Medicare Previews EHR Incentives Attestation SystemMedicare Previews EHR Incentives Attestation System

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Eligible hospitals, healthcare professionals, and critical access hospitals (CAHs) can begin applying for Medicare electronic health record (EHR) incentive payments beginning April 18, when the Centers for Medicare & Medicaid Services' (CMS') Web-based Medicare and Medicaid EHR Incentive Program Registration and Attestation System will be made available to healthcare providers.

There are 15 measures for eligible professionals and 14 measures for eligible hospitals that require the collection of data and the use of numerator, denominator, and exclusion results to calculate a percentage to determine if the applicant met minimum criteria for the meaningful use objective. In a document released Monday, CMS said Medicare incentive payment applicants must report these numerator, denominator, and exclusion results (if applicable) for the meaningful use objectives and attest that they have successfully met the program's requirements.

The newly released document includes attestation screenshots that give applicants an idea of what the online process will look like as well as guidance on what information they need to have as they answer the questions online. CMS will release additional information about the attestation process soon, it said, including user guides with step-by-step instructions for completing attestation, and educational webinars that describe the attestation process in-depth.

For the Medicaid EHR Incentive Program, providers follow a similar process using their state's attestation system. The Medicaid EHR Incentive Program is a voluntary program established by Congress, but administered individually by each state and territory. CMS said preparation for the program varies from state to state and has published the estimated date each state intends to begin accepting registrations for its Medicaid EHR Incentive Program. So far, CMS has paid out $37.6 million in EHR incentives under the Medicaid program.

Eligible professionals, hospitals, and CAHs must meet different requirements when they participate in the Medicare EHR Incentive Program.

For eligible professionals, the meaningful use criteria requires that they must report on 15 core measures, five of 10 menu measures, and six clinical-quality measures, consisting of three required core measures and three additional measures. For eligible hospitals and CAHs, the meaningful use criteria requires that they must report on 14 core measures, five of 10 menu measures, and 15 clinical quality measures.

In its preview document, CMS displays several screens that give eligible professionals examples of the information they will be asked to provide. For example, on the screen where eligible professionals are told they must answer and meet all 15 of the core measures, the document explains that certain core and menu measures can be based either on all patient records or only those records maintained in certified EHR technology.

"Where appropriate, the eligible professionals must indicate how data from patient records was extracted. Certain core and menu measures also provide exclusions based on specific requirements. Eligible professionals may be excluded from meeting an objective if they meet the circumstances of the exclusion," the document said.

Under the Medicare EHR Incentive Program, eligible professionals can receive up to $44,000 over five years. There is an additional incentive for eligible professionals who provide services in a Health Professional Shortage Area (HSPA). To receive a maximum incentive payment, Medicare eligible professionals must begin participation by 2012. Incentive payments for eligible hospitals and CAHs are based on a number of factors, beginning with a $2 million base payment.