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Check your progress toward Meaningful Use with this EHR Participation Timeline.

 

As an Eligible Provider, you must meet 3 Stages of Meaningful Use of your EMR in order to receive your reimbursement from Medicare or Medicaid. You may qualify for one or the other, or both, but not at the same time. Each year you qualify, you will receive a reimbursement check. The steps for qualifying are:

  • Purchase and use your EMR for 90 days
  • Determine to meet Medicare or Medicaid requirements
  • Attest online to Stage 1 meaningful use (see Attestation below)
  • Continue using your EMR as described in Stage 2 meaningful use
  • Attest online to Stage 2 when complete

Stage 2 Meaningful Use Core and Menu Criteria

Eligible Professionals must report – or attest – on all 17 Core Criteria:

  1. Use computerized provider order entry (CPOE) for medication, laboratory and radiology orders
  2. Generate and transmit permissible prescriptions electronically (eRx)
  3. Record demographic information
  4. Record and chart changes in vital signs
  5. Record smoking status for patients 13 years old or older
  6. Use clinical decision support to improve performance on high-priority health conditions
  7. Provide patients the ability to view online, download and transmit their health information
  8. Provide clinical summaries for patients for each office visit
  9. Protect electronic health information created or maintained by the Certified EMR Technology
  10. Incorporate clinical lab-test results into Certified EMR Technology
  11. Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, or outreach
  12. Use clinically relevant information to identify patients who should receive reminders for preventive/follow-up care
  13. Use certified EMR technology to identify patient-specific education resources
  14. Perform medication reconciliation
  15. Provide summary of care record for each transition of care or referral
  16. Submit electronic data to immunization registries
  17. Use secure electronic messaging to communicate with patients on relevant health information

Plus any 3 of these 6 Menu Criteria:

  1. Submit electronic syndromic surveillance data to public health agencies
  2. Record electronic notes in patient records
  3. Imaging results accessible through CEHRT
  4. Record patient family health history
  5. Identify and report cancer cases to a State cancer registry
  6. Identify and report specific cases to a specialized registry (other than a cancer registry)

Read the entire Stage 2 Meaningful Use description.

For more details and to register for Meaningful Use, visit the EMR Incentive Program Site or the CMS web site.

Stage 1 Meaningful Use Core and Menu Criteria

Eligible Professionals must purchase and use their EMR for 90 days, then report – or attest – on all 10 of these Core criteria:

  1. Demographics (50%)
  2. Vitals: BP and BMI (50%)
  3. Problem list: ICD-9-CM or SNOWMED (80%)
  4. Active medication list (80%)
  5. Medication allergies (80%)
  6. Smoking status (50%)
  7. Patient clinical visit summary (50% in 3 days)
  8. Hospital discharge instructions OR patient with electronic copy (50%) OR (50% in 3 days)
  9. e-Prescribing (40%)
  10. CPOE (30% including a med)
  11. Drug-drug and drug-allergy interaction (functionality enabled)
  12. Exchange critical information (perform test)
  13. Clinical decision support (one rule)
  14. Security risk analysis
  15. Report clinical quality (BP, BMI, Smoke, plus 3 others)

Plus any 5 of these 10 menu criteria:

  1. Drug-formulary checks (one report)
  2. Structured lab results (40%)
  3. Patients by conditions (one report)
  4. Send patient-specific education (10%)
  5. Medication reconciliation (50%)
  6. Summary care record at transitions (50%)
  7. Feed immunization registries (perform at least one test)
  8. Hospital Advance medical directives (50% > 65yrs.)
  9. Send reminders to patients for preventative and follow-up care (20% > 65yrs. < 5yrs.)
  10. Patient electronic access to labs, problems, meds and allergies (10% in 4 days)

Attestation

Once you have met all the criteria for Stage One, you will need to complete the Attestation provided by the Center for Medicare and Medicaid Services (www.cms.gov) as proof your practice is eligible to receive stimulus reimbursement. The Attestation is comprised of a series of questions which must be satisfactorily answered in order to qualify.

You will attest for each stage separately, once you have completed the criteria.

Calculate your reimbursement. Select the tab for the first year you will have 90 days of use for Stage 1, then move down the column for either Medicare or Medicaid to see how much your reimbursement can be each year. Remember, you can attest for Medicare or Medicaid or both, but not at the same time.

 

Medicare

  • 2013: $15,000
  • 2014: $12,000
  • 2015: $8,000
  • 2016: $4,000


Total: $39,000

Medicaid

  • 2013: $21,500
  • 2014: $8,500
  • 2015: $8,500
  • 2016: $8,500
  • 2017: $8,500
  • 2018: $8,500


Total: $63,750

*Totals estimated if EP does not switch programs

Medicare

  • 2014: $12,000
  • 2015: $8,000
  • 2016: $4,000


Total: $24,000

Medicaid

  • 2014: $21,500
  • 2015: $8,500
  • 2016: $8,500
  • 2017: $8,500
  • 2018: $8,500
  • 2019: $8,500


Total: $63,750

*Totals estimated if EP does not switch programs

Medicare

Total: $0.00

Medicaid

  • 2015: $21,500
  • 2016: $8,500
  • 2017: $8,500
  • 2018: $8,500
  • 2019: $8,500
  • 2020: $8,500


Total: $63,750

*Totals estimated if EP does not switch programs

Medicare

Total: $0.00

Medicaid

  • 2016: $21,500
  • 2017: $8,500
  • 2018: $8,500
  • 2019: $8,500
  • 2020: $8,500
  • 2021: $8,500


Total: $63,750

*Totals estimated if EP does not switch programs

 

Medicare

  • 2012: $18,000
  • 2013: $12,000
  • 2014: $8,000
  • 2015: $4,000
  • 2016: $2,000


Total: $44,000

Medicaid

  • 2012: $21,250
  • 2013: $8,500
  • 2014: $8,500
  • 2015: $8,500
  • 2016: $8,500
  • 2017: $8,500


Total: $63,750

*Totals estimated if EP does not switch programs

  

 

What is Meaningful Use and the ARRA stimulus program?

The American Recovery and Reinvestment Act (ARRA) has budgeted $19.2 billion to invest in healthcare IT. One of these initiatives is the implementation of Electronic Health Records, or EMR (also referred to as EMR). The term “meaningful use” refers to a set of EHR/EMR performance criteria broken out across five stages over five years, that medical providers must meet in order to prove that they are using an EMR in their practice in a meaningful way. If providers meet all the criteria, they qualify to receive ARRA incentive funds. Stage 1 and Stage 2 criteria are listed below.

 

Requirements for Ambulatory Practice Eligibility

Eligible Medicaid providers include:

  1. A non-hospital based provider who see at least 30% of Medicaid insured patients
  2. A non-hospital based pediatrician who see at least 20% of Medicaid insured patients
  3. A provider who practices in FQHC with at least 30% needy patients

Eligible Medicare providers include:

  1. Doctor of medicine or osteopathy
  2. Doctor of dental surgery or dental medicine
  3. Doctor of podiatry
  4. Doctor of optometry
  5. Chiropractor
 

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