Fact Sheet Medicaid EHR Incentive Program Overview The Health Information Technology for Economic and Clinical Health (HITECH) Act established programs under the Centers for Medicare and Medicaid Services (CMS) to provide incentive payments for the meaningful use of certified electronic health record (EHR) technology by eligible providers. Georgia's Medicaid EHR Incentive Program is a multiyear, multi-stage program administered by the Georgia Department of Community Health (DCH). CMS administers the Medicare incentive program. Program Goals Georgia's Medicaid EHR Incentive Program serves two main goals: Instill and support the use of EHRs in meaningful ways to help Georgia and the nation improve the quality, safety and efficiency of patient care Incentivize Georgia's providers to participate in the transformation of our nation's health care system Program Participation The program is limited to eligible Medicaid professionals for six years of participation, and eligible Medicaid hospitals for three years. Participants must use certified EHR technology and meet all eligibility requirements. Participation is voluntary and 100 percent federally funded. Eligible Medicaid Professionals Defined as: Physicians (M.D. and D.O.) Nurse Practitioners Certified Nurse-Midwives Dentists Physician Assistants (under limited circumstances) Professionals cannot be hospital-based, and they must meet 30 percent minimum Medicaid patient volume thresholds. For pediatricians, the minimum threshold is 20 percent with reduced incentive payments. Eligible Medicaid Hospitals Defined as: Acute Care Hospitals (including Critical Access Hospitals) must meet a 10 percent minimum Medicaid patient volume 1 of 3 Georgia Department of Community Health | 2 Peachtree Street NW, Atlanta, GA 30303 | www.dch.georgia.gov | 404-656-4507 June 2013 jk-6-11-13 Fact Sheet Medicaid EHR Incentive Program Children's Hospitals are not required to meet patient volume thresholds and cannot be pediatric wings of larger hospitals Certified EHR Technology Certification of the EHR technology by an Office of the National Coordinator-Authorized Testing and Certification Body (ONC-ATCB) is required. Certification assures purchasers and users that an EHR system or product module offers the necessary technological capability, functionality and security to satisfy meaningful use objectives. Adopt, Implement, Upgrade & Meaningful Use Participants must: Adopt (acquire and install) Implement (commence usage of ) Upgrade (expand functionality with new version, etc.) or Demonstrate meaningful use of the technology during year one of their program participation. In all subsequent years of program participation, providers must demonstrate meaningful use (i.e., show that they are "meaningfully using" their EHR technology to meet thresholds for a number of objectives). Requirements Participants must: Meet the eligibility requirements Attain applicable Medicaid patient volume thresholds Adopt, implement, upgrade or meaningfully use certified EHR technology Register with CMS and the State of Georgia Provide the necessary Attestation of certified EHR usage Incentives for Eligible Medicaid Professionals For those meeting all program requirements, eligible professionals (excluding pediatricians) may receive up to $63,750 total during their six years of program participation. The Year One payment is $21,250; each subsequent year is $8,500. The total incentive for pediatricians who meet the 20 percent patient volume threshold but fall short of the 30 percent patient volume threshold is $14,167 in the first year and $5,667 in each subsequent year. This adds up to a maximum Medicaid EHR incentive payment of $42,500 that may be paid over a six-year period. Incentives for Eligible Medicaid Hospitals Hospital incentive payments are based on a number of factors, beginning with a base payment. The aggregate payment will be divided into three payments: 40 percent in Payment Year One, 40 percent in Payment Year Two and 20 percent in Payment Year Three. (Note: Certain hospitals may qualify for both the Medicaid and Medicare incentive programs.) 2 of 3 Fact Sheet Medicaid EHR Incentive Program Registration In Payment Year One, adoption/implementation/upgrade or demonstration of meaningful use is NOT required at the time of registration and attestation at the federal level. However, it is required for your registration and attestation at the state level. Federal registration is available now through the CMS website: www.cms.gov/EHRIncentive Programs/. State of Georgia registration is available at www.mmis.georgia.gov after you receive your "Welcome" e-mail. Incentive Payments An attestation of certified EHR usage including the applicable patient volume and incentive payment calculators must be submitted during the state level registration process and approved by DCH for an incentive payment. Once approved, allow at least 30 45 days for payment. There is only one incentive payment per year, and providers must reapply every year. For More Information Visit these resources to learn more: CMS Medicare & Medicaid Incentive Program: www.cms.gov/EHRIncentivePrograms/ DCH Georgia Medicaid EHR Incentive Program: www.dch.georgia.gov/ehr GA-HITEC Technical Assistance to meet meaningful use: www.GA-HITEC.org or 404-752-1184 or 877-658-1990 Office of the National Coordinator List of Certified EHR Technology: healthit.hhs.gov/chpl Hewlett-Packard Enterprise Services (HPES) For assistance completing the Patient Volume Calculator or Registration, please utilize the "Contact Us" option at www.mmis.georgia.gov or call 1-800-766-4456. 3 of 3