Changes in EHR Incentive Payments

Written by on April 3, 2012 in Law & Finance - No comments
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Medicare/Medicaid EHR Incentive programs payments have been reassigned. Is your practice covered?

By Judy Know & Jill Girardeau

The Health Information Technology for Economic and Clinical Health (HITECH) Act provides incentive payments through the Medicare and Medicaid programs to hospitals and certain individual health care providers – referred to as eligible professionals – that adopt and “meaningfully use” certified electronic health records (EHR) technology. Please note that hospitals may receive the payments directly from the Medicare and Medicaid programs. A reassignment from an eligible professional is not necessary to receive such payments. However, a hospital affiliated medical practice that employees eligible professionals will not be able to receive EHR incentive payments unless its eligible professional has reassigned their rights to such payments to the medical practice. As more individual health care providers receive these payments, an increasing number of medical practices have inquired about receiving these payments via reassignment from the individual providers. Under the Medicare program, eligible professionals include physicians, dentists, chiropractors, podiatrists and optometrist. Hospital-based professionals who provide substantially all (i.e. 90 percent) of their services in an inpatient or emergency room setting, such as emergency physicians, anesthesiologists, hospitalists and pathologists, are not eligible to receive payments from the Medicare program. Under the Medicaid program, eligible professionals include physicians, dentists, certified nurse-midwives, nurse practitioners and physician assistants who lead rural health clinics or federally qualified health centers who meet certain Medicaid volume criteria. Please not that the Medicare EHR Incentive Program will provide incentive payments to eligible professionals, eligible hospitals and critical access hospitals that demonstrate meaningful use of certified EHR technology. The Medicaid Incentive Program will provide incentive payments to eligible professionals, eligible hospitals and critical access hospitals as they adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology.

The HITECH Act and the related rules do not provide for automatic payment of the EHR incentive payments to an eligible professional’s medical practice (including a medical practice affiliated with a hospital) or other entity which bills for the eligible professional’s services. However, the HITECH Act and the related rules do permit (but do not require) eligible professionals to reassign their right to receive the HER incentive payments to an employer or other entity with which they have a contractual arrangement allowing the entity to bill for the services of the eligible professionals. It is important to note that each eligible professional may reassign the entire amount of the incentive program to only one employer or entity. An eligible professional may also reassign his or her incentive payments to a state-designed entity promoting the adoption of certified EHR technology. This reassignment must be consistent with the general rules governing reassignment of Medicare and Medicaid payments. As a result, medical practices, medical practice foundations, community clinics and hospital outpatient clinics that bill for their eligible professional’s services may receive the EHR incentive payments, provided that these organizations have taken appropriate steps to ensure receipt of such payments

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