All Medicare eligible hospitals and eligible professionals will have a payment reduction in 2015 if they are not demonstrating meaningful use. For example, if you are a physician and accept both Medicare and Medicaid, you must be demonstrating meaningful use by 2015 (in either the Medicare or the Medicaid EHR incentive program) or you will have a Medicare fee-schedule reduction for all your Medicare claims. The payment reduction for Medicare Fee-for-Service for physicians who are not demonstrating meaningful use is 1% in 2015, 2% in 2016, and 3% in 2017 and subsequent years.

1. Adopt, implement, or upgrade certified electronic health records technology
2. Use the certified EHR for at least 90 continuous days
3. Enroll in the incentive program through CMS’s online portal or through your state’s Medicaid program
4. Attest to the percentage of patient visits over a continuous 90-day period in the past calendar year that was attributable to Medicaid
5. Attest to meeting the functionality EHR requirements
6. Report numerators, denominators, and exclusion criteria for each applicable quality measure
7. Receive your certified EHR incentive payment for Meaningful Use

Read the entire EHR/EMR meaningful use eligibility Final Rule.

On January 2011, CMS launched a website where you can register your intent to use certified EHR technology. The official web site for the Medicare and Medicaid EHR Meaningful Use incentive programs provides a link to the registration site for the Meaningful Use Incentive program. When registering the eligible professional will provide the following practice information.

• Name, NPI, business address and practice phone
• Taxpayer Identification Number (TIN) to which you want the incentive payment made
• Chose your incentive program – Medicare or Medicaid
• If Medicaid – must chose a State
• All Medicare EPs must be enrolled in PECOS

Eligible Professionals are required to prove Meaningful Use of their EHR technology by reporting on 20 objectives.

• 15 Core Objectives of EHR use and an additional
• Five items from a list of ten Menu Objectives
• Six total Clinical Quality Measures
  
  • Three Core or alternate Core
  • Three out of the 38 from Menu set

Some meaningful use (MU) objectives are not applicable to every provider’s clinical practice. Perhaps you do not have any eligible patients to meet one of the objectives or actions that is required. In those cases, you would be excluded from having to meet that measure. Two examples of eligible providers utilizing certified EHR that would be excluded from a specific Core objective are listed below.

• Dentists who do not perform immunizations
• Chiropractors do not ePrescribe

No.

Physical Therapists, Occupational Therapists, and Social Workers are not eligible for EHR incentives per the final regulation. Neither are dieticians, diabetes nurse educations, case managers, social workers, or credentialed pedorthists (who make shoes for diabetic patients). Eligible professionals for EHR Incentives include:

Medicare Meaningful Use EHR Program

• Doctor of Medicine or Osteopathy. (Including hospital-owned ambulatory clinic physicians)
• Doctor of Dental Surgery or Medicine
• Doctor of Podiatric medicine
• Doctor of Optometry
• Chiropractor

Medicaid Meaningful Use EHR Program

• Doctor of Medicine or Osteopathy. (Including - Hospital owned ambulatory clinic Physicians)
• Doctor of Dental Surgery or Medicine.
• Doctor of Podiatric medicine
• Doctor of Optometry
• Chiropractor

Eligibility is not based on full-time or part-time status and will differ based on whether the eligible provider is seeking Medicare or Medicaid EHR Incentives.

Medicare EHR Meaningful Use Program

• Calculated by multiplying your submitted allowable charges to Medicare by 75%, up to the capped amount for the year
• Part B claims for the Fee for Service program
• Items in the Medicare Physician’s Fee Schedule
• Only the “professional” components, not the “technical”
• Only those furnished by the EP
• No minimum patient volume required
• To collect the full Meaningful Use EHR incentive payment of $18,000 in 2011, you’ll need to submit allowable charges of at least $24,000
• You can earn an EHR incentive with less (i.e., a payment of $12,000 for submitted allowables of $16,000)

Medicaid EHR Meaningful Use Program

• 30% of all your patient encounters must be attributable to Medicaid over any continuous 90-day period within the most recent calendar year
• No short-term outreach
• Required to annually re-attest to patient volume thresholds
• Medicaid replacement plans count towards the threshold
• Medicaid patients assigned through capitation count, too
• Pediatricians can qualify with 20% Medicaid volume
• Incentive also decreased by 33% ($42,500)

The first year of EHR use, an Eligible Professional is required to use the technology for 90 consecutive days, and then a continuous 12 months thereafter. The year is a calendar year for Eligible Professional starting January 1 and ending December 31. So the latest an Eligible Profession could begin use of the technology would be October 1, 2011.