1. Medicaid EHR Incentives for Children's Hospitals Under the HITECH Act
Friday, February 4, 2011 · 12:00-1:00 pm Eastern
This brown bag is brought to you by the Children's Hospital Affinity Group (CHAG) of the In-House Counsel Practice Group
Presenter:
Joseph E. Lynch, Esquire
Partner
King & Spalding LLP, Washington, DC
Co-Chairs of CHAG:
Stephanie Webster
Partner, King & Spalding LLP, Washington DC
Rhonda L. Comer General Counsel, Nationwide Children’s Hospital, Columbus, Ohio 1

2. Overview H.R. 408 – Spending Reduction Act of 2011
Medicaid EHR incentives issues concerning:
Children’s Hospitals and Their EPs
Children’s Hospitals
EPs
Questions 2

3. Issues for Children’s Hospitals and EPs
EHR certification – complete functionality is required
Timing of Medicaid EHR incentives
CMS must approve each State’s HIT Plan
States likely to pay Medicaid EHR incentives over 3 years
Qualifying under the “Adopt, Implement, Upgrade” option
Minimum requirement – contract to acquire or have access to certified EHR technology (all functionality)
EPs must also meet the Medicaid population requirement 3

4. Issues for Children’s Hospitals
Assignment of EPs’ EHR incentives
EPs’ 15% cost sharing obligation
Qualifying for Medicaid EHR incentives in non-consecutive years prior to FY 2016 (important concerning “adopt, implement, upgrade” qualification option) 4

5. Issues for EPs Medicaid patient volume
State HIT Plan specifies measurement methodology
CMS-approved measurement methodologies
Encounters paid at least in part under Medicaid
“Panel” option
Clinic/group patient volume
Used by all EPs in the clinic/group
Can include part-time EPs
When is the clinic/group volume an “appropriate” surrogate for an EP’s volume?
What constitutes a “clinic” or “group”?
“Pediatrician” definition/pediatric subspecialists 5

6. Questions 6

7. Medicaid EHR Incentives for Children's Hospitals Under the HITECH Act © 2011 is published by the American Health Lawyers Association. All rights reserved. No part of this publication may be reproduced in any form except by prior written permission from the publisher. Printed in the United States of America.
Any views or advice offered in this publication are those of its authors and should not be construed as the position of the American Health Lawyers Association.
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