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ONC – ATCB: EHR Certification Meaningful Use STAGE 1

The Medicare and Medicaid EHR Incentive Programs will provide incentive payments to eligible professionals, eligible hospitals and critical access hospitals (CAHs) as they adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology.

Electronic Health Record (EHR) or Electronic Medical Record (EMR)?

Sometimes people use the terms "Electronic Medical Record" or "EMR" when talking about Electronic Health Record (EHR) technology. Very often an Electronic Medical Record or EMR is just another way to describe an Electronic Health Record or EHR, and both providers and vendors sometimes use the terms interchangeably. For the purposes of the Medicare and Medicaid Incentive Programs, eligible professionals, eligible hospitals and critical access hospitals (CAHs) must use ¬certified EHR technology. Certified EHR technology gives assurance to purchasers and other users that an EHR system or module offers the necessary technological capability, functionality, and security to help them meet the meaningful use criteria. Certification also helps providers and patients be confident that the electronic health IT products and systems they use are secure, can maintain data confidentially, and can work with other systems to share information.

Certification for the Medicare and Medicaid EHR Incentive Programs

The Medicare and Medicaid EHR Incentive Programs require the use of certified EHR technology. Standards, implementation specifications, and certification criteria for EHR technology have been adopted by the Secretary of the Department of Health and Human Services. EHR technology must be tested and certified by an Office of the National Coordinator (ONC) Authorized Testing and Certification Body (ATCB) in order for a provider to qualify for EHR incentive payments.

IMPORTANT: Even if you are already using EHR technology, it must be tested and certified by an ONC-ATCB specifically for the Medicare and Medicaid EHR Incentive Programs.

What is "Meaningful Use"?

The American Recovery and Reinvestment Act of 2009 specifies three main components of Meaningful Use:

  • The use of a certified EHR in a meaningful manner, such as e-prescribing.
  • The use of certified EHR technology for electronic exchange of health information to improve quality of health care.
  • The use of certified EHR technology to submit clinical quality and other measures.

Simply put, "meaningful use" means providers need to show they're using certified EHR technology in ways that can be measured significantly in quality and in quantity.

CMS EHR Meaningful Use Criteria Summary

The criteria for meaningful use will be staged in three steps over the course of the next five years.

  • Stage 1 (2011 and 2012) sets the baseline for electronic data capture and information sharing.
  • Stage 2 (expected to be implemented in 2013) and Stage 3 (expected to be implemented in 2015) will continue to expand on this baseline and be developed through future rule making.

The HITECH Act specifies that physicians can qualify for $44,000 or more in economic stimulus incentives for adopting a Certified EHR. The government is putting in $19.2 billion dollars to help move all doctors off paper records onto electronic systems.

Incentives are paid per provider. Each practitioner in your practice will qualify for $44,000 in Medicare Incentives or $63,750 in Medicaid Incentives.

Core Measures (All Required)

  • CPOE Medication Orders
  • Drug Interaction Checks
  • Maintain Problem List
  • e-Prescribing (eRx)
  • Active Medication List
  • Medication Allergy List
  • Record Demographics
  • Record Vital Signs
  • Record Smoking Status
  • Clinical Quality Measures (CQMs)
  • Clinical Decision Support Rule
  • Electronic Copy of Health Information
  • Clinical Summaries
  • Electronic Exchange of Clinical Information
  • Protect Electronic Health Information

Menu Set Measures (Any 5 of 10 needed)

  • Drug Formulary Check
  • Clinical Lab Test Results
  • Patients Lists
  • Patient Reminders
  • Patient Electronic Access
  • Patient-Specific Educational Resources
  • Medication Reconciliation
  • Transition of Care Summary
  • Immunization Registries Data Submission
  • Syndromic Surveillance Data Submission

Medicare EHR Incentive Payment Schedule

Year of adoption Incentive payout over time
Payment Amount for 2011 $18,000
Payment Amount for 2012 $12,000 $18,000
Payment Amount for 2013 $8,000 $12,000 $15,000
Payment Amount for 2014 $4,000 $8,000 $12,000 $12,000
Payment Amount for 2015 $2,000 $4,000 $8,000 $8,000
Payment Amount for 2016   $2,000 $4,000 $4,000
Total Payment Amount $44,000 $44,000 $39,000 $24,000

Medicaid EHR Incentive Payment Schedule

Year Incentive payout over time
2011 $21,250.00 $0.00 $0.00 $0.00s $0.00 $0.00
2012 $8,500.00 $21,250.00 $0.00 $0.00 $0.00 $0.00
2013 $8,500.00 $8,500.00 $21,250.00 $0.00 $0.00 $0.00
2014 $8,500.00 $8,500.00 $8,500.00 $21,250.00 $0.00 $0.00
2015 $8,500.00 $8,500.00 $8,500.00 $8,500.00 $21,250.00 $0.00
2016 $8,500.00 $8,500.00 $8,500.00 $8,500.00 $8,500.00 $21,250.00
2017 $0.00 $8,500.00 $8,500.00 $8,500.00 $8,500.00 $8,500.00
2018 $0.00 $0.00 $8,500.00 $8,500.00 $8,500.00 $8,500.00
2019 $0.00 $0.00 $0.00 $8,500.00 $8,500.00 $8,500.00
2020 $0.00 $0.00 $0.00 $0.00 $8,500.00 $8,500.00
2021 $0.00 $0.00 $0.00 $0.00 $0.00 $8,500.00
Total $63,750.00 $63,750.00 $63,750.00 $63,750.00 $63,750.00 $63,750.00

Types of health care providers that can qualify

  • Hospitals
  • Skilled nursing facilities
  • Nursing facilities
  • Home health entities
  • Long term care facilities
  • Health care clinics
  • Community mental health centers
  • Renal dialysis facilities
  • Blood centers
  • Ambulatory surgical centers
  • Emergency medical service providers
  • Federally qualified health centers (FQHC)
  • Group practices
  • Pharmacists
  • Laboratories
  • Physicians
  • Practitioners
  • Indian Health Service providers
  • Rural health clinics
  • Therapists

Who is an Eligible Professional under the Medicare EHR Incentive Program?

Eligible professionals under the Medicare EHR Incentive Program include:

  • Doctor of medicine or osteopathy
  • Doctor of dental surgery or dental medicine
  • Doctor of podiatry
  • Doctor of optometry
  • Chiropractor

Who is an Eligible Professional under the Medicaid EHR Incentive Program?

Eligible professionals under the Medicaid EHR Incentive Program include:

  • Physicians (primarily doctors of medicine and doctors of osteopathy)
  • Nurse practitioner
  • Certified nurse-midwife
  • Dentist
  • Physician assistant who furnishes services in a Federally Qualified Health Center or Rural Health Clinic that is led by a physician assistant.

* Children's Health Insurance Program (CHIP) patients do not count toward the Medicaid patient volume criteria.

To qualify for an incentive payment under the Medicaid EHR Incentive Program, an eligible professional must meet one of the following criteria:

  • Have a minimum 30% Medicaid patient volume*
  • Have a minimum 20% Medicaid patient volume, and is a pediatrician*
  • Practice predominantly in a Federally Qualified Health Center or Rural Health Center and have a minimum 30% patient volume attributable to needy individuals

Qualifying geographic locations

  • All 50 US States
  • District of Columbia
  • Puerto Rico
  • The Virgin Islands Guam
  • American Samoa
  • The Northern Mariana Islands

Important dates to remember

  • October 1, 2010 - Reporting year begins for eligible hospitals and CAHs.
  • January 1, 2011 - Reporting year begins for eligible professionals.
  • January 3, 2011 - Registration for the Medicare EHR Incentive Program begins.
  • January 3, 2011 - For Medicaid providers, states may launch their programs if they so choose.
  • April 2011 - Attestation for the Medicare EHR Incentive Program begins.
  • May 2011 - EHR Incentive Payments expected to begin.
  • July 3, 2011 - Last day for eligible hospitals to begin their 90-day reporting period to demonstrate meaningful use for the Medicare EHR Incentive Program.
  • September 30, 2011 - Last day of the federal fiscal year. Reporting year ends for eligible hospitals and CAHs.
  • October 1, 2011 - Last day for eligible professionals to begin their 90-day reporting period for calendar year 2011 for the Medicare EHR Incentive Program.
  • November 30, 2011 - Last day for eligible hospitals and critical access hospitals to register and attest to receive an Incentive Payment for Federal fiscal year (FY) 2011.
  • December 31, 2011 - Reporting year ends for eligible professionals.
  • February 29, 2012 - Last day for eligible professionals to register and attest to receive an Incentive Payment for calendar year (CY) 2011.