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Medicaid Incentive Program & MACRA Medicare QPP Differences
Below are the highlights from Centers for Medicare & Medicaid Services (CMS) on the differences between Medicaid Incentive Program and MACRA Medicare QPP:
- Medicaid EPs who also qualify for Medicare QPP – those expected to participate in both program and 2016 was the last year Medicaid EPs can begin participation in the Medicaid Incentive program.
- CMS would like to remind eligible professionals (EPs) and eligible hospitals that the Medicaid EHR Incentive Program, which is administered voluntarily by states and territories, will continue through 2021. Here are the specifics:
Incentive Payment Information
- There are no payment adjustments in the Medicaid EHR Incentive Program.
- EPs and eligible hospitals who meet program requirements can continue to attest to their state Medicaid agencies to receive yearly incentive payments.
- The incentive payment is a fixed amount for each year of participation.
- EPs and eligible hospitals can receive incentive payments for six years non-consecutively. EPs and eligible hospitals who began the program in 2016 must participate consecutively to receive the full payment amount over six years.
- Eligible hospitals that are eligible to participate in the Medicare and Medicaid EHR Incentive Programs may attest under Medicare to avoid a payment adjustment.
Note: 2016 was the last year EPs and eligible hospitals could begin participation in the Medicaid EHR Incentive Program.
Medicaid EHR Incentive Program and the Merit-based Incentive Payment System (MIPS)
MIPS does not replace the Medicaid EHR Incentive Program. If a provider plans to participate in the Medicaid EHR Incentive Program through their state and they are also a Medicare Part B clinician who is eligible for MIPS, they will also need to participate in the MIPS program to avoid a negative MIPS payment adjustment.
- To learn more, visit the 2017 program requirements page on the EHR Incentive Programs website. For state-specific information and resources, review the Medicaid State Information page.
- Visit the QPP website to see if you need to participate in MIPS.