LIPIX Meaningful Use Services FAQs
General Questions
What is LIPIX?
What is NYeC? What is the REC Program?
What is an EHR?
What are the benefits of an EHR?
Is my EHR certified?
What is an HIE?
How is patient health information protected in an EHR?
Where can I get more information?
EHR Incentive Program Questions
What is Meaningful Use?
Who is considered an Eligible Professional (EP)?
Who is eligible for subsidized services through the REC Program?
How much can I earn?
How and when will I get paid?
Are payments from the CMS EHR Incentive Programs subject to federal income tax?
Will I be penalized if I do not participate?
When do I have to sign-up?
How do I register?
If I register for the Medicare EHR Incentive Program, do I have to attest after 90 days, or can I wait until I've
reached the maximum payment amount?
Can I start my 90-day reporting period at the end of one year and overlap into the next year?
To get my first payment through the Medicaid EHR Incentive Program, do I have to attest for AIU or can I attest for Meaningful Use?
If I participate in other incentive programs, do I still qualify for the EHR Incentive Program?
LIPIX is an independent not-for-profit
corporation established to develop a Regional Health Information Organization
(RHIO), a.k.a. a Health Information Exchange (HIE), in the New York Metropolitan
area.
Currently, LIPIX is working with the NYeC
Regional Extension Center (REC) to help qualified providers achieve Meaningful
Use on certified electronic health record (EHR) technology.
For more information, please visit www.lipix.org.
What is NYeC? What is the REC Program?
NYeC (pronounced "nice"), which
stands for the New York eHealth Collaborative, was founded by health care
leaders throughout New York State with support from the New York State
Department of Health, as a public-private partnership serving as a focal point
for key healthcare stakeholders to build consensus on health information
technology (HIT) policy priorities and collaborate on national, state and
regional HIT adoption, implementation, and optimization initiatives.
For more information, please visit www.nyehealth.org.
Through the American Recovery and
Reinvestment Act of 2009, NYeC was selected as a Health Information Technology
Regional Extension Center (REC) to promote physician adoption, implementation, and
Meaningful Use of EHRs. For more
information, please visit www.nyecrec.org.
An electronic health record (EHR) is a software application that
enables healthcare providers and institutions to record, access, and analyze
patient medical information in a computerized digital format. An EHR contains a record of clinical notes,
medication histories, laboratory and radiology test results, and other patient
health information captured over time from a variety of clinical sources and
settings. In summary, an EHR captures
and manages patient healthcare information in a manner that is far more
efficient, accessible, and secure than traditional paper-based medical record
systems.
What are the benefits of an EHR?
An EHR enables ubiquitous access to
medical information in both clinical and remote settings, facilitates a
detailed analysis of patient medical conditions, improves practice workflow
efficiency, and provides real-time, point-of-care clinical decision-support. The consistent use of an EHR results in
improved clinical outcomes, increased patient satisfaction, and significant
return-on-investment (ROI).
The Office of the National Coordinator is
establishing Authorized Testing and Certification Bodies (ONC‑ATCBs) to
certify electronic health record systems for the meaningful use incentive
program. Once a product is certified,
the name of the product will be published on the ONC website.
For more information, please visit the Office of the National Coordinator's website at
http://healthit.hhs.gov/certification.
A Health Information Exchange (HIE) is a
system that enables the seamless, secure electronic transfer of healthcare
information between individuals and organizations within a region, community,
or healthcare system. The objective of an
HIE is to enable safe, timely, cost-efficient, patient-centric healthcare.
HIEs also assist public health authorities in
the analyses of epidemiology and support the general public health.
LIPIX is a Regional Health Information
Organization (RHIO), which oversees the HIE in the New York Metropolitan
area. The LIPIX RHIO accesses patient
data in EHRs from different sources across the region and makes the data
accessible to physicians from their office computers. LIPIX is in full compliance with the Health
Insurance Portability and Accountability Act of 1996 (HIPAA) and New York State
laws.
How is patient health information protected in an EHR?
Certified EHRs are required to comply
with privacy and security regulations mandated by the Health Insurance
Portability and Accountability Act of 1996 (HIPAA). The HIPAA Privacy Rule provides federal
protections for personal health information held by covered entities and gives
patients various rights regarding control of that information. The Privacy Rule has also been designed to
enable the appropriate sharing of personal health information with authorized
stakeholders involved in patient care.
Where can I get more information?
For more information about the LIPIX Meaningful Use Services Program or LIPIX RHIO, email
mu@lipix.org or call 1‑877‑MY-LIPIX (695-4749)
and dial extension 5.
Meaningful Use is using a
certified EHR technology to improve quality, safety, and efficiency, and reduce
health disparities; engage patients and families in their health care; improve
care coordination; and improve population and public health; all the while
maintaining privacy and security. Who is considered an Eligible Professional (EP)? The Centers for Medicare and Medicaid
Services (CMS) define an eligible professional (EP) differently for the
Medicare and Medicaid EHR Incentive programs. However, for both programs, an EP cannot be hospital-based.
An EP is considered hospital-based if 90% or
more of the EP's services are performed in a hospital inpatient or emergency
room setting. Who
is eligible for subsidized services through the REC Program? LIPIX Meaningful Use Services offers subsidized assistance to practices with Priority Primary Care Providers (PPCPs). For more information, click here.
For more information about the Federal EHR Incentive Program, visit
http://www.cms.gov/EHRIncentivePrograms/
OR
Call the EHR Information Center
Hours of operation: 7:30am - 6:30pm (Central Time) Monday-Friday, except federal holidays
1-888-734-6433 (primary number) or 1-888-734-6563 (TTY number)
For more information about the NYeC REC Program, visit www.nyecrec.org
On February 17, 2009, the American
Recovery and Reinvestment Act of 2009 (ARRA) was signed into law. The Health Information Technology for Economic
and Clinical Health (HITECH) Act, a provision within ARRA, gave the Centers for
Medicare and Medicaid Services (CMS) the authority to offer financial
incentives to eligible physicians for the adoption and "Meaningful
Use" of Health and Human Services (HSS)-certified EHR technologies.
Subsequently, the Office of the National
Coordinator for Health Information Technology (ONC) and CMS released a proposal
offering additional detail on the specific requirements of "Meaningful
Use." The final ruling can be found
here.
For a good summary of Meaningful Use, please
see the article titled
The “Meaningful Use” Regulation for Electronic Health Records.
LIPIX will work with your practice to
help navigate the complexities of Meaningful Use and clarify the objectives and
measures you need to achieve so you can earn the CMS financial incentives.
For Medicare, an EP is defined as a doctor
of medicine or osteopathy, doctor of dental surgery or dental medicine, doctor
of podiatry, doctor of optometry, or a chiropractor.
For Medicaid, an EP is defined as a
physician, nurse practitioner, certified nurse-midwife, dentist, or physician
assistant practicing in a Federally Qualified Health Center (FQHC) or Rural
Health Clinic (RHC) that is also led by a physician assistant. Additionally,
to qualify for EHR incentive
payments, a Medicaid EP must either have a minimum 30% Medicaid
patient volume (20% for pediatricians) or practice predominantly in an FQHC or RHC
and have a minimum 30% patient volume attributable to needy individuals.
Click here to view a CMS EHR Incentive Program Flowchart
to check your eligibility.
For more information, visit www.CMS.gov/EHRIncentivePrograms/
A PPCP is defined as a licensed Doctor of Medicine (MD), Doctor of Osteopathic Medicine (DO), Nurse Practitioner (NP), Physician Assistant (PA), or Nurse Midwife
with prescriptive privileges who provides primary care clinical services.
Providers must be practicing in one of the following settings:
Providers enrolled in the Medicare EHR
Incentive program can earn up to $44,000 over 5 years. Incentive amounts are based on 75% of the fee-for-service
(FFS) allowable charges. Providers who
practice predominantly in a Health Professional Shortage Area (HPSA) can earn
up to 10% more in incentive payments under the Medicare EHR Incentive program.
However, providers who enroll in the program
after 2012 will receive reduced incentives.
Additionally providers that qualify for the Medicare EHR Incentive
program but do not demonstrate Meaningful Use by 2015 will be penalized with reduced
Medicare payments.
Providers enrolled in the Medicaid EHR
Incentive program can earn up to $63,750 over 6 years. Providers must enroll by 2016 to receive
incentive payments. Incentives are the same regardless of when the provider enrolls and are available through 2021.
For more information on the CMS Meaningful Use Incentive payments, click here.
How and when will I get paid?
Eligible professionals (EPs) participating in the Medicare EHR Incentive Program will receive a single lump sum payment for each year
they successfully demonstrate meaningful use (MU) of certified EHR technology. Payments will be made approximately 4 to 8 weeks after an EP
successfully attests that s/he has demonstrated MU.
However, if EPs have not met the threshold for allowed charges, payments will be held
until the maximum amount allowed has been reached to maximize the amount of the EHR incentive payment they receive. If the EP does not reach
the threshold, CMS expects to issue the incentive payment to the EP at the beginning of the following year, after all pending claims have been
processed.
Payments to Medicare providers will be made to the taxpayer identification number (TIN) selected at the time of registration, through the same
channels their claims payments are made. However, for EPs practicing in a health professional shortage area (HPSA), the additional incentive
payment will be paid separately to the same TIN as the incentive payment.
Medicaid incentives will be paid by the States. EPs participating in the Medicaid EHR Incentive Program should check with their State.
Are payments from the CMS EHR Incentive Programs subject to federal income tax?
Nothing in the ruling excludes these incentive payments from taxation or considers them tax-free income.
The incentive payments are likely to be treated as any other income. Providers should consult with a tax advisor
or the Internal Revenue Service regarding how to properly report this income on their filings.
There are some tax advantages for medical practices, such as potential write-offs for some
IT purchases including technology upgrades or staff training related to health IT.
Will I be penalized if I do not participate?
No. This is a voluntary program. However, if you qualify for the Medicare EHR
Incentive program, you must demonstrate Meaningful Use of an EHR by 2015, or
you will receive reduced Medicare payments.
There are no penalties for providers who
qualify for the Medicaid EHR Incentive program only.
Under the Medicare EHR Incentive program,
the largest incentive payments will be available from 2011-2012.
Reduced incentives will be available starting
in 2013 and penalties will be implemented starting in 2015.
Providers must enroll in the Medicaid EHR
Incentive program by 2016 to receive incentive payments. However, there are no payment reductions or
penalties under the Medicaid EHR Incentive program.
To register for the Medicare and Medicaid EHR Incentive Programs, go to the CMS Registration site
here and follow the directions.
EPs will need their individual NPI number to enroll. Also, EPs registering for the Medicare EHR Incentive Program will need to ensure
that they have an enrollment record in the Provider Enrollment, Chain and Ownership System (PECOS).
For more details on how to register, click here.
If I register for the Medicare EHR Incentive Program, do I have to attest after 90 days, or can I wait until I've reached the maximum payment amount?
Eligible Professionals (EPs) who register for the Medicare EHR Incentive Program can attest that they have demonstrated meaningful use of certified EHR technology as soon as the 90 day reporting period for the first year has ended or they can they can wait until they have reached the maximum payment amount. Either way, CMS will wait until the EP has reached the maximum amount allowed before paying the EP. If the EP does not reach the maximum amount, the EP will be paid at the beginning of the following year after all pending claims have been processed.
Can I start my 90-day reporting period at the end of one year and overlap into the next year?
No, the 90-day EHR reporting period must be a continuous period beginning and ending within the relevant payment year.
If I participate in other incentive
programs, do I still qualify for the EHR Incentive Program?
Some EPs may be eligible to participate in multiple incentive programs. See table below.
| Other Medicare Incentive Program | Eligible for CMS EHR Incentive Program? | |
| Medicare Physician Quality Reporting Initiative (PQRI) | Yes, if eligible. | |
| Medicare Electronic Health Record Demonstration (EHR Demo) | Yes, if eligible. | |
| Medicare Care Management Performance Demonstration (MCMP) | Yes, if eligible. The MCMP demonstration will end before EHR incentive payments are available. | |
| Electronic Prescribing (eRx) Incentive Program | If the EP chooses to participate in the Medicare EHR Incentive Program, he/she cannot participate in the Medicare eRx Incentive Program simultaneously in the same program year. If the EP chooses to participate in the Medicaid EHR Incentive Program, he/she can participate in the Medicare eRx Incentive Program simultaneously. |
For more information, visit www.cms.gov/EHRIncentivePrograms/
