The Medicaid EHR Incentive Program is limited to Eligible Professionals (EPs) for six years of participation, and Eligible Hospitals (EHs) for three years. The program provides incentive payments to EPs and EHs as they adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology. The program is slated to end in 2022 but eligible providers interested in participating must begin the application process by 2016.
- Physicians (M.D. and D.O.)
- Nurse Practitioners
- Certified Nurse-Midwives
- Physician assistants (who furnish services in a Federally Qualified Health Center or Rural Health Clinic that is led by a physician assistant)
To qualify for an incentive payment under the Medicaid EHR Incentive Program, an Eligible Professional must meet one of the following criteria:
- Have a minimum 30% Medicaid patient volume*
- Have a minimum 20% Medicaid patient volume, and is a pediatrician*
- Practice predominantly in a Federally Qualified Health Center or Rural Health Center and have a minimum 30% patient volume attributable to needy individuals
* Children's Health Insurance Program (CHIP) patients do not count toward the Medicaid patient volume criteria.
Adopt, Implement, Upgrade & Meaningful Use
Eligible Professionals must adopt (acquire and install), implement (training), upgrade (expand functionality with new version, etc.) or demonstrate meaningful use of the certified EHR technology during Year 1 of their program participation. In all subsequent years, providers must demonstrate meaningful use (i.e. how the technology moves beyond being a digital medical chart to being a valuable tool to transform health care service delivery and improve outcomes).
Certified EHR Technology
The Medicaid EHR Incentive Program requires that all EHR products and systems must be certified by the Office of the National Coordinator for Health Information Technology (ONC). For more information, visit the ONC website at https://chpl.healthit.gov/#/search.
Eligible Professionals cannot be hospital-based, and must meet a 30 percent minimum Medicaid patient volume threshold. For pediatricians, the minimum threshold is 20 percent with reduced incentive payments. However, pediatricians may qualify to receive the full incentive payment if they can demonstrate that they meet the minimum 30 percent Medicaid patient volume requirements.
For those meeting all program requirements, Eligible Professionals (excluding pediatricians) may receive a total of up to $63,750 during their six years of program participation. The Year 1 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.
Patient Volume Calculator
Eligible Professionals can download the Patient Volume Calculator to help expedite the patient volume calculation step when registering with the State of Georgia for the incentive payment. Eligible Professionals attesting for Program Year 2016 must use the 2016 Patient Volume Calculator. This process is explained in further detail in the Patient Volume Calculator video. The public health districts attesting for Program Year 2016 must use the 2016 DPH Patient Volume Calculator. This Patient Volume Calculator was created exclusively for the Department of Public Health and includes an additional button titled, “DPH Concierge".
To help facilitate the technology conversions and to assist providers in completing requirements, the Medicaid EHR Incentive Program has partnered with HP Enterprise Services and the Georgia Health Information Technology Extension Center (GA-HITEC), which will work with providers on all facets of the program—from completing the application process, to selecting, implementing and using health information technology.
EHR Selection/Meaningful Use Inquiries
Step One: Register with CMS.
Eligible Professionals must first register on the CMS Registration and Attestation System website at https://ehrincentives.cms.gov/hitech/login.action.
Step Two: Register with the State of Georgia.
Eligible Professionals must have registered for web access through their existing Georgia Medicaid web portal account (https://www.mmis.georgia.gov/portal/default.aspx) prior to registration for a Medicaid EHR incentive payment.
- EHR Fact Sheet for Eligible Professionals
- EHR FAQs for Eligible Professionals
- Medicaid EHR Incentive Program Toolkit for EPs
- EHR Tip Sheet for Providers