CMS FINALIZES REQUIREMENTS FOR THE MEDICAID ELECTRONIC HEALTH RECORDS (EHR) INCENTIVE PROGRAM The Centers for Medicare & Medicaid Services (CMS) today announced the final rule to implement the provisions of the American Recovery and Reinvestment Act of 2009 (Recovery Act) that provide incentive payments for the adoption and meaningful use of certified electronic health record (EHR) technology. The Medicare EHR incentive program will provide incentive payments to eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) that are meaningful users of certified EHRs. The Medicaid EHR incentive program will provide incentive payments to EPs and eligible hospitals for efforts to adopt, implement, upgrade, or meaningfully use certified EHR technology .
This fact sheet summarizes provisions in the final rule affecting state Medicaid programs and Medicaid providers.
The Office of the National Coordinator for Health Information Technology (ONC) is issuing a closely related final rule that completes the Secretary’s adoption of an initial set of standards, implementation specifications, and certification criteria for EHRs. ONC also issued a final rule establishing a temporary certification program for health information technology on June 24, 2010 and will issue a final rule for establishing a permanent program later this year.
The Recovery Act amended the Medicaid statute to provide for a 100 percent Federal financial participation (FFP) match for state expenditures for provider incentive payments to encourage Medicaid health care providers to adopt, implement, upgrade or meaningfully use certified EHR technology. It also established a 90 percent FFP match for reasonable state expenses related to administration of the incentive payments and to promote EHR adoption and health information exchange.
On September 1, 2009, CMS released a State Medicaid Director’s Letter that provided preliminary guidance on state expenses related to activities in support of the administration of incentive payments to providers. CMS has worked with all States and territories to facilitate their planning efforts for the purposes of administering the incentive payments to providers, ensuring their proper payments, and auditing and monitoring of such payments, and participating in statewide efforts to promote interoperability and meaningful use of EHRs. Subsequent guidance to States on implementation funding will be forthcoming.
The final rule CMS released today provides further guidance to states and Medicaid providers on the Medicaid EHR Incentive Program. CMS anticipates that the majority of States will launch their Medicaid EHR Incentive programs between January and August of 2011.
The Medicaid provisions of the final rule address seven topics:
The paragraphs below summarize the rule’s treatment of these topics.
Eligibility
The final rule:
Payments
The final rule:
For hospital payments, the calculation is:
(Overall EHR Amount) * (Medicaid Share) or Overall EHR Amount Equals {Sum over 4 year of [(Base Amount Plus Discharge Related Amount Applicable for Each Year) * Transition Factor Applicable for Each Year]} *
Medicaid Share Equals {(Medicaid inpatient-bed-days + Medicaid managed care inpatient-bed-days) divided by [(total inpatient-bed days) times (estimated total charges minus charity care charges) divided by (estimated total charges)]}
Adopting, Implementing, or Upgrading Certified EHR Technology
The final rule:
Demonstrating Meaningful Use of Certified EHR Technology
The final rule:
Conditions States Must Meet to Receive 90 Percent FFP
The final rule:
Financial Oversight/Combating Fraud and Abuse
The final rule:
The final rule may be viewed at http://www.cms.gov/EHRIncentivePrograms
Other Departmental HITECH Activities
ONC serves as the principal federal entity charged with coordinating the overall effort to implement a nationwide health information technology infrastructure that allows for the electronic use and exchange of health information.
Specifically, the ONC is authorized by Title XXX of the Public Health Service Act (PHS) to provide grant funding to support states’ efforts in achieving meaningful use of certified EHRs. To that end, on August 20, 2009, the Vice President announced the availability of two grant programs to help hospitals and health care providers implement and use EHRs.
The grants made available under Section 3012 of the PHS Act provide funding for Health Information Technology Regional Extension Centers that will provide primary care, small and solo practice clinicians with technical assistance in selection, acquisition, implementation and meaningful use of certified EHR technology. ONC has funded 60 new Health Information Technology Regional Extension Centers (RECs). The purpose of theRegionalExtensionCenterprogram is to provide physicians with the guidance and personalized support they need to adopt and meaningfully use EHRs. The objectives are to support 100,000 primary care providers in theUnited Statesand its territories by 2012. While direct REC assistance is prioritized to primary-care providers, all providers will be encouraged to participate in outreach and educational opportunities made available through the program and the program will extend best practices in health IT implementation to all physicians.
The grants made available under Section 3013 of the PHS Act provide funding for the State Health Information Exchange Cooperative Agreement Program. This grant funding opportunity establishes funding through cooperative agreements to support efforts to achieve widespread and sustainable health information exchange (HIE) within and among states, and to facilitate and expand the secure, electronic movement and use of health information among organizations according to nationally recognized standards. state programs to promote HIE will help to realize the full potential of EHRs to improve the coordination, efficiency and quality of care. These grants will support statewide planning and implementation and funding for the states’ overall HIT strategy.
State Medicaid programs are a critical, decisional partner in these comprehensive statewide plans for the electronic exchange of health information. Additionally, CMS recognizes that Medicaid EHR incentives are one important part of overall planning efforts for statewide HIT adoption and HIE that will be supported by these grant programs.
Ultimately, the Recovery Act provisions are not solely about information systems or information technology, but about improving health care quality and leveraging a wide range of stakeholders and resources, existing and projected, to achieve this goal through the exchange of health information. Additional information on the Medicare and Medicaid EHR Incentive Programs, including a link to the text of the final rule, can be found at http://www.cms.gov/EHRIncentivePrograms.
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CMS FINALIZES REQUIREMENTS FOR THE MEDICAID ELECTRONIC HEALTH RECORDS (EHR) INCENTIVE PROGRAM The Centers for Medicare & Medicaid Services (CMS) today announced the final rule to implement the provisions of the American Recovery and Reinvestment Act of 2009 (Recovery Act) that provide incentive payments for the adoption and meaningful use of certified electronic health record (EHR) technology. The Medicare EHR incentive program will provide incentive payments to eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) that are meaningful users of certified EHRs. The Medicaid EHR incentive program will provide incentive payments to EPs and eligible hospitals for efforts to adopt, implement, upgrade, or meaningfully use certified EHR technology .
This fact sheet summarizes provisions in the final rule affecting state Medicaid programs and Medicaid providers.
The Office of the National Coordinator for Health Information Technology (ONC) is issuing a closely related final rule that completes the Secretary’s adoption of an initial set of standards, implementation specifications, and certification criteria for EHRs. ONC also issued a final rule establishing a temporary certification program for health information technology on June 24, 2010 and will issue a final rule for establishing a permanent program later this year.
The Recovery Act amended the Medicaid statute to provide for a 100 percent Federal financial participation (FFP) match for state expenditures for provider incentive payments to encourage Medicaid health care providers to adopt, implement, upgrade or meaningfully use certified EHR technology. It also established a 90 percent FFP match for reasonable state expenses related to administration of the incentive payments and to promote EHR adoption and health information exchange.
On September 1, 2009, CMS released a State Medicaid Director’s Letter that provided preliminary guidance on state expenses related to activities in support of the administration of incentive payments to providers. CMS has worked with all States and territories to facilitate their planning efforts for the purposes of administering the incentive payments to providers, ensuring their proper payments, and auditing and monitoring of such payments, and participating in statewide efforts to promote interoperability and meaningful use of EHRs. Subsequent guidance to States on implementation funding will be forthcoming.
The final rule CMS released today provides further guidance to states and Medicaid providers on the Medicaid EHR Incentive Program. CMS anticipates that the majority of States will launch their Medicaid EHR Incentive programs between January and August of 2011.
The Medicaid provisions of the final rule address seven topics:
The paragraphs below summarize the rule’s treatment of these topics.
Eligibility
The final rule:
Payments
The final rule:
For hospital payments, the calculation is:
(Overall EHR Amount) * (Medicaid Share) or Overall EHR Amount Equals {Sum over 4 year of [(Base Amount Plus Discharge Related Amount Applicable for Each Year) * Transition Factor Applicable for Each Year]} *
Medicaid Share Equals {(Medicaid inpatient-bed-days + Medicaid managed care inpatient-bed-days) divided by [(total inpatient-bed days) times (estimated total charges minus charity care charges) divided by (estimated total charges)]}
Adopting, Implementing, or Upgrading Certified EHR Technology
The final rule:
Demonstrating Meaningful Use of Certified EHR Technology
The final rule:
Conditions States Must Meet to Receive 90 Percent FFP
The final rule:
Financial Oversight/Combating Fraud and Abuse
The final rule:
The final rule may be viewed at http://www.cms.gov/EHRIncentivePrograms
Other Departmental HITECH Activities
ONC serves as the principal federal entity charged with coordinating the overall effort to implement a nationwide health information technology infrastructure that allows for the electronic use and exchange of health information.
Specifically, the ONC is authorized by Title XXX of the Public Health Service Act (PHS) to provide grant funding to support states’ efforts in achieving meaningful use of certified EHRs. To that end, on August 20, 2009, the Vice President announced the availability of two grant programs to help hospitals and health care providers implement and use EHRs.
The grants made available under Section 3012 of the PHS Act provide funding for Health Information Technology Regional Extension Centers that will provide primary care, small and solo practice clinicians with technical assistance in selection, acquisition, implementation and meaningful use of certified EHR technology. ONC has funded 60 new Health Information Technology Regional Extension Centers (RECs). The purpose of theRegionalExtensionCenterprogram is to provide physicians with the guidance and personalized support they need to adopt and meaningfully use EHRs. The objectives are to support 100,000 primary care providers in theUnited Statesand its territories by 2012. While direct REC assistance is prioritized to primary-care providers, all providers will be encouraged to participate in outreach and educational opportunities made available through the program and the program will extend best practices in health IT implementation to all physicians.
The grants made available under Section 3013 of the PHS Act provide funding for the State Health Information Exchange Cooperative Agreement Program. This grant funding opportunity establishes funding through cooperative agreements to support efforts to achieve widespread and sustainable health information exchange (HIE) within and among states, and to facilitate and expand the secure, electronic movement and use of health information among organizations according to nationally recognized standards. state programs to promote HIE will help to realize the full potential of EHRs to improve the coordination, efficiency and quality of care. These grants will support statewide planning and implementation and funding for the states’ overall HIT strategy.
State Medicaid programs are a critical, decisional partner in these comprehensive statewide plans for the electronic exchange of health information. Additionally, CMS recognizes that Medicaid EHR incentives are one important part of overall planning efforts for statewide HIT adoption and HIE that will be supported by these grant programs.
Ultimately, the Recovery Act provisions are not solely about information systems or information technology, but about improving health care quality and leveraging a wide range of stakeholders and resources, existing and projected, to achieve this goal through the exchange of health information. Additional information on the Medicare and Medicaid EHR Incentive Programs, including a link to the text of the final rule, can be found at http://www.cms.gov/EHRIncentivePrograms.
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