September 8, 2010


Part 2: Medicaid EHR Incentive Program

As we learned from the previous post outlining the Medicare EHR incentive program, it is absolutely imperative that everyone (especially potential eligible providers) draw a clear line between Medicare and Medicaid’s requirements, time lines and payments.
This post will serve to outline the basics of the Medicaid EHR incentive program to give providers a trusted source of information regarding who is eligible, how to enroll, how to qualify and how to report along the way.
Am I eligible to participate? To be considered an ‘eligible professional’ under the Medicaid system, you must fit into one of the following categories:
1. see a minimum 30% Medicaid patient volume and be a:

  • Physician
  • Physician Assistant
  • Nurse Practitioner
  • Certified Nurse-Midwife
  • Dentist

2. see a minimum 20% Medicaid patient volume and be a:

  • Pediatrician

3. serve in a physician assistant led Federally Qualified Health Center or Rural Health Clinic and:

  • Spend a minimum 50% of service time in the FQHC or RHC facility
  • Have a minimum 30% patient volume attributed to ‘need-based patients’

How do I enroll? Unlike the Medicare program, Medicaid requires no additional enrollment to participate.  If you see Medicaid patients and process claims with Medicare, you have the tools necessary to participate.
How do I qualify to receive the incentive payments? Medicaid has decided to award payments to any eligible professional for adopting, implementing, upgrading or demonstrating meaningful use of certified EHR technology in the first participation year. (demonstration of meaningful use is required for each subsequent year to qualify for payment)
How do I report that I have met these requirements? During the first year of the incentives Medicaid is currently building an online form where eligible providers can attest to having a certified system in place.
How much money do I get and when do I get it? The maximum Medicaid payments total $63,750, and the first payments may begin as early as January, 2011.  The Medicaid payments are based on individual state participation so it is important to check the status of your particular state.
For more information on the Medicaid EHR incentive program visit the CMS Medicaid website.

About ifroehlich

Ms. Froehlich has been with DrFirst since its inception in 2000. In her role as Director of Marketing, she oversees the planning, directing, and coordinating all marketing and public relations efforts at DrFirst. Ms. Froehlich has a B.S. in Communications from the University of Illinois, Champaign-Urbana.