How to qualify for three federal health IT incentives: It's complicated

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The Centers for Medicare and Medicaid Services (CMS) has added 120 new answers to the FAQ section in its website on the electronic health record (EHR) incentive program. Among other things, CMS now explains how -- and to what extent -- providers can qualify for incentives under three different government programs: the Medicare electronic prescribing program, the Physicians Quality Reporting Initiative (PQRI), and the EHR incentive provision of the HITECH Act, which offers financial rewards to meaningful users of qualified EHRs .

Physicians can receive PQRI rewards for reporting quality data to CMS, regardless of their participation in the other programs. They can receive 1 percent of their Medicare payments as a bonus in 2011 if they meet the PQRI requirements; from 2012 to 2014, the bonus is 0.5 percent of their payments.

Eligible professionals who participate in the EHR incentive program can receive electronic prescribing bonuses, but only if they apply for the Meaningful Use incentives as Medicaid providers. If they receive Medicare incentives for Meaningful Use, they're barred from getting an e-prescribing reward, which would otherwise be 1 percent of their payments in 2011. Starting in 2012, physicians who don't prescribe electronically will be financially penalized.

The FAQ advises physicians who are now getting e-prescribing bonuses to continue reporting to the eRx program to avoid the penalty, whether or not they apply for the Meaningful Use bonus. CMS will look at claims data for the first half of 2011 to determine whether the e-prescribing penalty should be applied in 2012. But if providers participate both in the EHR and e-prescribing programs, they'll receive an incentive only for being meaningful users of EHRs.

To learn more:
- read the Government Health IT story
- see the CMS FAQs
- see the CMS fact sheet on changes in the HIT incentive programs

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