The End of Medicare EHR Incentive Program—What does that mean for Medicaid Providers?

The End of Medicare EHR Incentive Program—What does that mean for Medicaid Providers?

2017 is a year of transition as CMS concludes the Medicare EHR Incentive Program and Merit-based Incentive Payment System (MIPS) begins. With new information coming out daily, it can be challenging to keep up. Below are a few noteworthy points of interest.

• EPs that participate in the Medicaid EHR Incentive Program AND also bill Medicare AND meet MIPS requirements will be required to participate in MIPS. Therefore, EPs will receive a Medicaid incentive payment and be subject to apositive or negative payment adjustment on Medicare Part B charges.
• If a provider is dually eligible for both programs and does not submit to MIPS for 2017, a negative payment adjustment on Medicare Part B allowable charges will be assessed in 2019.
• There are three exclusions from MIPS eligibility.

1. Clinician’s first year of participation in Medicare
2. Participation in an advanced alternative payment model
3. Meeting the low volume threshold for Medicare billing charges (under $30,000) and Medicare patient volume (under 100 patients)

This transition can be both confusing and frustrating. We ask that you please refer to the Quality Payment Program site for detailed information on eligibility requirements, resources and tools.