Does MedicsDocAssistant EHR/EMR have the required certifications?
Yes. MedicsDocAssistant is 2011/2012 ONC-ATCB Certified as a Complete EHR, helping eligible professionals obtain the maximum Stimulus Act incentives to which they are entitled.
What is the official name of the Stimulus Act?
The Stimulus Act’s official name is the American Recovery and Reinvestment Act (ARRA).
How does it affect the Healthcare IT industry?
One part of the ARRA calls for $17 billion to be made available through Medicare and Medicaid to incentivize physicians (“eligible professionals”) for implementing and using a stimulus-certified EHR/EMR.
Which professionals are eligible for the EHR/EMR Stimulus Act incentives?
This depends upon whether the eligible professionals qualify for their incentives through Medicare or Medicaid.
Under Medicare, eligible professionals include DCs, DDSs, DPMs, DOs, MDs and ODs who are office-based (not hospital-based such as pathologists, anesthesiologists or ER physicians). Physical therapists, psychologists, nurses, nurse practitioners, physician assistants, medical assistants and social workers are examples of non-eligible professionals through Medicare.
Medicaid eligible professionals are those providers named under Medicare, as well as Certified Nurse Midwives, Nurse Practitioners, and under certain circumstances, Physician Assistants. All must also not be hospital based, and to qualify for Medicaid’s incentives, medical treatment must be provided to at least a 30% Medicaid patient population (20% for pediatrics).
How much is available to Medicare providers?
The maximum amount available to eligible professionals through Medicare is $44,000. See the explanation beneath the Medicare Incentives Schedule below for Medicare Part B amounts needed to qualify for the maximum incentives.
How much is available to Medicaid providers?
Under Medicaid, eligible professionals can receive up to $63,750 over six years and must qualify by 2016 to receive maximum incentives. To qualify, an eligible provider’s patient population must be comprised of at least 30% Medicaid patients and 20% for pediatricians. Requires proving Meaningful Use in year 2; year 1 can be for adoption only.
Are incentives paid per practice or per eligible provider?
They are paid per eligible provider, not per practice. This means that practices with more than one eligible provider would obtain the maximum amount of benefit to which each eligible provider is entitled for implementing an EHR/EMR certified for the Stimulus Act.
Can an eligible provider claim both Medicare and Medicaid benefits?
Eligible professionals can opt for the Medicare or Medicaid incentive, but cannot derive benefits of both. An EP may change his/her selection one time during the course of the incentive program.
Can eligible professionals who do not accept Medicare or Medicaid benefit from Stimulus Act incentives?
Eligible professionals who do not accept Medicare or who do not have at least a 30% Medicaid population (20% for pediatricians) cannot benefit from Stimulus Act incentives available for implementing a certified EHR/EMR.
What about the 2% incentive right now for using e-Rx?
Physicians who currently e-prescribe can receive (and have been receiving) a 2% incentive. This will continue until Stimulus Act funds begin. At that point, the 2% e-Rx incentive is cancelled.
What must we do to obtain Stimulus Act incentives?
In order to obtain these financial incentives, eligible professionals must “meaningfully use” their certified EHR/EMR. In other words, a provider cannot just buy an EHR or EMR system and expect to obtain incentives. The EHR or EMR needs to actually be used – meaningfully used.
What exactly is meaningful use? How is it determined?
Criteria for Stage I meaningful use requirements have been finalized by Centers for Medicare & Medicaid Services (CMS). The EHR selected must be able to handle the follwing 15 specific core capabilities set forth by CMS. Additionally, a listing of 10 optional capabilities exists, of which the eligible provider must choose 5, for a total of 20, giving the provider the ability to select 5 areas of importance to the provider, making it a more personal exercise.
As mentioned above, MedicsDocAssistant EHR Version 5.2 is a certified EHR/EMR through CCHIT for the 15 core requirements, and the 10 elective requirements, making it 100% certified for Stage 1 Meaningful Use.
Core Requirements for Meaningful Use
- Record patient demographics (including gender, race and ethnicity, date of birth, preferred language) at least 50% of the time
- Record vital signs (height, weight, blood pressure, body mass index, and growth charts for children) at least 50% of the time
- Maintain up-to-date problem lists at least 80% of the time
- Maintain active medication lists at least 80% of the time
- Maintain active medication allergy lists at least 80% of the time
- Record smoking status for patients older than 13 years of age at least 50% of the time
- Provide patients with a clinical summary for each office visit within 3 business days, at least 50% of the time
- On request, provide patients with an electronic copy of their health information (including test results, problem lists, meds lists, allergies) within 3 business days, at least 50% of the time
- Generate electronic prescriptions at least 40% of the time
- Use Computerized Physician Order Entry (CPOE) for medication orders at least 30% of the time. (note: CPOE for lab ordering, imaging ordering, and referrals are not addressed here – only medications)
- Implement drug-drug and drug-allergy interaction checks at least 40% of the time
- Be able to exchange key clinical information among providers by performing at least one test of the EHR/EMR’s ability to do this.
- Implement one clinical decision support rule, and ability to track compliance with the rule (this is reduced from the previous 5 rules to the final 1 rule)
- Implement systems that protect privacy and security of patient data in the EHR/EMR, by conducting or reviewing a security risk analysis, and taking corrective step if needed
- Report clinical quality measures to CMS or states – for 2011 provide aggregate numerator and denominator through attestation; for 2012, electronically submit measures (this refers to PQRI measures)
Elective Selections for Meaningful Use
Eligible providers must choose 5 of these.
- Implement drug-formulary checking
- Incorporate lab test data into the EHR/EMR as structured data
- Generate lists of patients by specific conditions (to use for quality improvement, reduce disparities, research, or outreach)
- Use EHR/EMR technology to identify patient-specific education resources, and provide those to the patient as appropriate – and do this at least 10% of the time
- Provide medication reconciliation between care settings, at least 50% of the time
- Provide summary of care record for patients transferred to another provider or setting, at least 50% of the time
- Submit electronic immunization data to local registries (performing at least one test of data submission, where registries can accept them)
- Submit electronic syndromic surveillance to public health agencies (perform at least one test, where local agencies can accept them)
- Send reminders to patients (per patient preference) for preventive and follow-up care, at least 20% of the time, or for over-65 year-olds or under-5 year-olds)
- Provide patients with timely electronic access to their health information, at least 10% of the time.
How long must meaningful use be proven to qualify for Stimulus Act incentives?
Reporting Period: The reporting period for the EHR Incentive program using a certified EHR is any continuous 90 day period during the first payment year. Please note that although the measure specifications assume a full calendar year you should only calculate the denominator and numerator from the first day of the 90 day reporting period to the last day of the 90 day reporting period.
Does the MedicsDocAssistant EHR have the required certifications?
In addition to the meaningful use requirements, the EHR/EMR must also be a certified product. CCHIT has now been named by the Office of the National Coordinator for Healthcare Information Technology (ONC) as a certifying body, and MedicsDocAssistant EHR Version 4.0 is 2008 CCHIT Certified®.
Certification ensures that the EHR/EMR can perform the functions called for in the standards and certification criteria final rule that ONC released.
When will the Stimulus Act funding begin for the use of certified EHR/EMR systems?
Users will be able to attest to their usage during April 2011 with the first round of funding beginning as early as mid May 2011.
Would it make sense to wait until 2011 to purchase and implement the EHR or EMR software?
Eligible professionals implementing later into 2011 will probably have a longer wait to obtain 2011 incentives. Note that 2011 and 2012 are the years with the highest possible incentive amounts. With “crunch time” approaching, the general suggestion is to implement and begin using the EHR as soon as possible.
Keep in mind the incredible benefits that using the MedicsDocAssistant EHR/EMR brings to the practice, aside from Stimulus Act incentives. There is no good reason to wait.
How will eligible professionals prove EHR usage?
Providers will be directed to a link on the CMS website where they will register their EHR.EMR usage. CMS has indicated this link will be available by January 1, 2011. CMS will alert providers once this link is available; ADS will also alert our own clients as well.
However, there are two things Medicare providers can do now (if they have not done so already) and one thing Medicaid providers can do (if they have not done so already) to prepare for Stimulus incentives.
Medicare and Medicaid providers who do not yet have an NPI number must register in the National Plan and Provider Enumeration System (NPPES). Go to https://nppes.cms.hhs.gov/NPPES/Welcome.do for an explanation on NPPES and instructions for registering. Skip this step if you already have an NPI.
If you are a Medicare provider and have an existing NPI, you can then go to https://pecos.cms.hhs.gov to register with PECOS (Provider Enrolment Chain and Ownership System), if you have not done so already. Only Medicare providers must register with PECOS. Medicaid providers need not register.
What about a general “Help” area for Stimulus-related questions?
CMS will set up a help desk to answer questions and offer basic information about the incentive program. CMS regional offices and ONC regional extension centers will cross-communicate so that a question asked of one that should really be directed to the other will be done so seamlessly.
States administering Medicaid are readying their incentive programs for Medicaid providers. CMS will send a letter to state Medicaid directors sometime this fall with policy guidance to help states start their programs.
What happens if an eligible professional does not implement an EHR or EMR?
Penalties will begin to apply in 2015 as noted in the Incentive Payment Schedules above. They will remain in perpetuity until a certified EHR or EMR is implemented.
Will our providers who do not qualify as Eligible Providers under Medicare or Medicaid be penalized for not implementing an EHR or EMR?
No. Those who are not classified as “eligible professionals” – and who therefore cannot obtain Stimulus incentives – will not be penalized for not implementing an EHR or EMR.
However, the benefits of using the MedicsDocAssistant EHR should always be considered, irrespective of the Stimulus Act. The system produces significant ROI with features such as electronic superbills, automated lab requests from the patient’s record with results directly back to the record along with alerts on abnormalities, voice and / or handwriting recognition for immediate transcription of notes into patients’ records, health maintenance and continuity of care capabilities, e-Rx and comprehensive medication management, interoperability and interconnectivity between systems, elimination of paper, and data security. These, and more, are reasons to use the MedicsDocAssistant EHR, even without Stimulus Act incentives.
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