Meaningful Use: Key Differences between the Medicaid and Medicare EHR Incentive Programs

 

 

Medicaid EHR Incentive Program (State-by-state)

Medicare EHR Incentive Program (Federal program)

Stage One Requirements for the First Payment Year

Adopt, implement, or upgrade; or, demonstrate Stage 1 Meaningful Use of certified EHR

Must demonstrate Stage 1 Meaningful Use of certified EHR for a continuous 90-days

Stage One Requirements for the Second Payment Year

Demonstrate Meaningful Use Stage 1 for 90 continuous days

Demonstrate Stage 1 Meaningful Use for a full calendar year

Stage One Requirements for Payment Years 3 and beyond

Demonstrate Stage 1 Meaningful Use for a full calendar year

Demonstrate Stage 1 Meaningful Use for a full calendar year

Last year to initiate program

2016

2014

Reporting period

None for 1st payment year, 90-days for 2nd payment year, full calendar year for 3rd payment year and beyond

90 continuous days for first payment year, entire year for second payment year and beyond

Number of years over which payment is made

6

5

Meaningful Use Requirements

14 Core Measures and 5 of the 10 Menu Measures; Variance by State inasmuch as states can add up to 4 of the following menu measures as core requirements:

• Generate a List of Patients for outreach, research or disparity reduction

• Send immunization data to the immunization registry

• Send lab results to a public health agency

• Submit electronic syndromic surveillance data to public health agencies

14 Core Measures and 5 of the 10 Menu Measures

Exclusion Clauses Available 

Up to 13 exclusion clauses for Stage 1

Up to 13 exclusion clauses for Stage 1

Eligible Providers

EPs (including MD, DO, Dentists, Midwives, Nurse Practitioners, PAs if working in a FQHC/RHC lead by a PA), acute care hospitals (including CAHs) and children's hospitals

EPs (including MD, DO, DPM, DC, DDS, DMD, OD), acute care hospitals and CAHs

Maximum Incentive

$63,750

$44,000 (Additional 10% bonus available for EPs in HPSAs)

Payment Adjustment for non-adoption

No payment reduction

Reductions begin in 2015 at 1% of Medicare allowable; increasing 1% each year, capped at a maximum 5% reduction