Meaningful Use of Electronic Health Records REQUIREMENTS FOR RECEIVING INCENTIVES By Shannon Larner Brainard, Esq. and Stephanie Barr, Esq. T he advancement of technology has resulted in many changes to the healthcare profession over the years. One such change is the development and utilization of electronic health records, or EHRs. EHRs contain information from all healthcare providers involved in a patient’s care. Authorized healthcare providers from different organizations can create, manage and consult the data contained in an EHR, giving providers the ability to easily share a patient’s medical information.1 In an effort to encourage healthcare providers to use EHRs, the Federal Government created Medicare and Medicaid EHR Incentive Programs to provide financial incentives for the “meaningful use” of electronic health records by eligible healthcare professionals, eligible hospitals, and critical access hospitals.2 The medicare eHR Incentive Program began in 2011 and will continue through 2016.3 eligible professionals can participate for up to five consecutive years throughout the duration of the program, with 2014 being the last year to begin participation.4 The program can provide up to a $44,000 incentive payment to providers over those five years of participation.5 The medicaid eHR Incentive Program began in 2011 and will continue through 2021.6 It is offered in states across the country and eligible professionals can participate for up to six years, which do not have to be consecutive. The program can provide up to a $63,750 incentive over those six years of participation.7 To receive an incentive payment, providers must first ensure that they are using eHRs that are certified specifically for the incentive programs.8 Providers must then show that they are meaningfully using their eHRs by meeting various objectives established by the Centers for medicare & medicaid services (Cms).9 Both programs are staged in three steps, with participation requirements 26 HBma BILLINg • JaNuaRY.FeBRuaRY.2014 increasing as the professional moves to the next step.10 all providers begin participation by meeting stage 1 requirements for 90 days in their first year of meaningful use and a full year in their second year of meaningful use.11 after providers meet the stage 1 requirements, they must meet stage 2 requirements for two full years.12 The first participants of the program must meet stage 2 requirements starting January 1, 2014. In stage 1, there is a total of 24 total meaningful use objectives, 19 of which must be met in order for providers to receive the incentive payment.13 These 19 objectives include 14 required core objectives and 5 objectives chosen from a list of 10 menu set objectives. In stage 2, eligible professionals must meet 17 core objectives and 3 menu set objectives selected from a list of 6, or a total of 20 core objectives, in order to demonstrate meaningful use and receive the incentive payment.14 To assist providers in understanding how to meet program requirements, Cms has created meaningful use specification sheets that include critical information on each objective. each specification sheet contains information such as meeting the measure for each objective; calculating the numerator and denominator for each objective; qualifying for an exclusion to an objective; defining terms that clarify objective requirements; and requirements for attesting to each measure.15 For providers participating in the medicare eHR Incentive Program, the financial incentive they receive by demonstrating meaningful use will soon transform into a requirement to avoid a penalty. starting in 2015, if these professionals do not successfully meet the meaningful use requirements, they will be subject to a payment adjustment or reduction.16 The adjustment will start at 1% and increase every year that the professional does not meet such requirements, up to a maximum of 5%.17 Finally, in 2012, Cms awarded a contract to a Cms audit Contractor to conduct audits of meaningful use incentive payment recipients.18 accordingly, it is important for providers to ensure that they understand and meet the core and menu set objectives for demonstrating meaningful use of their eHRs.
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