Your EMR Stimulus Act Questions Answered Stimulus Act and Meaningful Use Q&A 9/7/2010 The government requires physicians to implement Electronic Health Records (EHR/EMR) software by 2015. Here are the answers to your most frequently asked questions.
Stimulus Act Frequently Asked Questions What is the official name of the Stimulus Act? The Stimulus Act's official name is the American Recovery and Reinvestment Act (ARRA). How does it affect the Healthcare IT industry? One part of the ARRA calls for $17 billion to be made available through Medicare and Medicaid to incentivize physicians ("eligible professionals") for implementing and using a certified EHR. Who are eligible professionals? DCs, DPMs, DOs and MDs are "eligible professionals" and can benefit from incentives. Physical therapists, psychologists, nurses, nurse practitioners, physician assistants, medical assistants and social workers are examples of non-eligible professionals. How much is available to Medicare providers? The maximum amount available to eligible professionals through Medicare is $44,000. If the provider bills at least $24,000 to Medicare in 2011, 2012, 2013, 2014 and 2015, they will have earned the maximum of $44,000 over the course of the 5 year payment period. Medicare Incentives Schedule Year Eligible in 2011 Eligible in 2012 Eligible in 2013 Eligible in 2014 Eligible in 2015 2011 $18,000 $0 $0 $0 $0 2012 $12,000 $18,000 $0 $0 $0 2013 $8,000 $12,000 $15,000 $0 $0 2014 $4,000 $8,000 $12,000 $12,000 $0 2015 $2,000 $4,000 $8,000 $8,000 $0 2016 $0 $2,000 $4,000 $4,000 $0 Total $44,000 $44,000 $39,000 $24,000 $0
How much is available to Medicaid providers? Under Medicaid, eligible professionals can receive up to $63,500. To qualify, an eligible provider's patient population must be comprised of at least 30% Medicaid patients (20% for pediatricians). Medicaid Incentives Schedule Year Eligible in 2011 Eligible in 2012 Eligible in 2013 Eligible in 2014 Eligible in 2015 2011 $21,000 $0 $0 $0 $0 2012 $8,500 $21,000 $0 $0 $0 2013 $8,500 $8,500 $21,000 $0 $0 2014 $8,500 $8,500 $8,500 $21,000 $0 2015 $8,500 $8,500 $8,500 $8,500 $21,000 2016 $8,500 $8,500 $8,500 $8,500 $8,500 2017 $0 $8,500 $8,500 $8,500 $8,500 2018 $0 $0 $8,500 $8,500 $8,500 2019 $0 $0 $0 $8,500 $8,500 2020 $0 $0 $0 $0 $8,500 Total $63,500 $63,500 $63,500 $63,500 $63,500 Are incentives paid per practice or per eligible provider? Per eligible provider not per practice. This means that practices with more than one eligible provider would obtain the maximum amount of benefit to which each eligible provider is entitled. Can an eligible provider claim both Medicare and Medicaid benefits? Eligible professionals can opt for the Medicare or Medicaid incentive, but cannot derive benefit of both. Can eligible professionals who do not accept Medicare or Medicaid benefit from Stimulus Act incentives? Eligible professionals who do not accept Medicare or who do not have at least a 30% Medicaid population (20% for pediatricians) cannot benefit from Stimulus Act incentives.
What about the 2% incentive right now for using e-rx? Physicians who currently e-prescribe can, and have been receiving a 2% incentive. This will continue until Stimulus Act funds begin. At that point, the 2% e-rx incentive is cancelled. What must we do to obtain Stimulus Act incentives? In order to obtain these financial incentives, eligible professionals must "meaningfully use" their certified EHR. In other words, a provider cannot just buy an EHR and expect to obtain incentives. The EHR needs to actually be used. But not just used meaningfully used. What exactly is meaningful use? How is it determined? Criteria for Stage I meaningful use requirements have recently been finalized by CMS. The EHR selected must be able to handle 15 specific core capabilities set forth by CMS. Additionally, a listing of 10 optional capabilities exists, of which the eligible provider must choose 5, for a total of 20. This gives the provider the ability to select 5 areas of importance to the provider, making this a more personal exercise. The "menu of options" includes capabilities such as performing drug-formulary checks, incorporating clinical laboratory results into EHRs, providing reminders to patients for needed care, identifying and providing patient-specific health education resources, and employing EHRs to support the patient's transitions between care settings or personnel. Does the MedicsDocAssistant EHR meet the meaningful use requirements? The MedicsDocAssistant EHR is able to cover the 15 core features and all of the 10 optional features, making it 100% compliant for meaningful use. How long must the EHR be meaningfully used before incentives are paid? 90 days. Does the MedicsDocAssistant EHR have the required certifications? In addition to the meaningful use requirements, the EHR must also be a certified product. CCHIT has now been named by the Office of the National Coordinator for Healthcare Information Technology (ONC) as a certifying body, and MedicsDocAssistant EHR Version 4.0 is 2008 CCHIT Certified.
Certification ensures that EHRs can perform the functions called for in the standards and certification criteria final rule that ONC released. When will the funding begin? Users will be able to attest to their usage during April 2011 with the first round of funding beginning as early as mid May 2011. Would it make sense to wait until 2011 to purchase and implement an EHR? Eligible professionals implementing later into 2011 will probably have a longer wait to obtain 2011 incentives. Note that 2011 and 2012 are the years with the highest possible incentive amounts. With "crunch time" approaching, the general suggestion is to implement and begin using the EHR as soon as possible. Keep in mind the incredible benefits that using the MedicsDocAssistant EHR brings to the practice, aside from Stimulus Act incentives. There is no good reason to wait. How will eligible professionals prove EHR usage? Providers will be directed to a link on the CMS website where they will register their EHR usage. CMS has indicated this link will be available by January 1, 2011. CMS will alert providers once this link is available; ADS will also alert our own clients as well. However, there are two things Medicare providers can do now (if they have not done so already) and one thing Medicaid providers can do (if they have not done so already) to prepare for Stimulus incentives. Medicare and Medicaid providers who do not yet have an NPI number must register in the National Plan and Provider Enumeration System (NPPES). Go to https://nppes.cms.hhs.gov/nppes/welcome.do for an explanation on NPPES and instructions for registering. Skip this step if you already have an NPI. If you are a Medicare provider and have an existing NPI, you can then go to https://pecos.cms.hhs.gov to register with PECOS (Provider Enrolment Chain and Ownership System), if you have not done so already. Only Medicare providers must register with PECOS. Medicaid providers need not register. What about a general "Help" area for Stimulus-related questions? CMS will set up a help desk to answer questions and offer basic information about the incentive program. CMS regional offices and ONC regional extension centers will cross-communicate so that a question asked of one that should really be directed to the other will be done so seamlessly. States administering Medicaid are readying their incentive programs for Medicaid providers. CMS will send a letter to state Medicaid directors sometime this fall with policy guidance to help states start their programs.
How long can I wait to implement an EHR and still receive maximum incentives? The longer an eligible provider waits to implement, the riskier it is that maximum incentives will not be obtainable. Eligible professionals who implement too late for 90 days' usage into 2011 run the risk of not obtaining 2011 incentives. The same is true for eligible professionals who implement into 2012 and later. They may be able to obtain the maximum benefit from the time their 90 days ends, but their overall incentive funds would definitely be much less. Will our providers who are not DCs, DOs, DPMs or MDs be penalized for not implementing an EHR? No. Those who are not classified as "eligible professionals" - and who therefore cannot obtain Stimulus incentives - will not be penalized for not implementing an EHR. However, the benefits of using the MedicsDocAssistant EHR should always be considered, irrespective of the Stimulus Act. The system produces significant ROI with features such as electronic superbills, automated lab requests from the patient s record with results directly back to the record along with alerts on abnormalities, voice and / or handwriting recognition for immediate transcription of notes into patients records, health maintenance and continuity of care capabilities, e-rx and comprehensive medication management, interoperability and interconnectivity between systems, elimination of paper, and data security. These, and more, are reasons to use the MedicsDocAssistant EHR, even without Stimulus Act incentives. Will our providers who do not bill Medicare and / or who do not have the required percentage of Medicaid patients be penalized for not implementing an EHR? Same answer as above: providers who cannot benefit from Stimulus incentives will not be penalized for not implementing an EHR. But also as above, the benefits of using the MedicsDocAssistant EHR are significant enough to implement it, even without Stimulus incentives. Click here now to request more information or call us at 1-888-897-4237 How do I find out more? Schedule a personalized overview of the MedicsDocAssistant EHR here, or contact us for more information about electronic medical records or Stimulus Act compliance via online form here or call us at 1-888-897-4237 ext. 2046. See why 35,000 providers in every practice size and specialty rely on systems from ADS.