Registration for the Medicaid federal electronic health record (EHR) incentive program is now open.
Physicians and midlevel providers can receive up to $63,750 over six years for achieving "meaningful use" of a certified EHR product if they have at least a 30-percent Medicaid patient volume. Pediatricians can qualify for up to $42,000 with a 20-percent Medicaid volume. The program is state regulated, and Texas physicians who register and adopt, implement, or upgrade to a certified EHR in year one of the incentive program are eligible to receive the first-year EHR incentive. You will be required to meet the meaningful use criteria for 90 days in the second year of program by reporting data online through attestation.
Use the online eligibility tool from the Centers for Medicare and Medicaid Services (CMS) to verify program eligibility prior to enrollment. CMS will allow a physician to enroll prior to completing the meaningful use criteria and return later to complete reporting and attestation. Texas Medicaid also has state level registration requirements.
Texas Health and Human Services Commission (HHSC) also has the online EHR Incentive Program Module that includes several self-guided lessons on the various topics of the Medicaid EHR Incentive Program. The knowledge gained will come in handy for enrolling in the incentive program or for the second step toward payment: attesting to meaningful use.
Please note: Texas Medicaid HHSC recently made Policy Changes to the Medicaid EHR Incentive Program (April 2013)
Year One Instructions:
What can I do now?
Step 1: Select and adopt a certified EHR
Step 2: Register at the CMS Registration Portal (instructions)
What can I do later?
Step 3: Obtain EHR certification code (instructions)
Step 4: Register at the Texas Medicaid HIT website
Step 5: Receive incentive payment
Step 6: Year two "meaningfuly use" for 90 days and attest. (Meaningful Use - At a Glance; TMA Meaningful Use Achievement Toolkit; CMS In-depth Meaningful Use Guide)
Step 1: Select and adopt a certified EHR
The Medicaid federal incentive program requires the use of a certified EHR. The Office of the National Coordinator (ONC) maintains the Certified Health IT Product List (CHPL), a current list of all certified EHR products. Even if your current product has met previous certifications, be sure your current version appears on the list. Early adopters of EHRs are eligible for incentives; it does not matter when you purchased the EHR system as long as it appears on the CHPL.
If you need help finding or selecting an EHR system, you may benefit from technical consulting services from the Texas Regional Extension Centers (RECs). The RECs are vendor neutral and can help you find a system that fits the needs of your practice.
Step 2: Register at the CMS Registration website
Log in to the site using your National Plan and Provider Enumeration System (NPPES) web user account. If you do not already have an NPPES account, visit the NPPES website to register. (Note: If you have an NPI number, you automatically have an NPPES account.) If you do not have your password, call (866) 484-8049 and select option #6 to have your password reset or e-mail firstname.lastname@example.org.
CMS has a Medicaid EHR Incentive Program registration user’s guide (PDF) for the registration and attestation system.
Before you can proceed with the attestation process, you will be prompted for a certification ID. This number is a unique identifier assigned to each certified EHR (see step 3).
Step 3: Visit the Certified Health IT Product List (CHPL) to obtain your unique CMS EHR Certification ID.
Choose your EHR, add to cart and press “Get CMS EHR Certification ID.” View the CHPL user guide (PDF) for more detailed instructions.
Step 4: Create an account on the Texas Medicaid & Healthcare Partnership Health IT Portal (Instructions see pages 22-42). This website will require you to enroll and attest to the required 30% Medicaid patient volume (Pediatricians can qualify with 20-30% Medicaid volume). The patient volume will be calculated based on any continuous 90 days in the year previous to applying for the incentive.
You will have the ability to choose one of the following two options to calculate patient volume:
Patient Encounters – The total number of Medicaid encounter divided by the total patient encounters.
Patient Panel – The total number of Medicaid Panel Assignments and Encounters divided by total panel assignments and total panel encounters.
The following events are considered Medicaid Encounters
- Services rendered on any one day to an individual where Medicaid paid for any portion, or all of the service provided.
- Services rendered on any one day to an individual where Medicaid paid all or part of their premium, copayment, or cost-sharing.
Step 5: Incentive Payment
The federal Medicaid EHR incentive for any physician or midlevel meeting the 30% patient volume is $21,250 in the first year of program participation and $8,500 over program years 2-6. The total incentive is $63,750 over six years. Pediatricians with extended incentive eligibility (20-30% Medicaid volume) are eligible for 2/3 of the Medicaid incentive, $42,500 over six years. Pediatricians with a 30% volume will qualify for the maximum incentive amount of $63,750 over six years.
Step 6: Complete 90 days of "meaningful use" in the second year of program participation.
To earn your second year Medicaid EHR incentive of $8,500, it is required that you complete 90 days of meaningful use. Physicians must complete a set of 15 core criteria and choose 5 from 10 criteria on a menu set for Stage 1 meaningful use criteria. For more information on meaningful use, view the one-hour TMA Meaningful Use Webinar. As part of the meaningful use criteria, you will be required to e-prescribe. If you are eligible, you can receive both the Medicaid EHR incentive and the e-prescribing incentive in the same year. However, in order to avoid Medicare e-prescribing penalties in 2014 (2 percent of Medicare Part B claims), physicians needed to report e-prescribing via claims using G-code G8553 on at least 10 unique Medicare encounters by June 30, 2013. Meaningful use requires you generate and transmit permissible prescriptions for more than 40 percent of all permissible prescriptions. If you only accept Medicaid, there are no punitive penalties scheduled for failure to comply with meaningful use or e-prescribing.
Once you've successfully completed a 90 day period of meaningful use, log back on to the CMS Registration and Attestation website to enter attestation data. If you have not successfully met each required measure, you will be required to resubmit.
Want to make sure you've successfully met each meaningful use measure before officially attesting? Use CMS' Meaningful Use Attestation Calculator. You can print out the final result of each measure, but it may be helpful to record numerator and denominator data to use again for official attestation.
Need additional help?
Need on-site technical consulting help to get you to meaningful use? You don’t have to go on this journey alone. The Texas Regional Extension Centers (REC) can provide technical consulting. The REC can offer assistance if you are looking to select and implement an EHR in your practice, or if you are an existing EHR user looking to optimize your workflow and reach meaningful use.
Sign up for e-mail updates from Texas Medicaid, for support e-mail HealthIT@tmhp.com or call (800) 925-9126.
For more information on the EHR Incentive program contact Texas Medical Association’s Department of Health Information Technology at (800) 880-5720 or HIT@texmed.org.