Panel Discussion Q&A

The following questions were asked after our free, online panel discussion, "Stimulus Money: What Do I Need to Know?" on February 8, 2010. If you missed the panel discussion, you can still watch the recording: Watch "Stimulus Money: What Do I Need to Know?" | HITECH Act Information (44 minutes).

Our panel of industry leaders tackled these questions and provided their answers below. Keep in mind that the answers to these questions may have changed since they were originally answered on February 8, 2010. To view our most recent FAQs about stimulus money and the HITECH Act, go to the HITECH Act Frequently Asked Questions page.

• If a practice has two providers, is the practice then eligible for $88K?
• What if I do not normally bill Medicare? Does that make me ineligible?
• How do I sign up for the stimulus? Is there a guaranteed payment if I prove meaningful use?
• If we don't do a lot of Medicare billing will our office qualify for any funds?
• It seems like a very daunting task to set up EMR in an effective and meaningful way. Do you have training sessions on how to set up procedures and learn how to use it?
• What is medication reconciliation?
• In group practices, is each provider eligible for incentive payments separately, or are all providers eligible for only one payment under the group?
• Will Medicare HMO-type plans or alternatives also be covered, or is it strictly Medicare?
• When I report PQRI with ExamWRITER, should I use the Qualified EMR or Nonqualified EMR code?
• Are optometrists eligible for the Medicaid $65K?
• Will eyecare providers be required to meet the same criteria as family practice doctors? For example, measuring BMIs.
• Since ExamWRITER, by itself, will not satisfy e-prescribing, what does Eyefinity/OfficeMate recommend?
• Are there particular PQRI codes we should be submitting?
• Are the requirements for “meaningful use” finalized?
• Does use of these measures as well as PQRI reporting automatically show meaningful use, or are there other steps that need to be taken to show that we are using each of the criteria?
• Is October 1, 2011, the last opportunity to report?
• How will HHS actually verify use of the 25 measures? Will we be entering codes similar to PQRI?
• What is the Amount of EHR incentive for a provider who furnishes services in an HPSA?
• Is electronic billing supposed to be done from the practice management software, or can I use a web portal such as Eyefinity for billing and still be a meaningful user?

If a practice has two providers, is the practice then eligible for $88K?

It depends on how much Medicare each provider bills. If each provider bills $25K a year in 2011, then they would each be eligible for $18K the first year and so on. If each provider, however, only bills $10K, they'll only each be eligible for 75% of that amount in ARRA stimulus money.

What if I do not normally bill Medicare? Does that make me ineligible?

The benefits of the HITECH Act are available to Medicare and Medicaid providers only.

How do I sign up for the stimulus? Is there a guaranteed payment if I prove meaningful use?

The actual process has not been released by the Centers for Medicare and Medicaid (CMS). We know that there will be an application that an eligible provider must complete and submit, but that application is not yet available from the Office of the National Coordinator (ONC) or from CMS.

The application process for the 2011 incentives will be relatively easy, and minimal documentation will be required. In 2012 and beyond, the process will involve a higher level of complexity. The legislation is very clear that "meaningful users of certified EHR technology" are eligible for the incentives if they meet the Medicare or Medicaid thresholds.

If we don't do a lot of Medicare billing will our office qualify for any funds?

In 2011, if your office bills $25K in Medicare allowable charges, then your office will be eligible for the full $18K in stimulus money the first year. You will be eligible for the Medicare incentives, but the amount of the bonus is linked to the amount of Medicare billing for each provider.

It seems like a very daunting task to set up EMR in an effective and meaningful way. Do you have training sessions on how to set up procedures and learn how to use it?

A key initiative of the Eyefinity/OfficeMate Education Department in 2010 is to provide our doctors with the information they need to use ExamWRITER in an effective and meaningful way. We have a training campaign this year that includes four-day seminars, lunchtime Q&A sessions, and Webinars. For more detailed information, go to http://www.officemate.net/training_ex_overview.aspx.

What is medication reconciliation?

Medication reconciliation is the review of medications that the patient is currently taking to the admission, transfer, and discharge orders from a hospital/care center. This is to be done at the time care is transferred from a hospital/care center back to the participating provider. CCHIT provides the following definition for medication reconciliation:

"A process that can take various forms in various clinical settings. It is comparing what medications the patient was on prior to a care episode or transfer of care, any changes or modifications made during the care episode or transfer and the resulting list of medications the patient is to be taking after the care episode or transfer. Additionally, medication reconciliation can expose a difference between what the patient is actually taking and what the electronic record states the patient is taking."

In group practices, is each provider eligible for incentive payments separately, or are all providers eligible for only one payment under the group?

Each provider is eligible for stimulus money, and the amount for which they’re  eligible is based on the amount of Medicare they bill. In 2011, if each provider bills $25K, then they'll each be eligible for the full $18K bonus.

Will Medicare HMO-type plans or alternatives also be covered, or is it strictly Medicare?

Medicare advantage will be included and have stimulus money available.

When I report PQRI with ExamWRITER, should I use the Qualified EMR or Nonqualified EMR code?

At this time, you should use the G8448 PQRI code (Qualified, non-CCHIT certified EMR). Eyefinity/OfficeMate will announce when we become certified. After that announcement, use the other PQRI code for reporting an EMR was used in documenting your medical record.

Are optometrists eligible for the Medicaid $65K?

Optometrists are specifically listed as eligible providers in the HITECH Act.

Will eyecare providers be required to meet the same criteria as family practice doctors? For example, measuring BMIs.

As of now, there have not been any specific reporting criteria for optometrists.

Since ExamWRITER, by itself, will not satisfy e-prescribing, what does Eyefinity/OfficeMate recommend?

Eyefinity/OfficeMate recommends the DrFirst interface that allows you to electronically prescribe medications from the information already entered in the ExamWRITER record. This information is used to facilitate drug-drug interactions, drug-allergy interactions and drug-disease interactions. If you would like a demo of the DrFirst electronic prescribing interface please contact Eyefinity/OfficeMate at 800.269.3666.

Are there particular PQRI codes we should be submitting?

Here is a link to the American Optometric Association that lists the PQRI codes that Optometrists should be submitting to Medicare in 2010. These codes will likely change in 2011.

Are the requirements for “meaningful use” finalized?

The meaningful use criteria are still subject to change by government entities and some minor modifications could still take place.

Does use of these measures as well as PQRI reporting automatically show meaningful use, or are there other steps that need to be taken to show that we are using each of the criteria?

Eligible providers will be required to report that they're meeting each of the 25 criteria. At this time, it is not clear to whom, or where this information will be reported. But it has been clearly defined that each eligible provider will have to report this information to CMS in some form to be eligible for the HITECH Act stimulus money.

Is October 1, 2011, the last opportunity to report?

October 1, 2011, is the absolute last date to report your 2011 criteria to qualify for money in 2011. To be eligible for the 2011 incentives providers must be "meaningful users of certified technology" for 90 consecutive days prior to December 31, 2011.

How will HHS actually verify use of the 25 measures? Will we be entering codes similar to PQRI?

The actual process to report meaningful use has not been released. Once this information is released, Eyefinity/Officemate will do everything we can to provide you with all the information we can to help ensure stimulus money payments.

What is the Amount of EHR incentive for a provider who furnishes services in an HPSA?

Physicians operating in a HPSA (health provider shortage area) will be eligible for an incremental increase of 10% in their incentive payments.

Is electronic billing supposed to be done from the practice management software, or can I use a web portal such as Eyefinity for billing and still be a meaningful user?

You may still qualify if you submit claims manually through a web portal (i.e., double data entry into a Web form) as long as your practice management system is capable of producing a CMS 1500 form, checking for CMS errors, and submitting claims directly to insurance carriers or preparing claims in a format that can be uploaded to a clearinghouse.