We have been asked many times if the Meaningful Use (MU) incentive is real, and what are the results? Well, we finally have some hard numbers.

According to a report submitted to the HIT Policy Committee on Jan. 10, 2012, the total registrations during 2011 were 124,089 Eligible Professionals (EPs) for Medicare, 39,503 EPs for Medicaid, and 2,834 hospitals for both programs. Medicaid’s 9,614 EP registrations in December eclipsed Medicare’s 8,996, reflecting that 43 states now have launched their Medicaid meaningful use programs, and 33 have already paid incentives.

Through 2011, Medicare made $1.384 billion in Meaningful Use payments, and Medicaid paid $1.149 billion, bringing the total to nearly $2.534 billion. About 33,595 EPs had attested under the Medicare program with 99 percent successful. During 2011, 842 hospitals attested and all were successful (click here for the government report).

For physician practices that have Medicaid patients, we talked with Don Betts, Georgia Tech, who is a service delivery partner with GA-HITREC (click here). Don specializes in assisting physician practices in achieving Meaningful Use, and here is an overview of what he had to say regarding Medicaid’s Meaningful Use:

Healthcare providers can receive a maximum of $63,750 from Medicaid over a six year period. Eligible Professional (EP) means more provider types than the Medicare incentive – in addition to physicians, it includesnurse practitioners, midwives, dentists and physician assistants at a Federally Qualified Health Center (FQHC). The incentive is based on using a certified Electronic Health Record (EHR) in a defined Meaningful Use way. The Meaningful Use requirements will be phased in over 3 stages and several years, with Stage 1 having started in 2011. Medicaid is making it easier to receive the incentive for 2011 and 2012. EPs don’t have to meet Stage 1 requirements but merely show that they have adopted, implemented, or upgraded to a certified EHR. Here are some takeaways for Medicaid Stage 1 (2011 and 2012):

• How much $$: Each EP that has a minimum of 30% Medicaid patient encounters (20% for Pediatricians) can receive $21,250 in year one. For example, if there are 5 EPs in the practice, then there may be up to $106,250 (5 x $21,250) of incentives for year 1. Each EP’s patient volume needs to be reviewed to determine if there is potential. They can also qualify as a group.
• Who gets paid: Similar to Medicare, payments are made to the individual EP (his or her SSN) or to the physician practice (the practice’s TIN number). The EP may reassign the incentive $ to the physician practice.
• How to get paid: To get paid for year 1, each EP has to register with CMS, then “attest” with DCH by showing proof of the EHR upgrade and completing a volume calculator.
• State of Georgia: The Georgia Department of Community Health (DCH) administers the meaningful use program (click here ).
• HIPAA: don’t forget to review the new privacy and security requirements.

One final note – many physician practices have already qualified for Stage 1 and have received their checks. This is real money flowing to the practices (for details, click here ). If your client has potential, make sure they can benefit!

Many CPA firms have asked us about the Federal Meaningful Use incentive and the potential $$ for their clients. I spoke with Liz Hansen, VIA Consulting Group, who is a service delivery partner with GA-HITREC (clickhere). Liz specializes in assisting physician practices in achieving Meaningful Use, and here is an overview of what she had to say:

Physicians, or Eligible Professionals (EPs), can receive a maximum of$44,000 for Medicare over a 5 year period. The incentive is based on using a Meaningful Use Certified EHR (EMR) in a defined Meaningful Use way. The incentive is divided into 3 Stages, with Stage 1 starting in 2011 or 2012. Here are some takeaways for Medicare Stage 1:

• How much $$: The $$ incentive is 75% of Medicare Part B allowable charges up to a maximum of $24,000 of charges in a year for each EP (75% of $24,000 = $18,000 for Stage 1). For example, if there are 5 EPs in the practice, then there may be up to $90,000 (5 x $18,000) of incentive for Stage 1. Each physician’s Medicare allowable charges needs to be reviewed to determine if there is potential.
• Who gets paid: Payments are made to the individual EP (his or her SSN) or to the practice (the practice’s EIN number). To make sure everyone is on the same page, you must review employment contracts, operating agreements, ownership changes (physicians join or leave the practice), non-equity physician expectations and other items, so that when the Meaningful Use check $ arrives, you know who gets the money.
• How to get paid: To get paid for Stage 1, each EP has to “attest,” that is, use the EHR per the meaningful use requirements for a 90 day time period and report this data on the CMS website. It is a pass/fail grade. If the EP has a passing grade, the check will be mailed. If the EP fails, he or she will have to start the 90 day time period all over again.
• HIPAA: don’t forget to review the new privacy and security requirements.

One final note – many physician practices have already qualified for Stage 1 and have received their checks. This is real money flowing to the practices (for details, click here ). If your client has potential, make sure they can benefit!

The Meaningful Use legislation (ARRA, HITECH Act) included many changes to HIPAA (Click here )

Here are a few key items:

• Privacy & Security – access to all health information data must be controlled — this includes laptops, thumb drives and remote access.

• Major penalties for violators – up to $1.5 million per year for violations involving willful neglect.

• Business Associates – access to health information for patients OR employees of healthcare providers. Business Associates must comply with HIPAA regulations and are subject to the same penalties.  NOTE: a CPA firm may be considered a Business Associate.

HIPAA has gotten more stringent, encompasses more areas, and significantly increases the $ penalties.