Eligible Professional Types

The following types of healthcare practitioners are eligible to apply for the NY Medicaid EHR Incentive Program:

• Physicians (M.D. or D.O.)
• Nurse Practitioners
• Certified Nurse Midwives
• Dentists
• Physician Assistants who practice in a Federally Qualified Health Center (FQHC) that is led by a Physician Assistant or Rural Health Clinic that is led by a Physician Assistant

Medicaid Patient Volume (MPV) Requirements

Eligible Professionals (EP) who enroll in the Medicaid EHR Incentive Program must demonstrate each year that at least 30% of their patient volume is attributed to Medicaid during a 90–day reporting period they choose (see section below for more details). EPs must also attest to the Medicaid patient volume requirement by attesting to either the standard or alternative patient volume methods in the attestation portal.

Additionally, EPs in groups have an option to combine the totals of all EPs in the group and attest using aggregate totals. There is assistance available for those who have difficulty assembling their Medicaid Patient Volume. Medicaid encounter types which can be counted towards both methods:

• ✓ Medicaid Fee–For–Service
• ✓ Medicaid Managed Care
• ✓ Family Health Plus

For more information on Medicaid Patient Volume visit:
Medicaid Patient Volume Overview

Medicaid Patient Volume (MPV) Reporting Period

The patient volume reporting period may be any consecutive 90–day period within the calendar year (CY) prior to the payment year attesting to or preceding 12–month period from the date of the attestation*. The patient volume recorded within this 90–day period must be "representative" of the provider´s overall practice.

*Expanded Reporting Period Disclaimer: Please be aware that it may take an additional 90 days to validate your attestation if you select a 90–day reporting period up to the date of attestation.

For more information on Medicaid Patient Volume visit:
Medicaid Patient Volume Overview

Pre–Payment Requirements

Eligible professionals (EP) participating in the NY Medicaid EHR Incentive Program must maintain all program requirements in each participation year. The requirements include the following:

• ✓ Must be enrolled as a NY Medicaid fee–for–service provider
• ✓ Payee must be enrolled as payable NY Medicaid Provider
• ✓ Maintain ETIN association either personally or with a group/hospital

For a full list of pre–payment requirements, visit:
Participation Checklist

For more information on common pre–payment review scenarios, visit:
Pre–Payment Review Scenarios

EHR Reporting Period

Any continuous 90–day period within 2011.

Certified EHR Technology (CEHRT) Requirements

At least 2011 Edition CEHRT is required to meet the MU Stage 1 Reporting Objectives.

Please see the ONC 2011 Edition Final Rule for additional details on the CEHRT requirements.

1. Computerized provider order entry (CPOE)
2. E–Prescribing (eRx)
3. Report ambulatory clinical quality measures to CMS/States
4. Implement one clinical decision support rule
5. Provide patients with an electronic copy of their health information, upon request
6. Provide clinical summaries for patients for each office visit
7. Drug–drug and drug–allergy interaction checks
8. Record demographics
9. Maintain an up–to–date problem list of current and active diagnoses
10. Maintain active medication list
11. Maintain active medication allergy list
12. Record and chart changes in vital signs
13. Record smoking status for patients 13 years or older
14. Capability to exchange key clinical information among providers of care and patient–authorized entities electronically
15. Protect electronic health information

Eligible Professionals, eligible hospitals and CAHs seeking to demonstrate Meaningful Use are required to submit aggregate CQM numerator, denominator, and exclusion data.

For more information on 2011 CQM Reporting, visit:
Clinical Quality Measures Basics

For Post Payment Audit Guidance, visit:
Post Payment Audit Home