Medicaid EHR Incentive Payments. EHR Incentive Payments are available through the Medicaid program to: Physicians Nurse Practitioners Nurse Midwives Rural.

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Presentation transcript:

Medicaid EHR Incentive Payments

EHR Incentive Payments are available through the Medicaid program to: Physicians Nurse Practitioners Nurse Midwives Rural Health Clinics Federally Qualified Health Centers

Medicaid Incentive In order for a physician, nurse practitioner or nurse midwife to be eligible for a Medicaid bonus payment, at least 30% of the physician, NP or CNM patient visits must be Medicaid recipients.

Rural Health Clinic and FQHC EHR Incentive Payments RHC and FQHCs can receive bonus payments through the physicians, NPs, CNMs or PAs who practice predominantly in a rural health clinic. In the case of PAs, the clinic must be “PA led”. In addition, at least 30 percent of the RHC or FQHC providers’ patient volume must be attributable to “needy” individuals

Who is a “Needy Individual” Someone who is receiving assistance under Medicaid Someone who is receiving assistance S-CHIP Someone who is furnished un-compensated care by the provider; Someone for whom charges are reduced by the provider on a sliding scale basis based on an individual's ability to pay.

RHCs and FQHCs can receive an amount not in excess of 85 percent of net average allowable costs for certified EHR technology (and support services including maintenance and training that is for the adoption and operation of, such technology

What is Average Allowable Cost? The term `average allowable costs' means the average costs for the purchase and initial implementation or upgrade of such technology (and support services including training that is necessary for the adoption and initial operation of such technology.

Limits on Medicaid Incentive Payments In no case shall— *the net average allowable costs under this subsection for the first year of payment exceed $25,000 *the net average allowable costs under this subsection for a subsequent year of payment, exceed $10,000

Double dipping? An eligible professional shall not qualify as a Medicaid provider under this subsection unless any right to payment under Medicare with respect to the eligible professional has been waived.

Incentive Limits In No Case, shall payments be made for costs after 2021 OR over a period of longer than 5 years. Total Incentive – PER PROVIDER: $65,000 over 5 years.