MAD will calculate yearly payment amounts and the total
payment amounts based on the guidelines described below.
A. An eligible professional provider may
receive a maximum of $63,750 in the incentive payments over six years, unless
otherwise reduced or increased by CMS.
(1) An
eligible professional provider must initiate registration to receive payment in
2016 in order to participate in the program.
(2) An eligible professional provider may
receive payment on an annual or non-consecutive basis for up to six years
between 2011 through 2021.
(3)
Payment will be made one time per year per eligible professional
provider.
(4) To receive an
incentive payment in the second, third, fourth, fifth and sixth payment year,
the eligible professional provider must demonstrate that it is a meaningful
user of EHR technology, as described in
42
CFR
495.4.
|
PY 2011
|
PY 2012
|
PY 2013
|
PY 2014
|
PY 2015
|
PY 2016
|
|
CY 2011
|
$21,250
|
|
CY 2012
|
$8,500
|
$21,250
|
|
CY 2013
|
$8,500
|
$8,500
|
$21,250
|
|
CY 2014
|
$8,500
|
$8,500
|
$8,500
|
$21,250
|
|
CY 2015
|
$8,500
|
$8,500
|
$8,500
|
$8,500
|
$21,250
|
|
CY 2016
|
$8,500
|
$8,500
|
$8,500
|
$8,500
|
$8,500
|
$21,250
|
|
CY 2017
|
$8,500
|
$8,500
|
$8,500
|
$8,500
|
$8,500
|
|
CY 2018
|
$8,500
|
$8,500
|
$8,500
|
$8,500
|
|
CY 2019
|
$8,500
|
$8,500
|
$8,500
|
|
CY 2020
|
$8,500
|
$8,500
|
|
CY 2021
|
$8,500
|
|
Potential:
|
$63,750
|
$63,750
|
$63,750
|
$63,750
|
$63,750
|
$63,750
|
B. An eligible hospital aggregated incentive
amount calculation will be a one-time, up front calculation for each hospital,
based on the methodology described in Paragraph (2) of Subsection B below.
(1) An eligible hospital has a base amount of
$2,000,000 for each of four years, plus a discharge-related amount, times the
MAD share of the total. The detailed formula is below.
{Sum over four years of [(base amount + discharge related
amount applicable for each year) * transition factor applicable for each year]}
* [(MAD inpatient-bed-days + MAD managed care inpatient-bed-days) / {(total
inpatient-bed-days) * (estimated total charges - charity care charges) /
(estimated total charges)}].
(2) MAD will make payment to a hospital as
follows:
(a) A hospital will be eligible for
funding over three years with payments distributed at 50 percent of the total
payment in the first participation year of program enrollment, 40 percent of
the total payment in the second participation year of program enrollment, and
10 percent in the third participation year of program enrollment.
(b) MAD will accept the most recent submitted
cost reports as the basis for calculation of EHR incentive program
payments.
(c) MAD will use the MAD
management information system (MMIS) data as the basis for validating hospital
MAD eligible recipient volume.
(d)
MAD will use the federal fiscal year as the basis for calculation of all
measures related to a hospital.
(e)
MAD will use the hospital audit agent to support the MAD calculation of each
eligible hospital incentive payment, and reach agreement with the eligible
hospital and their representative, the New Mexico hospital association on the
accuracy of each eligible hospital calculation before submitting the results
for payment.
(f) A hospital may not
request a re-calculation of the medicaid EHR incentive program payment once the
parties have agreed to the base year for the medicare cost report.
