Understanding Meaningful Use In Medicare And Medicaid

Nationwide, physicians who treat Medicaid or Medicare patients must begin establishing “meaningful use” of Electronic Medical Records (EMR) by 2015 or risk having their reimbursements reduced. Meaningful Use is a term that refers to a set of EMR usage requirements that qualified providers must meet in order to receive incentive payments.

The intent of Meaningful Use is to help ensure that providers using EMRs implement the software in a manner that supports higher quality and more efficient delivery of healthcare. Because physicians may not receive both Medicaid and Medicare incentives, it is important to understand the difference between Medicare and Medicaid Meaningful Use before participating.

Incentive Money

Under Medicare, the incentive amount is 75% of the physician's Medicare allowed charges for the year, up to a maximum of $44,000. Under Medicaid, it is 85% of the physician's Medicaid allowed charges up to $63,750 per year.

Incentive payments for the Medicare program are spread out over five years and for the Medicaid program over six years, with diminishing amounts available to those who start in later years. For providers in federally designated health professional shortage areas, incentive payments will be 10% greater.

Requirements to Qualify

Every Medicare eligible professional must have a National Provider Identifier (NPI) and be enrolled in the CMS Provider Enrollment, Chain and Ownership System (PECOS) to participate in the EHR incentive program. Most physicians also need to have an active user account in the National Plan and Provider Enumeration System (NPPES). The Medicaid EHR incentive program is offered and administered voluntarily by states and territories.

Time Frame

Medicare must complete 90 days of continuous EHR Meaningful Use within the calendar year before reporting to the government. Under the Medicaid plan, you are not required to demonstrate Meaningful Use until Year 2. The Year 1 requirement for Medicaid is demonstration of “efforts to adopt, implement, or upgrade certified EMR technology.”

Providers Who Are Eligible for Incentive Payments

In both the Medicare and Medicaid programs, physicians, podiatrists, chiropractors, optometrists and dentists are eligible for incentive payments. However, in the Medicaid program, nurse practitioners, certified nurse-midwives, and physicians assistants are also qualified to participate.

Penalties for Non-Participation in the ARRA Program

Unlike the Medicaid incentive program, the Medicare program incorporates penalties. The Medicare fee schedule for providers who are not "meaningful EMR users" will be reduced by 1% in 2015, by 2% in 2016 and by 3% in 2017.

Implementing Meaningful Use

If you need more information about the implementation of Meaningful Use and how it improves efficiency for medical professionals, contact e-MDs, a leader in electronic medical record software provision. e-MDs will help you understand how to use your new EMR system or assess and upgrade your current system in a way that achieves ARRA-defined Meaningful Use.

e-MDs offers a host of affordable, certified EHR solutions for physicians and facilities looking to modernize or enhance their services with the latest electronic health records technology. e-MDs is committed to providing affordable and integrated EMR and Practice Management Software solutions, including clinical, financial and document management modules designed to automate medical practice processes and chart management – delivering the clinical tools needed to succeed in today’s health care environment.

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