Achieving

Meaningful Use
Stage 2

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Achieving

Meaningful Use
Introduction
Key timelines
Meaningful Use Timeline & CMS Reporting 2014
Requirements of Stage 2
Reporting Clinical Quality Measures
Attest for Stage 2 with CureMD
Stage 2 FAQs

Introduction
The Medicare and Medicaid EHR Incentive Programs offer nancial incentives for the
meaningful use of certied EHR technology to improve patient care.

To receive an EHR incentive payment, providers have to show that they are meaningfully
using their EHRs by meeting thresholds for a number of objectives. CMS has established
the objectives for meaningful use that eligible professionals, eligible hospitals, and critical
access hospitals (CAHs) must meet in order to receive an incentive payment.

The Medicare and Medicaid EHR Incentive Programs are staged in three steps with
increasing requirements for participation. All providers begin participating by meeting the
Stage 1 requirements for a 90-day period in their rst year of meaningful use and a full year
in their second year of meaningful use.

After meeting the Stage 1 requirements, providers will then have to meet Stage 2
requirements for two full years. Eligible professionals participate in the program on the
calendar years, while eligible hospitals and CAHs participate according to the federal scal
year.

Stage 3

Stage 1
2011
Data Capturing
& Sharing

in

2015
Stage 2
Improved Outcomes
2014
Advanced
Clinical Processes

Key Timelines of Stage 2

CMS
CDC

Nov 30,
2011

Registration
for the EHR
Incentive
Program
Begins

Last day for

eligible
hospitals
and CAHs to
register and
attest to
receive an
Incentive
Payment for
FY 2011

JAN 2011

Feb 29,
2012

For
Medicade
Providers,
States may
lauch their
programs if
they so
choose

Last day for

EPs to
register and
attest to
receive and
Incentive
Payment for
FY 2011

JAN 2011

Certied
EHR
technology
available &
listed on
ONC
website

May 2011
EHR
Incentive
Payments
begin

FALL

WINTER

SPRING

FALL

WINTER

2010

2011

2011

2011

2012

2014

2015

2021
Last year to
receive
Medicaid
EHR
Payment

2016

NOV/DEC

1-2Q11

late 2011

2014

2016

RFI for
additional
public input

Moniter
Stage 1
submissions

Final
recommendations to
ONC

Last year to
initiate
participation in the
Medicare
EHR
Incentive
Program

Last year to
receive a
Medicare
EHR
Incentive
Payment

2Q11
Draft
recommendations to
HIT Policy
Committee

in

2015
Medicare
payment
adjustments
begin for
EPs &
eligible
hospitals
that are not
meaningful
users to
EHR
technology

2021

Last year to
initiate
participation in
Medicaid
EHR
Incentive
Program

New Criteria From 2014,

Improving Patient Care Stage 2

Saving Money, Time, Lives

providers participating in the

includes new objectives to

With this next stage, EHRs will

EHR Incentive Programs who

improve patient care through

further save our healthcare

have met Stage 1 for two or

better clinical decision support,

system money, time for doctors

three years will need to meet

care coordination and patient

and hospitals, and lives.

Meaningful Use Stage 2 criteria.

engagement.

Meaningful Use Timeline & CMS Reporting 2014

CMS had previously established a timeline in the Stage 1 of the MU Program, requiring
providers to ascend to the criteria for Stage 2 after two years of the program which meant
that this timeline required Medicare providers demonstrating Meaningful Use in 2011 to
meet the 2013 criteria of Stage 2.

CMS then had the criteria for Stage 2 delayed for a year, making it effective in the year 2014.
For the year 2014, providers, regardless of their current Stage in the Meaningful Use timeline, are required to demonstrate Meaningful Use for three months in that year. Medicare
Providers: The 3 month reporting period has been xed to the scal year for hospitals and
critical access hospitals and the calendar year for eligible providers.

Medicaid Providers: For those who are only eligible to receive the Medicaid EHR Incentives,
the reporting period of 3 months is not xed to any quarter and can be fullled at any time of
the year with 3 consecutive months of MU demonstration.

Requirements of Stage 2
Meaningful use includes both a core set and a menu set of objectives that are specic to
eligible professionals or eligible hospitals and CAHs. For eligible professionals, there are a
total of 24 meaningful use objectives. To qualify for an incentive payment, 19 of these 24
objectives must be met:
14 required core objectives
5 objectives chosen from a list of 10 menu set objectives

For eligible hospitals and CAHs, there are a total of 23 meaningful use objectives. To qualify
for an incentive payment, 18 of these 23 objectives must be met:
13 required core objectives
5 objectives chosen from a list of 10 menu set objectives

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CMS provides Meaningful Use Specication Sheets that bring together critical information
on each objective to help you understand what you need to do to meet the program requirements. Each specication sheet covers a single eligible professional core or menu set objective in detail, including information on:
Meeting the measure for each objective
How to calculate the numerator and denominator for each objective
How to qualify for an exclusion to an objective
In-depth denitions of terms that clarify objective requirements
Requirements for attesting to each measure

Stage 2 - 2014

Stage 1 - 2014

17 Core Measures

15 Core Measures

6 Menu Measures (at least 3)

10 Menu Measures (at least 5)

90 Days Reporting Period

90 Days Reporting Period

$8000-Incentive (MCR)

Depends on the year of participation

Reporting Clinical Quality Measures

Clinical quality measures, or CQMs, are tools that help measure and track the quality of
health care services provided by eligible professionals, eligible hospitals and critical access
hospitals (CAHs) within our health care system. These measures use data associated with
providers ability to deliver high-quality care or relate to long term goals for quality health
care. CQMs measure many aspects of patient care including:
Health outcomes
Clinical processes
Patient safety
Efcient use of health care resources
Care coordination

in

 Patient engagements
Population and public health
Adherence to clinical guidelines

Measuring and reporting CQMs helps to ensure that our health care system is delivering
effective, safe, efcient, patient-centered, equitable, and timely care.

To participate in the Medicare and Medicaid Electronic Health Record (EHR) Incentive
Programs and receive an incentive payment, providers are required to submit CQM data
from certied EHR technology. Beginning in 2014, all providers must use EHR technology
that has been certied to the 2014 standards and capabilities that contains new CQM
criteria. Providers will report using the 2014 criteria regardless of whether they are in Stage
1 or Stage 2 of meaningful use.

Please visit the 2014 Clinical Quality Measure Page to learn more about 2014 CQMs and
2014 reporting options.

To access the EHR Incentive Program 2014 CQM electronic specications please visit the
eCQM Library page.

To learn more about electronic reporting please visit the Electronic Reporting Specication
page of the EHR Incentive Program.

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Attest for Stage 2 with CureMD

MU Registration

A session in which CureMD will walk you through the

registration process.

Initial Assessment &

We will assess your current process ow, and determine

Recommended Plan

the fastest path to achieving Meaningful Use.

MU Training

Training Session on MU Compliance and Progress

Tracking.

Monitor Progress

A monthly session where your progress towards

Towards MU Compliance

Meaningful Use will be reviewed.

MU Attestation

A session in which CureMD will walk you through the

Meaningful Use attestation process.

in

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Stage 2 FAQs
How will the Physician Payment be calculated under Medicare?
The Medicare payments will be calculated by multiplying the submitted allowable charges to
Medicare by 75%, up to the capped amount for the year. So a physician aiming to collect the
full incentive payment of $18,000 in 2011 will need to submit allowable charges of at least
$24,000. Conversely, a physician submitting only $16,000 in allowables would collect
$12,000 in 2011, even though the cap is higher.

Do providers register only once for the Medicare and Medicaid Electronic Health
Record (EHR) Incentive Programs, or must they register every year?
Providers are only required to register once for the Medicare and Medicaid EHR Incentive
Programs. However, they must successfully demonstrate that they have either adopted,
implemented or upgraded (rst participation year for Medicaid) or meaningfully used
certied EHR technology each year in order to receive an incentive payment for that year.

Additionally, providers seeking the Medicaid incentive must annually re-attest to other
program requirements, such as meeting the required patient volume thresholds. Providers
will register using the Medicare and Medicaid EHR Incentive Program Registration &
Attestation System, a web-based system. Providers who have elected to participate in the
Medicare EHR Incentive Program will also use this system to attest to their program
eligibility and meaningful use.

Providers who select the Medicaid EHR Incentive Program will demonstrate their eligibility
and attest via their State Medicaid Agency's system. If any basic registration information
changes, the provider will need to update their information in the Medicare and Medicaid
EHR Incentive Program Registration & Attestation System.

When can I register and where do I register for the Medicare and Medicaid Electronic
Health Record (EHR) Incentive Programs?

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Registration for the Medicare EHR Incentive Program began on January 3, 2011 and is
available for eligible professionals (EPs), eligible hospitals and critical access hospitals
(CAHs) online at CMS.

Please note that although the Medicaid EHR Incentive Programs will begin January 3, 2011,
not all states will be ready to participate on this date. Information on when registration will
be available for Medicaid EHR Incentive Programs in specic States is posted at CMS Incentive Program.

Can eligible professionals (EPs) receive electronic health record (EHR) incentive
payments from both the Medicare and Medicaid programs?
Not for the same year. If an EP meets the requirements of both programs, they must choose
to receive an EHR incentive payment under either the Medicare program or the Medicaid
program. After a payment has been made, the EP may only switch programs once before
2015.

How much are the Medicare and Medicaid Electronic Health Record (EHR) incentive
payments to eligible professionals (EPs)?
Under the Medicare EHR Incentive Program, EPs who demonstrate meaningful use of
certied EHR technology can receive up to a total of $44,000 over 5 consecutive years.
Additional incentives are available for Medicare EPs who practice in a Health Provider
Shortage Area (HPSA) and meet the maximum allowed charge threshold. Under the
Medicaid EHR Incentive Program, EPs can receive up to a total $63,750 over the 6 years
that they choose to participate in program. EPs may switch once between programs after a
payment has been made and only before 2015.

Are there any special incentives for rural providers in the Medicare and Medicare
Electronic Health Record (EHR) Incentive Programs?

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We note that nothing in the Act excludes such payments from taxation or as tax-free income.
Therefore, it is our belief that incentive payments would be treated like any other income.
Providers should consult with a tax advisor or the Internal Revenue Service regarding how to
properly report this income on their lings.

In order to receive payments under the Medicare and Medicaid Electronic Health
Record (EHR) Incentive Programs, does a provider have to be enrolled in the Provider
Enrollment, Chain, and Ownership System (PECOS)?
In order to receive Medicare EHR incentive payments, EPs, eligible hospitals, and critical
access hospitals must have an enrollment record in PECOS. Medicaid EPs do not have to be
in PECOS. There are three ways to verify that you have an enrollment record in PECOS:
1.

Check the Ordering Referring Report on the CMS website. If you are on that report, you
have a current enrollment record in PECOS. Go to CMS Provider, click on "Ordering
Referring Report" on the left.

2.

Use Internet-based PECOS to look for your PECOS enrollment record. If no record is
displayed, you do not have an enrollment record in PECOS. Go to CMS Provider, click on
"Internet-based PECOS" on the left.

3.

Contact your designated Medicare enrollment contractor and ask if you have an enrollment
record in PECOS. Go to CMS Provider, click on "Medicare Fee-For-Service Contact
Information" under "Downloads." If you are not in PECOS, the best way to submit your
application is through internet-based PECOS.

This information is accurate, to the best of our knowledge. As more information becomes
available from HHS and other agencies, this page will be updated accordingly. Please check
the CMS website.

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