Many of the states that are ready to begin registration in the next few months plan to issue their first incentive payments by late January or early February 2011 (Modern Healthcare, 12/23). Other states might not launch their incentive programs until spring or summer of 2011 (Kraynak, HealthLeaders Media, 12/23).
Video: EHR: Medicare and Medicaid Incentive Program Registration Webinar for Eligible Hospitals
CVS Caremark Corporation (CVS) To Help Pharmacy Patients Who Are Registering In Medicare Part D
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Registration Opens for the Medicare and Medicaid Electronic Health Records (EHR) Incentive Programs
While the Medicare EHR Incentive Program is administered by CMS, the Medicaid EHR Incentive Program is voluntarily offered and administered by the states. California, Missouri, and North Dakota are expected to open registration for the Medicaid Incentive Program in February 2011, with other states likely to offer the program during the spring and summer of 2011. Registration marks a major step for providers in the process of obtaining incentive payments under the EHR Incentive Programs. Under these programs, Medicare and Medicaid incentive payments totaling as much as $27 billion from 2011 to 2021 will be available for payment to eligible professionals (EPs) and eligible hospitals for the “meaningful use of certified EHR technology.” Providers are encouraged by CMS to register and participate early to obtain the maximum incentive payments.
Registration for CMS EHR Incentive Programs
On your mark: Determining your eligibility Before you register, you need to determine if you are eligible. Eligibility differs for eligible hospitals and professionals — criteria that you should review as soon as possible. Those who’d prefer a more interactive experience can use CMS’s Eligibility Wizard to reveal what program(s) they qualify for. It’s crucial to know that EPs qualifying for both Medicare and Medicaid Incentive Programs have to choose one or the other prior to registration. (Hospitals can receive payments from both.) Moreover, EPs can only change programs once before 2015 after receiving their first incentive payment. The major difference between the programs is money, nearly $20,000 (Medicare’s 44,000 to Medicaid’s $63,750), but there are plenty more. Choose your own adventure.
Even if you don’t take Medicare, Medicare may have created a marketing and growth opportunity for your business
Medicare has approved two new billing codes designed to encourage doctors to connect with patients promptly after hospital or nursing home discharge, to assess their needs, and to coordinate their in-home and outpatient care. Both the codes are titled Transitional Care Management (TCM). Medicare-certified home health agencies remember what a great marketing tool it was when Medicare started paying doctors for certifying plans of care more than a decade ago. At the time, the advantage only applied to certified home health. A handful of certified agencies now recognize that Medicare is handing them another opportunity. In addition, these new codes apply to any care or services the patient needs (e.g. non-medical home care, home improvement, ambulation devices, lift chairs, home infusion, etc.). Private duty and HME providers should take note that CMSs final rule for these news billing codes twice specifies that doctors need to assess patients for ADL needs and refer to the services that help with ADLs.
Tips to Demystify Medicare Open Enrollment
Once you’ve found a plan that fits your budget and medication needs, don’t forget about convenience when filling your prescriptions. A pharmacy accepted as “preferred” by a Medicare Part D Plan is a network pharmacy that offers covered drugs to plan members at lower out-of-pocket costs than what the member would pay at a non-preferred network pharmacy. For example, Walmart is a preferred pharmacy on multiple plans including the Humana Walmart-Preferred Rx Plan. (Incidentally, people who have high blood pressure or who are concerned about heart health should also know that Humana and Walmart just announced that members of the Humana Walmart-Preferred Rx Plan will have access to 10 hypertension drugs for a penny each when filled at one of the 4,400 Walmart or Sam’s Club pharmacy locations).