Meaningful Use Reimbursement Checks

The Center for Medicare and Medicaid Services’ (CMS) EHR Incentive Program has started issuing checks to providers and New York State is seeing its share of early success. As of June 1st, 2011, 13 providers in New York State have been sent payments from Medicare for their successful attainment of Meaningful Use Stage 1. Nationally, approximately 320 providers have completed the process.

But, it is worth noting that the official numbers underrepresent the true number of Meaningful Users across the country. The actual number is even higher. The Regional Extension Center (REC,) helps primary care providers in New York State reach Meaningful Use. NYeC and its partners have brought at least two dozen providers in New York to Meaningful Use in just the first month of the program.

The official CMS list does not include all providers who passed Meaningful Use attestation, because it only includes those who have passed and been issued a check. In the first year of the program, providers can attest to Meaningful Use as early as April, but their payment is based on their Medicare Part B allowable charges billed to CMS for the current calendar year.

Eligible providers achieving Meaningful Use receive an EHR incentive payment equal to 75% of their Medicare Part B allowable charges up to a statutory limit of $18,000 in the first year. Thus, in order to receive the highest possible incentive, the provider needs to have billed $24,000 in Part B charges. The math is simple: 75% of $24,000 is $18,000. Many who already attested in April and May won’t hit $24,000 in charges until later in the year, so check issuance is on pause until they bill $24,000, or until the billing year closes, whichever comes first.

To calculate the available incentive from CMS for an Eligible Provider in the Medicare EHR Incentive program, follow these steps:

• Take the amount billed to Medicare this calendar year under Part B.
• Multiply the amount by 75%.
• Compare that to the maximum amount the provider can get under the program for a given year which is $18,000 for year 1.
• Take the lower of the two numbers from steps 2 and 3. This is the available incentive for the eligible provider.

For those who attested to Meaningful Use successfully, CMS will calculate their payment amount throughout the year and will issue a check when the provider hits the maximum amount identified in step 3. If they do not reach the limit by the end of the year, a check will be issued using the 75% calculation method. For example, a provider reaching $10,000 in Part B by the end of this calendar year will receive $7,500. A full listing of all Meaningful Users across the country including is published by CMS. Click here to view:

http://www.cms.gov/apps/files/EHR_providers.pdf