Updated: 9/1/2010
by Healthcare Business Specialists
Electronic Health Records Stimulus Payments
This page will include updates on Electronic Health Record Stimulus Payments
April 17, 2010: I finished this 19 page document on Electronic Medical Record Incentives Here is the hyperlink to the EMR Incentive document.
2010 Electronic Medical Records Summary of EMR information on April 15 2010.pdf
2010 Electronic Medical Records Stimulus Payments
Most Provider-Based Rural Health Clinics Excluded from
Electronic Medical Records Stimulus Payments
To read an article regarding the proposed Electronic Stimulus payments and the possible exclusion of most provider-based rural health clinics follow the link to the National Rural Health Association website to the article posted on February 1st, 2010.
http://h184435wp.setupmyblog.com/2010/02/cms-proposed-rule-excludes-most-provider-based-clinics/
Medicaid Electronic Health Records[4]
Incentive Payments
Rural Health Clinics are eligible for EHR incentive payments beginning in 2011. There is specific language for RHCs separate from anything dealing with individual physicians. Beginning in 2011, RHCs would be eligible for incentive payments to the extent the RHC can demonstrate that they are “meaningful users” of certified EHR. For RHCs, the EHR incentive payments will flow through the Medicaid program even though the money for the payments will come from the federal treasury.
In order to obtain the RHC EHR incentive payments, the RHC must demonstrate that at least 30% of the RHCs patients are “needy”. This means they are on: Medicaid, S-CHIP, are uninsured or eligible for a sliding fee scale (i.e. low-income).
EHR Incentive Payments are available through the Medicaid program to:
• Physicians
• Nurse Practitioners
• Nurse Midwives
• Rural Health Clinics
• Federally Qualified Health Centers
In order for a physician, nurse practitioner or nurse midwife to be eligible for a Medicaid bonus payment, at least 30% of the physician, NP or CNM patient visits must be Medicaid recipients.
RHCs can receive bonus payments through the physicians, NPs, CNMs or PAs who practice predominantly in a rural health clinic. In the case of PAs, the clinic must be “PA led”. In addition, at least 30 percent of the RHC or FQHC providers’ patient volume must be attributable to “needy” individuals.
Who is a “Needy Individual?”
• Someone who is receiving assistance under Medicaid
• Someone who is receiving assistance S-CHIP
• Someone who is furnished un-compensated care by the provider;
• Someone for whom charges are reduced by the provider on a sliding scale basis based on an individual's ability to pay.
RHCs can receive an amount not in excess of 85 percent of net average allowable costs for certified EHR technology (and support services including maintenance and training that is for the adoption and operation of, such technology.
The term `average allowable costs' means the average costs for the purchase and initial implementation or upgrade of such technology (and support services including training that is necessary for the adoption and initial operation of such technology.
In no case shall—
* The net average allowable costs under this subsection for the first year of payment exceed $25,000
* The net average allowable costs under this subsection for a subsequent year of payment, exceed $10,000
An eligible professional shall not qualify as a Medicaid provider under this subsection unless any right to payment under Medicare with respect to the eligible professional has been waived.
• In No Case, shall payments be made for costs after 2021 OR over a period of longer than 5 years.
• Total Incentive – PER PROVIDER: $65,000 over 5 years.
[1] This answer was derived from the NARHC Listserve with credit to Steve Rousso, Principal, MBA, MPA, HFS Consultants, Oakland, CA and to Brenda Caswell,CPC.
[2] Bill Finerfrock, Executive Director of the NARHC.
[3][3]Bill Finerfrock, Executive Director of the NARHC.
[4] This information is provided by the NARHC List-Serve, Bill Finerfrock, Executive Director.
[5] Assuming Cahaba GBA is your MAC.
Electronic Medical Records Incentive Regulations
The Department of Health and Human Services has released the initial set of standards, implementation specifications, and certification criteria for electronic health record technology as an interim final rule on January 13, 2010. The 35 pages of regulations can be accessed by going to the following link:
http://edocket.access.gpo.gov/2010/pdf/E9-31216.pdf
On the same day 169 pages of proposed regulations implementing the Electronic Medical Records incentive programs were released. To read these regulations go to:
http://edocket.access.gpo.gov/2010/pdf/E9-31217.pdf
Both of these regulations will be summarized in our RHC Update seminar and will be available on our website; once we have completed our review of the Federal regulations.