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HITECH Act: Medicaid Reimbursement Plan

by John Moore | February 17, 2009

Yesterday’s post and table provided the physician reimbursement schedule under Medicare.  And astute reader contacted us to inform us that there is another reimbursement schedule that a physician (or hospital) could tap into under Medicaid.

Medicaid reimbursement will be managed at the State level, which will institute the guidelines provided by HHS.  Much of the basic qualifications are similar, e.g., meaningful use of certified EHR, but other aspects diverge significantly.

The high points:

  • Significantly more complicated process to receive reimbursement.
  • Total reimbursement amounts up to $65,000/physician over five years.  First year costs applied to purchase, install and training.  Follow-on years, reimbursement for operations and maintenance.
  • Reimbursement is for a percentage of total expenditures by physician for certified EHR.
  • Extended time horizon, payments through 2021.
  • Physician must demonstrate that a certain percentage of patients (20-30%) are covered by Medicaid.

Table below provides physician payment schedule under Medicaid.  For more info, look to Division B of the American Reinvestment and Recovery Act, beginning on page 490.

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9 responses to “HITECH Act: Medicaid Reimbursement Plan”

  1. […] John Chilmark has posted a couple of Medicare and Medicaid reimbursement charts that I think are worth looking at. I’ll leave the discussion of the reimbursement schedules on Jonh’s blog: HITECH Act Reimbursement Schedule Medicaid Reimbursement Schedule […]

  2. Jake says:

    There’s also a big question about organizations (such as Community Mental Health Centers) providing services under Medicaid and how they’ll be reimbursed. The bill pretty vague about this.

  3. John Lynn says:

    I read somewhere that mental health was more or less left out of the bill. There was something for community health centers that I guess could possibly do mental health as well, but I remember reading that the mental health community wasn’t part of this bill at all.

  4. Martin says:

    Unfortunately I see nothing that provides a stimulus to the small pharmacist to accept ePrescribing. I know the package provides incentives to caregivers but I do not believe that will encompass pharmacies.

  5. John Lynn says:

    Hey John,
    Just wanted to let you know that this chart is off. It’s missing an extra 10k year since it’s 10k for 5 years. Also, it’s only at 85% so the first year it’s 21250 and then $8500 for 5 years after that.

  6. Debbie says:

    Hello John,
    I am curious if anyone knows how medicaid reimbursement will be awarded to small CAH hospitals…or rural hospitals?
    I thought I had read that there was some upfront financing through medicaid.
    Thank you,
    Debbie

  7. John Moore says:

    Debbie,
    We have not seen anything to date regarding upfront financing from the feds but we have seen plenty of vendors offering such, most famous among them, GE.

  8. Does anyone know if the qualification test (i.e., 20 to 30% Medicaid) will be adminsitered by the States or the RECs? Will it be administered at the individual pratitioner level or at the group level (e.g., NPI, Tax ID, PC)?

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