Eligible Providers

Eligible Provider, “Meaningful Use” and ARRA Stimulus Funds

Background

The nation’s healthcare system is undergoing a transformation in an effort to improve quality, safety and efficiency of care, from the upgrade to ICD-10 to information exchanges of EHR technology. To help facilitate this vision, the Health Information Technology for Economic and Clinical Health Act, or the "HITECH Act" established programs under Medicare and Medicaid to provide incentive payments for the "meaningful use" of certified EHR technology. The Medicare and Medicaid EHR incentive programs will provide incentive payments to eligible professionals and eligible hospitals as they adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology. The programs begin in 2011. These incentive programs are designed to support providers in this period of Health IT transition and instill the use of EHRs in meaningful ways to help our nation to improve the quality, safety and efficiency of patient health care.

NOTE: This is a new program, and it is separate from other active CMS incentive programs, such as Physicians Quality Reporting Initiative (PQRI), Reporting Hospital Quality Data for Annual Payment Update (RHQDAPU) and e-Prescribing

Who is a Medicare Eligible Provider (Meaningful Use)

Eligible Providers in Medicare FFS

Eligible Professionals (EPs)

Doctor of Medicine or Osteopathy

Doctor of Dental Surgery or Dental Medicine

Doctor of Podiatric Medicine

Doctor of Optometry

Chiropractor

Eligible Hospitals

Acute Care Hospitals*

Critical Access Hospitals (CAHs)

Who is a Medicare Advantage Provider (Meaningful Use)

Eligible Providers in Medicare Advantage (MA)

MA Eligible Professionals (EPs)

Must furnish, on average, at least 20 hours/week of patient-care services and be employed by the qualifying MA organization

-or-

Must be employed by, or be a partner of, an entity that through contract with the qualifying MA organization furnishes at least 80 percent of the entity’s Medicare patient care services to enrollees of the qualifying MA organization

MA-Affiliated Eligible Hospitals

Will be paid under the Medicare Fee-for-service EHR incentive program

Who is a Medicaid Eligible Provider (Meaningful Use)

Eligible Providers in Medicaid

Eligible Professionals (EPs)

Physicians

Nurse Practitioners (NPs)

Certified Nurse Midwives (CNMs)

Dentists

Physician Assistants (PAs) working in a Federally Qualified Health Center (FQHC) or rural health clinic (RHC) that is so led by a PA

Eligible Hospitals

Acute Care Hospitals (now including CAHs)

Children’s Hospitals

Built with help of DrExplain