Meaningful Use Information Center

In 2009, the U.S. Federal Government signed into law the American Recovery and Reinvestment Act (ARRA) as part of the stimulus package to help improve the economy. Part of the ARRA Act, the Health Information Technology Act, known as the HITECH Act, provides funding to eligible providers for the adoption of the electronic health record (EHR).

HITECH ACT Goals:

• improve the quality, safety, cost, and efficiency of health care
• engage patients and their families in their own healthcare
• reduce health disparities
• improve care coordination
• improve population and public health
• ensure privacy and security for personal health information

EHR Incentive Program Administration
The HITECH Act is administered by the Centers for Medicare & Medicaid Services (CMS). Most dentists who qualify for incentive payments will qualify under their state Medicaid program, however there are a few specialty dentists that will qualify under the Medicare Program. (See Notable Differences between the Medicare and Medicaid EHR Incentive Programs)

Dental-Specific EHR Incentive Program
Currently, there are no dental specific criteria in Stage 1 or Stage 2 of the program and there is not a vendor specific certification for dental. Vendors are required to meet ALL of the certification requirements regardless of whether their customers use them all. Dentrix Meaningful Use Access has met the EHR certification criteria, and once acquired, will help eligible providers qualify for the incentive payment.

Henry Schein and CMS
Henry Schein has communicated closely with the Centers for Medicare and Medicaid Services (CMS) since the inception of the EHR Incentive Program to clarify how it affects our customers. We are pleased to have formed a tight-knit relationship with their organization to ensure that the information we provide is completely accurate and the solutions that we provide meet their goals and standards.

Although the Federal Government has not specified dental specific criteria, the American Dental Association (ADA) wrote an article to promote awareness of issues that may affect dentists and dental practices. This may also help you to better understand the government program, and how it affects you and your practice.

Below is a list of terms that you may hear in association with this important legislation. Where available, simply click on the link to learn more about each term.

• Stimulus Package
• ARRA (American Recovery and Reinvestment Act)
• EHR Incentive Program
• "Meaningful Use" Certified
• HITECH Act (Health Information Technology for Economic and Clinical Health)
• CMS (Centers for Medicare and Medicaid Services)
• ONC (Office of National Coordinator of Health Information Technology)
• EP (Eligible Professionals)
• CCHIT (Certification Commission for Healthcare Information Technology)
• A/I/U – Adopt, Implement or Upgrade

Eligible Professionals

Healthcare professionals and hospitals must meet the eligibility criteria defined by law in order to receive incentive payments for implementing Electronic Health Records programs. Under the Medicaid Program, an “eligible professional”:

• Provides at least 30% of their services to Medicaid patients
• Meets the specific stage and yearly criteria.

Flow Chart – Determine Eligibility for Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs

Source: Eligibility Requirements for Professionals under the Medicaid EHR Incentive Program

Eligible Providers who adopt, implement or upgrade to a certified EHR can receive incentive payments over the six years that they choose to participate in the program. The initial payment for Stage 1 Year 1 is $21,250.00 if you are deemed an eligible professional, and register and attest with CMS. See the Checklist for more details.

Stage 1 Meaningful Use Criteria

Stage 1 only requires an EP to meet Meaningful Use in the second year. Year 1 requires an eligible provider to adopt, implement or upgrade to a certified EHR system. The Meaningful Use requirements for Stage 1 Year 2 include:

• Meaningful use of the EHR certified software for 90 consecutive days within a 12 month period
• 15 core objectives
• Choose 5 of 10 objectives from a menu set
• 6 Clinical Quality Measures (3 core or alternative core and 3 out of 38 from menu set)

Source: Stage I Medicare and Medicaid Meaningful Use Requirements

What is “Meaningful Use?”

• The use of certified EHR in a meaningful manner (e.g. ePrescribing)
• The use of certified EHR technology for electronic exchange of health information to improve quality of care
• Use of certified EHR technology to submit clinical quality measures (CQM) and other such measures selected by the Secretary of Health and Human Services

For more in-depth information, view this power point slide presentation about the EHR Incentive Program Meaningful Use Stage 1 Requirements.

Stage 2 Meaningful Use Criteria

The ONC released the final rules for Stage 2 meaningful use on August 23, 2012 which step up interoperability. The rules take effect in 2014 and are designed to increase the requirements of use of EHRs among providers. Learn more about Stage 2 criteria on the CMS website.

Henry Schein will continue to monitor any changes necessary to continue to offer a certified EHR. The criteria for an eligible professional to receive EHR incentive payments change as the EHR Incentive Program progresses.

Certified EHR Technology
The Medicare and Medicaid EHR Incentive Programs require the use of certified EHR technology. Standards, implementation specifications, and certification criteria for EHR technology have been adopted by the Secretary of the Department of Health and Human Services. You can find a list of Certified EHR Technology on the Certified Health IT Product List. Dentrix Meaningful Use Access has met the criteria established, and has been certified by CCHIT.

For more information about Certified EHR Technology, visit the CMS website.

Definition of Adopt, Implement, or Upgrade:
For Medicaid, the eligible provider must Adopt, Implement, or Upgrade (AIU) certified EHR software. As posted on the CMS website, for AIU, a provider does not have to have installed certified EHR technology. The definition of AIU in 42 CFR 495.302 allows the provider to demonstrate AIU through any of the following:

• Acquiring, purchasing or securing access to certified EHR technology
• Installing or commencing utilization of certified EHR technology capable of meeting meaningful use requirements
  or
• Expanding the available functionality of certified EHR technology capable of meeting meaningful use requirements at the practice site, including staffing, maintenance, and training, or upgrade from existing EHR technology to certified EHR technology per the ONC EHR certification criteria.

Thus, a signed contract indicating that the provider has adopted or upgraded would be sufficient.

Adopting Dentrix Meaningful Use Access to Qualify under the Medicaid EHR Incentive Program
If you're an eligible professional, Dentrix Meaningful Use Access may help you qualify as a meaningful user of certified electronic health records. Remember that the individual state where you are licensed has its own process and oversight.

Here's how to apply:

1. Make sure you're eligible for the Medicaid EHR Incentive Program. View eligibility guidelines at the Eligibility page.
2. Login to the https://ehrincentives.cms.gov/hitech/login.action
3. Register for the Medicare and/or Medicaid EHR Incentive Programs through CMS.*
   1. To obtain your Certification ID number when filling out your incentive form, go to the CMS website http://onc-chpl.force.com/ehrcert
   2. Click the Ambulatory Practice button at the bottom
   3. Search for Dentrix
   4. Click "Add to Cart"
   5. Click "Get CMS EHR Certification ID" (button is within box)
4. Apply with your state Medicaid governing organization. Choose your state here.
5. Attest for the Medicaid EHR Incentive Program through your individual state. Please note—you will not attest for the Medicaid Incentive Program through the CMS website.

*A Registration User Guide can be found at https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/EHRMedicaidEP_RegistrationUserGuide.pdf.