Medicaid Qualifying Providers
Medicaid Incentives are available for physicians, hospitals, nurse practitioners, nurse mid-wives, pediatricians, rural health clinics, and Federally Qualified Health Centers who are not hospital-based and have Medicaid patient volumes as follows:
- For physicians, nurse practitioners, and nurse midwives in private practice, the Medicaid threshold is 30 percent of patients. Pediatricians seeing more than 20 percent Medicaid patients but less than the 30 percent of the threshold could receive a reduced incentive payment.
- For physicians, nurse practitioners, nurse midwives, and physician assistants working in either rural health clinics or federally qualified health centers, the threshold is also 30 percent; however, they can include SCHIP enrollees, patients for whom no payment is made to the clinic for their care, or patients to whom a sliding fee scale is applied.
Medicaid Incentive Payments
Presently, the Act does not specify a start date for Medicaid incentives however, leading industry experts believe it will be in parallel with the Medicare Incentive timeline or as soon as 2011.
Medicaid Incentive payments are set up to help offset some or all of the actual initial costs of a Certified EHR system plus, additional annual payments for support.
In year one, this provider group is eligible for a payment amount of up to 85% of the net allowable cost for their Certified EHR technology, and is paid up to a maximum incentive payment cap of $25,000. This year 1 payment cannot include any support or related costs expected during the following four years after initial purchase. However, to offset future support only costs, each provider can earn up to $10,000 annually, for four additional consecutive years to support the “meaningful use” of electronic health records. (Medicaid Pediatricians are eligible for 2/3 of the amount otherwise specified.)