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CMS's proposed rule on EHR incentives excludes many hospital-based physicians
(Courtesy of MGMA Washington Connection)
In the proposed rule outlining the Medicare and Medicaid electronic health record (EHR) incentive program, the Center for Medicare & Medicaid Services (CMS) has taken an expansive view of which hospital-based professionals will be excluded from the program. Mandated as part of the American Recovery and Reinvestment Act of 2009 (ARRA), the Medicare incentive program offers up to $44,000 over five years to eligible professionals (EPs) who are “meaningful users” of a certified EHR and up to $63,750 under the Medicaid program. The first payment year is 2011.
The regulations, published in the Federal Register on Jan. 13, proposed a definition of a hospital-based professional that could exclude many EPs seeking to take advantage of the incentive program by implementing an EHR. Hospital-based EPs (including those in all outpatient settings where hospital care is furnished to registered hospital outpatients) would not be eligible for the Medicare incentive payments, nor would the majority of hospital-based EPs qualify for Medicaid incentive payments. The only exception to this rule is for those EPs practicing predominantly in an federally qualified health center (FQHC) or rural health clinic (RHC). CMS proposes to define hospital-based EPs as those who furnish at least 90 percent of their professional services in a hospital setting, including inpatient and outpatient settings, as well as emergency departments. CMS would determine non-eligibility based on site-of-service codes.
To help practice administrators understand this incentive program, take advantage of the payments, and avoid cuts to their Medicare reimbursement, MGMA has developed a Webinar series outlining the government’s regulatory requirements, best approaches for EHR software selection, successful vendor contracting, and seamless software implementation.
