Written by: John Lynn
Jessica Shenfeld, Esq. is the founding partner at The Law Office of Jessica Shenfeld, a boutique law firm that caters to physicians’ legal needs. She is also CEO of EHR Incentive Help, Inc., which helps physicians satisfy the Meaningful Use criteria and apply for the Medicare/Medicaid EHR Incentive Program benefits. For more information, visit http://jessicashenfeld.com/healthcare-legal-services/ehr-incentive/.
A reader asked about the best way for a locum tenens to attest to Meaningful Use for the Medicaid EHR Incentive Program. As you may know, the phrase “locum tenens” is Latin for “place holder” or “substitute.” Locum tenentes physicians – like substitute teachers – may receive assignments that vary in length from a couple weeks to many months. As such, a locum tenens physician can work in multiple clinic/office locations over any given ninety-day period. This issue addressed below applies not only to locum tenens, but also to any doctor that works in multiple practice locations and wants to apply for the EHR Incentive Program as an individual eligible professional (EP). The reader’s question breaks down into two separate questions:
1. What location should the doctor use to demonstrate Meaningful Use?
2. What patient data should the doctor use to calculate the patient volume threshold – that at least 30% of the patients the EP treated were Medicaid patients?
The important point to remember is that doctors that work at more than one clinical practice site are NOT required to use data from all sites to support their demonstration of meaningful use and the patient volume threshold.
1. Meaningful Use: Under the Medicaid EHR Incentive Program, an EP must have at least 50% of their of their patient encounters during the EHR reporting period at a practice/location or practices/locations equipped with certified EHR technology capable of meeting all of the meaningful use objectives. In lay terms, that means that in order to receive the Medicaid EHR incentive, a doctor must have had a certified EHR system installed (either adopted, implemented, or upgraded) in at least half locations where they practiced over any 90-day period in the prior calendar year.
2. Patient Volume: In order to be eligible for the Medicaid EHR Incentive Program, at least 30% of an EP’s patients over that same 90-day reporting period must have been Medicaid patients. This calculation is called the “patient volume” calculation, and it may be calculated differently in each state. The answer that applies in New York is that EPs may choose one (or more) clinical practice sites in order to calculate their patient volume. While the calculation does not need to include all practice sites, at least one of the sites from which patient data is drawn must have certified EHR technology. In other words, if an EP practices in two locations, one with certified EHR technology and one without, the EP must include the patient volume from the site that includes the certified EHR technology. In this example, the EP has the choice as to whether he wants to include the patient volume from the site without certified EHR technology to calculate patient volume calculation.
Although the reader asked about the Medicaid EHR Incentive Program, a locum tenens can apply for the Medicare EHR Incentive Program using the framework outlined above with one exception: to establish Meaningful Use, at least half the practice sites where the locum tenens worked over a 90-day period in that same calendar year must have had a certified EHR system capable of meeting the Meaningful Use requirements. The patient volume analysis above applies to both Medicaid and Medicare.