Meaningful Use Mondays – Medicare vs. Medicaid Penalties and Other Differences

To continue last Monday’s post regarding the differences between participation under Medicare and Medicaid, the Medicaid program imposes no penalties (or as Medicare euphemistically calls them, “adjustments”) for not being a successful meaningful user. Medicare adjustments are scheduled to begin in 2015. Upon discovering this discrepancy, one (somewhat devious-minded) physician suggested to me that this provided a loophole: declare as a Medicaid participant, begin participating (successfully or unsuccessfully) in 2015, and insulate yourself from any penalties. I’m sorry to report that, as creative as this strategy seemed, non-meaningful use Medicaid participants will still be subject to adjustments to their Medicare fee schedules when those penalties begin.

Two other noteworthy differences between the programs:

  • The Medicare payment schedule is front-loaded, with more money available in the first years of a provider’s participation. Medicaid incentives remain constant after the first year’s $21,250 for adoption, implementation, or upgrade of an EHR.
  • The Medicaid programs are run by individual states, so requirements and processes may vary somewhat from the Medicare program and from each other.

For information specific to the EHR incentives under Medicaid, the following resources are available: CMS Medicaid State Information and Medicaid FAQ.

For anyone who wants to see how much they really know about meaningful use, take the fun and educational Meaningful Use IQ Test on EMR Straight Talk.

Lynn Scheps is Vice President, Government Affairs at EMR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money.