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Med-Pro Management, Inc.

Medical Practice Management and Consulting


July 2011 

In This Issue
Insurance Exchanges
CMS Paid First EHR Incentives
Insurance Exchanges
On July 11th, 2011, the federal government released proposed rules that will govern how states set up and run exchanges where individuals and small businesses can shop for health insurance.

Insurers, consumer advocates and others will have 75 days from July 11 to comment. Final rules are expected later this year.


The so-called exchanges are a key element of the health care overhaul law. Exchanges are marketplaces where consumers can do comparison shop for health insurance, similar to shopping online for airline tickets.


Premiums will vary based on plan and location.  People who earn less than 133% of federal poverty level, $14,484 in 2011, will qualify for Medicaid. Above the 133% level, there will be sliding subsidies for private insurance on the exchanges for those who earn up to 400% of the poverty level, about $43,560 this year. 


Click here to read more about insurance exchanges ...


"All change is not growth, as all movement is not forward."

Ellen Glasgow


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CMS Paid First EHR Incentives
Medicare & Medicaid EHR Incentive Program Webinar
Medicare & Medicaid EHR Incentive Program Webinar

Since the EHR incentive program opened in January of 2011, more than $158 million has been paid for both the Medicare and Medicaid EHR incentive programs.  In total, the Federal Government has paid:

  • $75 million for the Medicare EHR incentive program
  • $83.3 million for the Medicaid EHR incentive program

The following are notable differences between the Medicare and Medicaid EHR incentive programs:



Federal Government will implement (will be an option nationally)Voluntary for States to implement (may not be an option in every State)
Payment reductions begin in 2015 for providers that do not demonstrate Meaningful UseNo Medicaid payment reductions
Must demonstrate Meaningful Use in the first yearAdopt, implement and upgrade option for 1st participation year
Maximum incentive is $44,000 for Eligible Professionals (10% bonus for Eligible Professionals in Health Professional Shortage Area)Maximum incentive is $63,750 for Eligible Professionals
Meaningful Use definition is standard for MedicareStates can adopt certain additional requirements for Meaningful Use
Last year a provider may initiate program is 2014; Last year to register is 2016; Payment adjustments begin in 2015Last year a provider may initiate program is 2016; Last year to register is 2016
Eligible Professionals include:
  • Doctor of Medicine or Osteopathy
  • Doctor of Dental Surgery or Dental Medicine
  • Doctor of Podiatry
  • Doctor of Optometry
  • Chiropractor

...and subsection (d) hospitals and Critical Access Hospitals (CAHs).

Eligible Professionals include:
  • Physicians (primarily Doctors of Medicine and Doctors of Osteopathy)
  • Nurse Practitioner
  • Certified Nurse-Midwife
  • Dentist
  • Physician assistant who furnishes services in a Federally Qualified Health Center or Rural Health Clinic that is led by a physician assistant.

...and acute care hospitals (including CAHs) and children's hospitals.


In order to receive the Medicare or MediCaid EHR incentive payments, follow the steps below:

  1. Successfully register for the Medicare EHR Incentive Program;
  2. Meet Meaningful Use criteria using certified EHR technology (Check to see if your software is certified under the EHR incentive program at:; and
  3. Successfully attest, using CMS' Web-based system, that you have met meaningful use criteria using certified EHR technology.
If you are interested to find out more about any of the topics mentioned, please do not hesitate to send us an email at or call us at (888) 549-1713.



Med-Pro Management, Inc.


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