Deadline nears for maximum Medicare EHR incentives

June 9, 2012

Health care practitioners have just a few months to ensure they earn the maximum possible payments through the Medicare Electronic Health Records (EHR) Incentive Program, according to the AOA Health Information Technology (HIT) Subcommittee.

In fact, they must act within the next 90 days, AOA HIT Subcommittee Chair Philip Gross, O.D., noted.

Under the Medicare EHR Incentive Program, health care practitioners can earn up to a total of $44,000 ($48,400 in federally designated health professional shortage areas) over the six-year life of the program if they install EHR systems that are certified for use under the program and achieve compliance with the program’s EHR utilization criteria, known as “meaningful use” standards.

Health care practitioners can earn incentives for up to five years while the program is in effect.

The incentive program began in 2011 and runs through the end of 2016.

However, in order to realize the maximum total incentives, practitioners must enter the program during the first two years.

“That means optometrists who did not implement a certified EHR system and meet the meaningful use standards during 2011, must do so before the end of 2012 to achieve the maximum financial benefit,” Dr. Gross said.

To qualify for Medicare EHR incentives during their first year of participation in the program, practitioners must achieve compliance with the meaningful use standards over a 90-day reporting period. That means practitioners who wish to earn a first round of Medicare EHR incentives this year must install a certified EHR and achieve meaningful use by about Oct. 1, Dr. Gross said.

Federal officials generally estimate practitioners need about 90 days to select and implement an EHR system.

“That means practitioners who want to earn the maximum potential incentives need to act now,” Dr. Gross said.

Federal law authorizes first year payments of up to $18,000 for health care practitioners who enter the Medicare EHR Incentive Program in 2011 or 2012.

That maximum first-year payment drops to $15,000 for those who enter the program in 2013, and then to $12,000 for those who enter in 2014.

Health care practitioners must register for the Medicare EHR incentive program no later than the end of 2014.

In addition to reducing the maximum amount they can earn during their first year in the incentive program, practitioners who enter the program after 2012 will reduce the number of years during which they can qualify for incentives.

After earning an initial, first-year incentive payment, practitioners can earn up to $12,000 for a second year of participation in the program, up to $8,000 during their third year, up to $4,000 during their fourth year, and up to $2,000 in their fifth year.

However, federal law stipulates no incentive payments can be made under the program after 2016.

“That means health care practitioners who enter the program in 2013 will effectively deny themselves the opportunity to qualify for a fifth incentive payment; practitioners who wait until 2014 will deny themselves their last two potential payments,” Dr. Gross said.

AOA resources

A list of Certified EHR Programs for Optometrists is available on the AOA website EHR page (www.aoa.org/ehr).
The AOA EHR Web page lists the Medicare EHR program’s 25 meaningful use objectives (with 15 required or “core” objectives and 10 “menu” objectives, from which practitioners can select five).

The AOA’s “Navigating Meaningful Use, Quality Reporting, and e-Prescribing with EHRs” courses will be offered this month at Optometry’s Meeting® and at a half dozen state optometric association meetings before the end of this year.

The three two-hour classes are designed to provide the specific HIT guidance practitioners need, whether they are just now planning to initiate EHRs in the office, implementing basic HIT functions such as e-prescribing, hoping to earn substantial Medicare or Medicaid incentive payments by meeting government standards for the “meaningful use” of EHRs, or planning to use HIT to facilitate participation in Medicare’s Physician Quality Reporting System (PQRS) program.

  • “EHR Software Selection and Implementation” is an entry-level HIT course for optometrists who plan to implement EHR technology in the coming months.
  • “EHR Incentive Programs and Meaningful Use Update” is a more advanced course for practitioners who have already implemented EHRs and are now preparing to take part in the Medicare or Medicaid EHR incentive program.
  • “PQRS and e-Prescribing Made Easy” explains how EHR systems can facilitate participation in the Medicare PQRS or other quality reporting programs.

Optometrists should check with their respective state optometric associations to find out which Navigating with EHR courses will be offered during their meetings.

Demonstrations of EHR systems will be offered by leading software vendors following the courses at Optometry’s Meeting®.

All three of the lectures are COPE-approved.

The AOA EHR Web page and courses have been developed as part of the AOA EHR Preparedness Program for Optometry, sponsored by Codex Techworks, Compulink, Eyefinity, First Insight, FoxFire Systems Group, Kowa, Marco, Practice Director (a division of the Williams Group), QuikEyes, and RevolutionEHR.

Navigating Meaningful Use, Quality Reporting, and e-Prescribing with EHRs

AOA affiliate and EHR course dates:
Indiana July 11, 2012
Mississippi Aug. 25, 2012
Kentucky Sept. 29, 2012
Connecticut Oct. 13, 2012
California Nov. 9-10, 2012
Arizona Dec. 8-9, 2012

By the numbers

Program rules mean health care practitioners who implement certified EHRs and meet meaningful use standards during 2012 can still potentially qualify for a maximum five-year total of $44,000 (consisting of payments of $18,000 for 2012, $12,000 for 2013, $8,000 for 2014, $4,000 for 2015 and $2,000 for 2016).

For practitioners who enter the incentive program during 2013, the maximum incentive total will effectively be reduced by $5,000 to $39,000 (consisting of payments of $15,000 in 2013, $12,000 in 2014, $8,000 in 2015, and $4,000 in 2016).

Health care practitioners who wait until 2014 will see their maximum total reduced to $24,000 (with potential payments of $12,000 in 2014, $8,000 in 2015, and $4,000 in 2016).

“Beginning in 2015, the CMS may reduce Medicare payments for physicians who are not meaningfully using EHRs in 2013,” Dr. Gross said. “Therefore, in addition to earning bonus payments now, all optometrists should consider implementing EHRs immediately to avoid Medicare payment reductions in the near future.”

Medicare EHR incentives are set at 75 percent of the practitioner’s total Medicare approved payments for the year, up to specified limits.

To help ensure receipt of the maximum possible bonuses under the Medicare EHR incentive program, the AOA HIT Subcommittee recommends optometrists register for the program online as soon as possible using the Medicare EHR Incentive Program Registration and Attestation System Web page (https://ehrincentives.cms.gov).

Health care practitioners need not have a certified EHR system in place to register for the program, the U.S. Centers for Medicare & Medicaid Services emphasized.

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