Can I continue to participate in this initiative and receive the EHR incentive payment?
The Recovery Act specifically states that under Medicare, eligible professionals cannot receive a payment for both the MIPPA e-prescribing incentive program and an incentive payment for the Recovery Act.
No such provision is in the Medicaid incentive section of the Recovery Act; however, there is a provision for Medicaid incentives that requires an eligible professional to net out from their payment formula any payment received (other than payment from a State or local government) that is directly attributable to payment for certified EHR technology or support services.
CMS will need to reconcile these two issues in its forthcoming proposed rule; however, we believe there will be situations where a provider could receive both the MIPPA e-prescribing incentive and the Medicaid incentive under the Recovery Act. Hence, if a provider can qualify for the MIPPA e-prescribing program and the Medicaid incentive program under the Recovery Act, they could receive payments under both. We expect that the number of providers who could potentially qualify for both programs would be very small.
The incentive payments available under MIPPA, signed into law on July 15, 2008, are different from those under the Recovery Act, which became law on February 17, 2009. MIPPA established a five-year program of incentive payments to eligible professionals (EPs) who are “successful electronic prescribers” (e-prescribers), as defined by the statute. Beginning in 2012, the program will impose penalties on EPs who are not successful e-prescribers.
Under the Recovery Act, beginning in 2011, Medicare EPs who earn payments under the incentive program for meaningful use of certified EHR technology that features e-prescribing capabilities would not also be eligible to earn a separate incentive payment for being a successful e-prescriber under MIPPA. However, eligible professionals who e-prescribe using stand-alone e-prescribing products and who do not participate in the Medicare Recovery Act incentive program will still be eligible to receive incentive payments if found to be successful e-prescribers under the E-Prescribing Incentive Program authorized by MIPPA.”
For more information, click here to visit the CMS Web site.
I installed an EHR last year and have just begun submitting prevention measures. Do I still qualify for any of the funding?
Participation in the Prevention measures (QIO) work would not prohibit a practice from receiving incentives.
However, the EHR would be subject to meeting the meaningful use requirements set forth by the federal government. Decisions about EHR standards, implementation specifications and certification criteria have not been made yet, and are under development. Policies will be proposed in a regulation from the Office of the National Coordinator for Health Information Technology (ONC).
