CSS3 Button Css3Menu.com


Incentive Programs Overview

 

Below are numerous oppurtunities for certain Medicare and / or Medicaid providers to receive incentive payments for participating in initiatives.

 

Incentive Programs Available

 

  • Physician Quality Reporting System
    • The 2006 Tax Relief and Health Care Act (TRHCA) (P.L. 109-432) required the establishment of a physician quality reporting system, including an incentive payment for EPs who satisfactorily report data on quality measures for covered professional services furnished to Medicare beneficiaries. CMS named this program the Physician Quality Reporting System.

 

  • Electronic Prescribing (eRx) Incentive Program
    • Section 132 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) authorized a new and separate incentive program for EPs who are successful electronic prescribers as defined by MIPPA. This new incentive program, which began on January 1, 2009, is separate from and is in addition to the Physician Quality Reporting System program. EPs do not need to participate in Physician Quality Reporting System to participate in the eRx Incentive Program. Note: Medicare EPs may not earn incentives under the eRx and Electronic Health Records incentive programs at the same time.

 

  • Electronic Health Record (EHR) Incentive Program
    • The American Recovery and Reinvestment Act of 2009 (Recovery Act) includes the Health Information Technology for Economic and Clinical Health Act, or the “HITECH Act,” which established programs under Medicare and Medicaid to provide incentive payments to EPs, hospitals, and critical access hospitals for the “meaningful use” of certified EHR technology. Note: Medicare EPs may not earn incentives under the eRx and Electronic Health Records incentive programs at the same time.

 

 

For the most part, EPs may participate in more than one incentive program at the same time. However, there are some limitations. Below outlines the programs that EPs may participate in at the same time:

 

 

  PQRS E-RX Medicare EHR Incentive Medicaid EHR Incentive
PQRS   YES YES YES
E-RX YES   NO YES

 

 

 

 

 

Are You Eligible for Medicare EHR Incentive Program? Click Here

The Medicare EHR incentive program registration began in 2011. The last year to register for the Medicare Incentive Program is 2014. These incentives are for individual providers when they show "meaningful use" of electronic health records. It is important to understand that each physician in a practice or hospital could receive up to $44,000 over a five-year period. Payments occur once a year.

 

These healthcare professionals are entitled to Medicare incentive payments:

  • Medical Doctors
  • Doctors of Osteopathy
  • Dentists
  • Dental Surgeons
  • Podiatrists
  • Optometrists
  • Chiropractors

These health professionals must not be hospital-based. Physicians employed by hospitals who are working in the ambulatory setting — including ambulatory clinics — are eligible for Medicare incentive payments.

Are You Eligible for Medicaid EHR Incentive Program? Click Here

The Medicaid incentive program differs a bit from Medicare in that physicians don't necessarily have to meet the different stages of "meaningful use" in as strict of a timeframe to receive payments. You could receive up to $63,700 over five years.

 

THESE HEALTHCARE PROFESSIONALS ARE ENTITLED TO MEDICAID INCENTIVE PAYMENTS:

  • Physicians
  • Pediatricians
  • Physician Assistants*
  • Nurse Practioners*
  • Nurse Midwives*
  • Dentists
  • Optometrists (in certain states)

*Must have prescriptive authority

 

Physician assistants are eligible if they work in a Federally Qualified Health Center or Rural Health Center that also is led by a physician assistant

.

TO QUALIFY FOR A MEDICAID INCENTIVE PAYMENT, THE HEALTH PROFESSIONAL MUST NOT BE HOSPITAL-BASED AND MUST MEET ONE OF THE FOLLOWING CRITERIA:

  • Has a minimum 30 percent Medicaid patient volume;
  • Has a minimum 20 percent Medicaid patient volume and is a pediatrician;
  • Practices predominantly in a Federally Qualified Health Center or Rural Health Center and has a minimum 30 percent patient volume of needy individuals;
  • A healthcare professional is hospital-based if 90 percent or more of the person's services are performed in a hospital inpatient or emergency room setting.
Are You Eligible for PQRS Incentive Program? Click Here

The Physician Quality Reporting System incentive payments are available until 2014. Beginning in 2015, EPs who do not satisfactorily report Physician Quality Reporting System measures will be subject to payment adjustments. The 2015 payment adjustments are based on PQRS performance in 2013.

 

These healthcare professionals are entitled to Medicare PQRS incentive payments:

 

  • Medical Doctors
  • Doctors of Osteopathy
  • Dentists
  • Dental Surgeons
  • Podiatrists
  • Optometrists
  • Chiropractors
  • Practitioners: physician assistant, nurse practitioner, clinical nurse specialist, certified registered nurse anesthetist (and anesthesiologist assistant), certified nurse midwife, clinical social worker, clinical psychologist, registered dietician, nutrition professional, or audiologist
  • Therapists: physical therapist, occupational therapist, or qualified speech-language therapist.

 

 

 

Are You Eligible for E-Presribing Incentive Program? Click Here

The eRx incentive payments are available until 2013. Beginning in 2012, payment adjustments will take effect for EPs who are not successful eelectronic prescribers.

 

 

These healthcare professionals are entitled to Medicare E-Prescribing (eRx) incentive payments:

To participate in the eRx Incentive Program, these professionals listed below must additionally have prescribing authority

 

  • Medical Doctors
  • Doctors of Osteopathy
  • Dentists
  • Dental Surgeons
  • Podiatrists
  • Optometrists
  • Chiropractors
  • Practitioners: physician assistant, nurse practitioner, clinical nurse specialist, certified registered nurse anesthetist (and anesthesiologist assistant), certified nurse midwife, clinical social worker, clinical psychologist, registered dietician, nutrition professional, or audiologist
  • Therapists: physical therapist, occupational therapist, or qualified speech-language therapist.