Medicare Incentive Payments Tip Sheet From CMS


Buried on the CMS site explaining Meaningful Use is a great Tip Sheet responding to some key questions that we’ve been hearing from physicians.  This document is worth reviewing – and you should to get the complete details. However, here are some highlights from the document:

1. Eligible Professionals (EPs) who participate in the Medicare EHR Incentive program cannot participate in the Electronic Prescribing Incentive Program (eRx). However, EPs who qualify under the Medicaid program can participate in both the EHR and eRx incentive programs.

2. Hospital-based EPs are not eligible to receive payments through the Medicaid or Medicare EHR Incentive Program.

3. PQRI has been approved indefinitely, but payments are only available until 2014.  However, after that, EPs who do not participate in the PQRI program will be subject to payment adjustments.

4. The eRx Incentive program is available through calendar year 2013. However, beginning in 2012 payment adjustments will take effect for EPs who do not participate in eRx. These penalties will be waived for those EPs who participate in the EHR Incentive Program in 2012 and beyond.

5. The EHR Incentive Program starts in calendar year 2011 and incentive payments are available for up to 5 years through Medicare (or 6 years through Medicaid).  However, no payments will be available to EPs who start participating in 2015 or later. Beginning in 2015, payment adjustments will be made under the Medicare fee-for-service program for EPs who have not successfully demonstrated meaningful use.  Under the Medicaid program, 2016 is the latest EPs can start to participate and there are currently no penalties described for not achieving meaningful use of EHRs.

So, with regard to whether EPs can participate in multiple incentive programs at the same time, here’s the bottom line:

For Medicare:


EHR & eRX – NO (but successful participation in EHR in 2012 and beyond will result in penalties being waived for eRx)

For Medicaid:



The Tip Sheet includes 6 tables – three of which highlight scenarios to demonstrate the available incentives under the three programs (PQRI, eRx and EHR).

Question:  Does this Tip Sheet help?  What can CMS do to help explain these programs?

How can AmericanEHR support your efforts?

This post is the personal opinion of the author and does not necessarily reflect the official policy or position of the American College of Physicians (ACP). ACP does not endorse a specific EHR brand or product and ACP makes no representations, warranties, or assurances as to the accuracy or completeness of the information provided herein.


One response to "Medicare Incentive Payments Tip Sheet From CMS"
  • June 21, 2012

    Have you seen any documentation regarding who gets taxed if the provider reassigns their EHR incentive payment to the organization they are contracted with to provide services? The payments are taxable, per CMS. But if the organization receives it, not the provider, then does the organization pay the Federal Income tax? Thank you

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