The payment may be in the form of a single consolidated payment or in the form of periodic installments as the Secretary (HHS) may specify.

Are Medicare Advantage organizations eligible for incentive monies?
Qualifying MA organizations are defined as those Medicare Advantage organizations that are organized as a health maintenance organization. These organizations and their providers are eligible for the incentives as long as the provider delivers a minimum of twenty hours a week of patient care services and the organization furnishes at least 80 percent of the services of the individual professional to clients of their organization.

Who is eligible for Medicaid incentive payments?
A healthcare provider is eligible for incentive payments from Medicaid who is not hospital-based and has at least 30 percent of the professional's patient volume coming from Medicaid patients; Who is a pediatrician, who is not hospital-based and who has at least 20 percent of the patient volume coming from Medicaid patients;
Practices predominantly in a FQHC or rural health clinic and has at least 30 percent of the professional's patient volume coming from Medicaid patients; --Is a children's hospital, or an acute-care hospital that is not described in clause (i) and that has at least 10 percent of the hospital's patient volume coming from Medicaid patients.
Incentive payments will be based on a calculation that factors the physician's Medicaid mix in combination with up to $25,000 the first year and $10,000 each subsequent year for five years.
Note: Because pediatricians have to meet a lower threshold of only 20% Medicaid patients to qualify for the incentives, they are only eligible for 66% of the incentive payments described above.

Eligibility Requirements Most physicians stand to earn incentive payments if they can demonstrate meaningful use. However, there are some who will not qualify - those not accepting Medicare, or those that do not have a patient base that is comprised of more than 30% Medicaid patients. Additionally, physicians delivering all care in a hospital, such as anesthesiologists, pathologists or emergency physicians do not qualify.

Note that while most providers must demonstrate that 30% of their patients are using Medicaid in order to qualify for that portion of the program, pediatricians need only prove 20%. This is an effort to facilitate the participation of more pediatricians in the program that would not normally accept Medicare and very well might not have a sufficient Medicaid volume to qualify.

Refer to the Medicaid eligibility guidelines above.

How are Pediatricians and Family Physicians going to be able to participate?
Pediatricians and Family Practitioners must meet the Medicaid payer mix threshold and accept Medicare in order to qualify for Medicaid incentives. If they do not meet these eligibility requirements, they can apply for grants and/or loans to offset the upfront costs of the purchase of an EHR.