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Medicare To Start Payments For Meaningful Use

CMS will soon be issuing the first bonuses to providers for meeting federal EHR standards.

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The federal Centers for Medicare and Medicaid Services said this week it will soon issue the first bonus payments for Medicare providers who have demonstrated "meaningful use" of electronic health records.

"Providers who have successfully attested to having met meaningful use, and who have met all the other program requirements, can expect to receive their 2011 incentive payments soon," CMS said in an email to its EHR listserv subscribers.

However, physicians and other individual "eligible providers" won't receive their payments until they have billed Medicare for at least $24,000 in allowed charges this year, according to CMS.

Agency spokesman Joseph Kuchler said CMS does not have any specifics as to the number of providers or dollars involved, but promised more information next week.

The 2009 American Recovery and Reinvestment Act authorized approximately $27 billion in Medicare and Medicaid incentive payments between 2011 and 2017 for hospitals, physicians, and certain other healthcare providers to install and use "certified" EHRs according to federal standards. Six authorized private-sector testing bodies together have certified more than 700 ambulatory and inpatient EHR products.

Providers must demonstrate meaningful use for 90 consecutive days during their first year of participation in the program as long as they begin by 2014. CMS opened an online attestation system last month.

In subsequent years, meaningful use must be continual, and the standards will become more stringent in 2013 and again in 2015. Anyone not meeting the standards will see their reimbursements cut starting in 2015.

Individuals may earn as much as $18,000 in additional Medicare payments for their first year of participation and a total of $44,000 over five years. Hospital bonuses have a baseline of $2 million, then are adjusted according to on a complex formula that accounts for number of beds, discharges from acute care units, and percentage of patients on Medicare and Medicaid. Hospital participation is based on the federal fiscal year, which ends Sept. 30, while individuals follow the calendar year.

Hospitals may earn extra payments for both Medicare and Medicaid, while eligible providers must choose one or the other. Medicaid bonuses run as high as $63,750 per provider over the life of the program, but only those with at least 30% of their patients on Medicaid (20% for pediatrics) can participate.

So far, 15 states have opened their Medicaid EHR incentive programs, with Indiana and Ohio the latest to do so. CMS said that these states collectively have paid out more than $83 million in bonuses for meaningful use.

The Healthcare IT Leadership Forum is a day-long venue where senior IT leaders in healthcare come together to discuss how they're using technology to improve clinical care. It happens in New York City on July 12. Find out more.

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