- Provider for Medicare or Medicaid;
- Be a meaningful EHR user
- Physicians must qualify
- Proves to have implemented a qualified EHR software and be interoperable
Physicians with a qualified EHR, qualified EMR in place before 2011 or 2012 will be eligible for the maximum Medicare incentive payments allowed by the stimulus package. Doctors who have not adopted an EHR before 2015 and who fail to obtain a hardship exemption will see a 1% cut to Medicare pay, a reduction that phases up to 3% for 2017 and remains each year after that.
In 2011, however, the reward for e-prescribing will begin to decrease, a fee for not using e-prescribing will begin in 2012. The e-prescribing incentive payment will be 1 percent in 2011 and 2012, and 0.5 percent in 2013. The fee for not using e-prescribing will be a reduction in Medicare reimbursement by 1 percent in 2012, 1.5 percent in 2013, and 2 percent in 2014.
Depreciation and Expenses 2009
Section 179 limits. The maximum expense deduction you can elect for qualified property you placed in service in tax years that begin in 2009 remains at $250,000 ($285,000 for qualified enterprise zone property and qualified renewal community property). This limit is reduced by the amount by which the cost of property placed in service in the tax year exceeds $800,000
Under the 2008 Economic Stimulus Act (ESA), you can take further advantage of the Section 179 expense allowance to write off the entire cost of your new and used Healthcare equipment purchases in 2008.
Specifically, the expense allowance has been temporarily increased from $128,000 to $250,000 for taxpayers with total capital investments of $800,000 or less. Equipment acquired with a capital lease ($1 purchase option) and placed into service by December 31, 2008 is eligible for the increased allowance.
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EMR Software - Electronic Medical Records Stimulus Program
2006, 2007, 2008, 2011 CCHIT Certified Software Explained
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President Barack Obama on Feb. 17, 2009 signed into law the “American Recovery and Reinvestment Act of 2009” (ARRA), authorizing $19 billion to assist in the development of a robust health information technology infrastructure.
According to the bill's Medicare Provision, "Physicians who implement a certified (CCHIT) solution and become "meaningful users" between 2010 and 2012 will be eligible from $44K to $64K over five years. Physicians who wait to become "meaningful users" between 2012 and 2014 will receive smaller incentives. Physicians who have not become "meaningful users" by 2015 will not qualify for any payments, and will be subject to increasing penalties. Incentives are based the lesser of either 75% of the provider's Medicare Part B billings or the maximum allowable incentive."
The law defines a meaningful user as a physician who:
- Uses a certified EHR in a meaningful manner, which includes the use of electronic prescribing (e-prescribing)
- Uses a certified EHR that can accommodate the electronic exchange of health information to improve quality
- Submits information on clinical quality measures, as chosen by the Health and Human Services (HHS) Secretary, for the reporting period
This "meaningful use" includes using the technology to exchange electronic health data to improve care quality and submitting care quality measures to HHS. Not only that, hospitals and doctors will need to meet these requirements within a specified time frame.
What does this mean to you as a Provider?
Physicians can now be paid between $44,000 to $64,000 over five years from Medicare/Medicaid if they are utilizing an EHR in 2011 and beyond
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Late adopters will receive significantly less
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Providers may receive incentives under only one of the programs
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2015: penalty reductions in Medicare/Medicaid fees for non-EHR users
Qualifying Under the Medicare Provision
Physicians qualifying under the Medicare provision are eligible for up to $44,000. The total amount that you receive is based on how early you adopt and your Medicare Part B billings. (You must submit Medicare Part B claims to qualify.) You will receive the lesser amount of either 75% of your Medicare Part B charges or $44,000 over a five year period from 2011 to 2015. You can also qualify for an early adopter incentive of $3,000 (if you qualify for either 2011 or 2012)
Qualifying Under the Medicaid Provision
Providers qualifying under Medicaid are eligible for up to $63,750 over six years. Your payment is calculated as 85% of the EHR cost (up to $25,000 for the first year), and 85% of annual cost (up to $10,000) over the following five years. To qualify for the Medicaid provision, at least 30% of your cases must be attributable to Medicaid. For pediatricians, the minimum percentage of Medicaid patients is reduced to 20%. However, office-based pediatricians are only eligible to receive up to two thirds of the maximum payment.
Payment Reduction
Office-based physicians who do not adopt EHR (EMR) technology by 2015 have their Medicare payments reduced by the following:
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1% in 2015
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2% in 2016
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3% in 2017 and beyond
In 2018 and beyond, the HHS Secretary may decrease one additional percent per year (to a maximum of 5%) contingent upon the levels of overall EHR adoption in the market.
Certified EMR
The law also defines a certified EHR technology as that which:
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Includes patient demographic and clinical health information, including medical history and problem lists
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Has the ability to provide clinical decision support.
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Has decision supporting tools that support physician order entry and be able to capture and query quality information.
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Tools that will also be able to exchange and integrate health information from outside sources.
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