Incentive payments may be received by both physicians (and other included clinicians) who meet the definition of an Eligible Professional (EP) and Eligible hospitals.
- Eligible Professional is a physician, which includes doctors of medicine, osteopathy, dentistry, podiatry, optometry, and chiropractors. [495.100, referencing Section 1861(r) of the Social Security Act]
- Eligible Hospital—generally means short-term acute-care hospitals [495.100, referencing 42 CFR 412.1(a)(1)]. Eligible Hospitals excludes: psychiatric, rehabilitation, children’s1, long-term care, cancer2, Maryland hospitals, and hospitals not in one of the fifty states, the District of Columbia, or Puerto Rico3 (referencing 42 CFR 412.23]
The Proposed MU Rule also creates a set of definitions for Qualified EP and Qualified Hospital, which are nothing more than EPs (who are not hospital-based) and Eligible Hospitals who are meaningful users for the EHR Reporting Period.
1. Children’s hospitals meeting the requirements of the Medicaid program are eligible for Medicaid EHR incentive programs.
2. Though the referenced section (42 CFR 412.23) excludes cancer hospitals, CMS in the Preamble indicates that they plan to include cancer hospitals in the scope of eligible hospitals.
3. The definition in the referenced section (42 CFR 412.23) includes Puerto Rico, but the Preamble indicates that Puerto Rico hospitals are not eligible.
