Medicaid EHR Incentive Program Eligibility Verification Checklist医疗电病历的激励计划的资格审核检查表.docxVIP

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Medicaid EHR Incentive Program Eligibility Verification Checklist医疗电病历的激励计划的资格审核检查表.docx

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Medicaid EHR Incentive Program Eligibility Verification Checklist医疗电病历的激励计划的资格审核检查表

State Medicaid Agency:Person Completing Form:E-Mail Address:Explanation of Numbered Notes(1)EP - Eligible Professional(2)EH - Eligible Hospital(3)American Recovery Reinvestment Act of 2009 (Public Law 111-5); Health Information Technology for Economic Clinical Health Act (HITECH)(4)42 CFR Parts 412, 413, 422 and 495; Medicare and Medicaid Programs; EHR Incentive Program Final Rule.(5)Not required of EP in IHS facilities.Practitioner TypeApplicabilityState Verification Process and Data ElementsEligibility RequirementsEP(1)EH(2)Statute(3)Final Rule(4)Pre-payment VerificationProcess and Data ElementsPost-payment Review ProcessRisk Profile Process and Data ElementsSMHP (or Amendment)Citation with Date1. EP or EH must be one of the permissible professional or hospital types??42 USC § 1396b(t)(2)(A-B)§ 495.368 (a)(1)(i) Combating fraud and abuse???QualificationsApplicabilityState Verification Process and Data ElementsEligibility RequirementsEP(1)EH(2)Statute(3)Final Rule(4)Pre-payment VerificationProcess and Data ElementsPost-payment Review ProcessRisk Profile Process and Data ElementsSMHP (or Amendment)Citation with Date2. EP or EH must be licensed to practice in the State(5)???§ 495.368 (a)(1)(i) Combating fraud and abuse???3. EP or EH must be a Medicaid provider in that State.???§ 495.304 (a) Medicaid provider scope and eligibility???4. EP or EH cannot be excluded, sanctioned, or otherwise deemed ineligible to receive payments from the State (e.g. already received incentive payment)???§ 495.368 (a)(1)(i) Combating fraud and abuse???Patient VolumeApplicabilityState Verification Process and Data ElementsEligibility RequirementsEP(1)EH(2)Statute(3)Final Rule(4)Pre-payment VerificationProcess and Data ElementsPost-payment Review ProcessRisk Profile Process and Data ElementsSMHP (or Amendment)Citation with Date5. EP must have at least a 30% Medicaid patient volume (or 20% for pediatricians), unless s/he is practicing predominantly in an FQHC or RHC??42 USC § 1396b(t)(2)(A