Answer to Your Question

What are the differences between the Medicare and Medicaid electronic health record (EHR) incentive programs?

There are several important differences between the Centers for Medicare & Medicaid Services (CMS) EHR Incentive Programs.

  • The Medicare program is administered by the federal government. The Medicaid program is administered by states and is voluntary for states to implement. For more information on timing and availability of state Medicaid incentive programs, please view the CMS Medicaid EHR Incentive Program list of launch dates.
  • The Medicare program’s maximum incentive is $44,000 for eligible professionals (EPs), while the maximum incentive in the Medicaid program is $63,750 for eligible professional (EP)s.
  • The Medicare program uses a common definition of meaningful use (MU). State Medicaid programs, however, can add additional requirements for MU.
  • The last year a provider may initiate the Medicare program is 2014, while the last year a provider may initiate the Medicaid program is 2016.
  • Only some physicians and a subsection of hospitals and critical access hospitals (CAHs) are eligible to initiate the Medicare program. Five types of eligible professional (EP)s, acute care hospitals (including CAHs), and children’s hospitals may initiate the Medicaid program. For more information about eligibility for the Medicare EHR Incentive Program, please see the “Who is eligible for Medicare incentive payments?FAQ. For more information about eligibility of the Medicaid EHR Incentive Program, please see “Who is eligible for Medicaid incentive payments?”.

For a more detailed comparison of the Medicare and Medicaid programs, please view the CMS EHR Incentive Program comparison chart.

References

  1. The National Learning Consortium team developed this content using the Centers for Medicare and Medicaid Services “Notable Differences between the Medicare and Medicaid EHR Incentive Programs” chart [PDF].
  2. The National Learning Consortium team developed this content using the EHR Incentives & Certification” page on healthit.gov.

Financial Incentive Programs and Meaningful Use

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