AOA advocacy ensures ODs can earn Medicaid incentives in 10 states

June 19, 2013

Medicaid Electronic Health Records (EHR) incentive programs are expected to open to optometrists in 10 states thanks to efforts by the AOA Advocacy Group and affiliated state optometric associations. Participating practitioners can earn much greater incentives through the Medicaid programs than through Medicare in Alabama, Ohio, Illinois, Michigan, Kentucky, Louisiana, South Carolina, Virginia, New Jersey, and soon in Maryland.

Those extra incentive dollars can be important in helping practitioners who serve low-income populations implement EHRs and ensure their patients have the benefits of state-of-the-art health information technology.

Under the Medicaid EHR Incentive Program, health care practitioners who demonstrate they have billed at least 30 percent of their insurance claims to Medicaid during a 90-day reporting period can qualify for up to $63,750 in incentives over the six-year life of the incentive program. This is more than 40 percent higher than the Medicare EHR Incentive Program, which by comparison offers up to $44,000 ($48,400 in federally designated Health Professional Shortage Areas).

Last year, optometrists in only five states were participating in Medicaid EHR incentive programs. Four years ago, only two states offered Medicaid EHR incentives to optometrists.

Like Medicare, state Medicaid agencies offer incentive payments to health care practitioners who install EHR systems certified for use under federal EHR incentive programs and that meet specific standards.

However, to participate in a state Medicaid EHR incentive program, optometrists must be formally designated as providers of physician services under the state’s Medicaid plan – a set of federally required operating rules for Medicaid programs. While optometrists routinely provide physician services under virtually all state Medicaid programs, not all states have taken the step of formally designating optometrists as providers of physician services.

Maryland is expected to become the latest state to open its Medicaid EHR incentive program to optometrists. The Maryland Department of Health and Mental Hygiene authorized the necessary change in the state Medicaid plan following a meeting with Maryland Optometric Association (MOA) representatives last year, according to MOA Executive Director Jennifer Thornton.

When the federal government’s EHR incentive initiative was launched in 2009, the AOA Advocacy Group provided all state Medicaid programs with information on the benefits of including optometrists in their state EHR incentives programs.

State optometric associations seeking further assistance in approaching state Medicaid agencies regarding EHR incentive programs should contact Brian Reuwer at BReuwer@aoa.org.

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