Meaningful Use FAQ

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Q: What will it cost an organization to implement a certified EHR technology?
A: In the Notice of Proposed Rule Making (NPRM), CMS estimates that the average cost for an eligible professional to adopt/implement/upgrade a certified EHR technology is $54,000 per physician Full-Time Employee (FTE). In addition, CMS estimates that annual maintenance costs average about $10,000 per physician FTE per year. For eligible hospitals, CMS estimates the range to be between $1 million and $5 million for installation and $1 million annually for maintenance, upgrades, and training.

Q: In regards to Computer Physician Order Entry (CPOE) how will the total amount of orders be measured for an eligible professional, namely, how will paper order requisitions be quantified?

Q: Will existing data-exchanges to/from the EHR be required to be compliant with the latest HL7 specifications?

Q: If a state immunization registry does not have integration capabilities, yet organizations in that state have capabilities to test and demonstrate a data-exchange from/to the registry to/from the EHR, will the organization meet the meaningful use requirement by default?

Q: How will organizations exhibit and communicate meaningful use to HHS/CMS/ONC?

Q: Given the heavy investment for organizations to implement contingency plans - namely downtime solutions - is it reasonable to reward for demonstrated exhibition as this ensures continuity of care for the patient in the event of disaster?

Q: Who is eligible for Meaningful Use reimbursements
A: Medicare defines an “eligible professional” as

  • Doctor of medicine/osteopathy
  • Doctor of dental surgery/medicine
  • Doctor of podiatric medicine
  • Doctor of optometry
  • Chiropractor.

Medicaid defines an “eligible professional” as

  • Physicians
  • Dentists
  • Certified nurse midwives
  • Nurse practitioners
  • Physician’s assistants in a FQHC or RCH (that is so led by a physician assistant).

Q: Are physicians who lease office space in hospitals or physician contractors, considered “hospital-based?”
A: “Hospital-based” is defined by the site of service and not by any employment or billing arrangement. However, the language could be interpreted in such a way as to allow some physicians in hospitals to participate in the program for providers if they do not use the facilities or equipment (including the EHRs) provided by the hospital.

Q: Are exemptions possible to avoid the reductions beginning in 2015?
A: There may be exemptions; however, this authority is intended to be used for rural providers who may not have access to broadband or other requisite technologies.

Q: How much money is available to those providers using a certified electronic health record?
A: Medicare will reimburse individual providers up to $44,000 over a 5 year period. Medicaid will reimburse individual providers up to $63,750 over a 6 year period.

Q: Will reimbursement dollars paid to providers be taxed?
A: No. Reimbursement dollars paid to the provider are from the federal government and are not taxable.

Q: Does owning a “certified” EHR guarantee receipt of stimulus money from the American Recovery and Reinvestment Act?
A: Owning a “certified” EHR does not guarantee you a reimbursement from the federal government. To guarantee reimbursement a “certified” EHR must be utilized in a “meaningful” way.

Q: How will payment be structured for exhibition of meaningful use?
A: as published by CMS in a “Notice of Proposed Rulemaking” (NPRM): "We propose to make a single, consolidated, annual incentive payment to EPs after ascertaining that an EP has demonstrated meaningful use for the applicable reporting period and reached the threshold for maximum payment. CMS believes this method will pose the least administrative burden. The Fiscal Intermediaries/Medicare Administrative Contractor (MAC) will calculate incentive payments for qualifying eligible hospitals and will disburse payments on an interim basis once the hospital has demonstrated it is a meaningful user for the EHR reporting period for the payment year.”

Q: What is the timeline for certified EHRs to be implemented and meaningfully used?
A: For hospitals, the Medicare and Medicaid EHR Incentive Program beings on October 1, 2010 and for eligible professionals, it begins January 1, 2011. Penalties for lack of demonstration of meaningful use (less than 100% of the fee schedule for hospitals or eligble professionals that bill Medicare of Medicaid for services rendered) begin for hospitals on October 1,2014 and January 1, 2015 for eligible professionals.

Q: How will I get paid from Medicare/Medicaid?
A: All reimbursements will be paid in a single, consolidated, annual incentive payment, Medicare will be paid via CMS, and Medicaid will be paid from the state Medicaid agency or your designated intermediary (ex: CenCal)

Q: Is there a Percentage of those 25 listed Criteria that must be Live to those documented Thresholds for a practice to have met the Criteria for Meaningful Use? For instance…if they implemented 50% of those Criteria is there a % reimbursement for that amount or is it all or nothing? Must you have implemented all 25 criteria before considered have proven Meaningful Use?

Q: What percentage of Meaningful use is fulfilled by each implemented module?

Q: Does owning a certified EHR guarantee that I will receive the stimulus money?
A: In order to guarantee that you receive a reimbursement you must be using a certified EHR (example: CCHIT) in a “meaningful” way. These two things combined make up the definition of “meaningful use”.

Meaningful Use Resources