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Criteria for Participation

Eligible professionals (EPs) and eligible hospitals (EHs) and Critical Access Hospitals (CAHs) participating in the Texas Medicaid Electronic Health Record Incentive Program must meet program criteria to receive incentives. A returning eligible clinician (EC) must meet:

  • 30 percent Medicaid patient volume thresholds
  • Practice predominantly in an FQHC or RHC.

An exception to this rule is a returning pediatrician may have at least 20 percent Medicaid volume to qualify at reduced incentive rate noted under timeframe left for incentive payments.

For enrollment and MU reporting assistance, contact the Gulf Coast Regional Extension Center.

Modified Stage 2

To avoid the payment adjustment in CY 2018, eligible hospitals and eligible professionals will attest to the objectives and clinical quality measures as finalized in the 2015 EHR Incentive Programs Final Rule (80 FR 62762 through 62955). For returning ECs and EHs, the EHR reporting period will be a minimum of any continuous 90-day period between January 1, 2018 and December 31, 2018. For all returning participants that choose to report CQMS by attestation in 2018, the reporting period is 365 days or 90-days for first time reporters using:

  • 2014 Edition
  • 2015 Edition CEHRT, or
  • Combination of both 2014 and 2015 CEHRT

Stage 3

In 2018, Stage 3 reporting is optional, but all providers must use electronic health record technology certified to the 2015 Edition. A provider who has technology certified to a combination of the 2015 Edition and 2014 Edition may potentially attest to the Stage 3 requirements, if the mix of certified technologies would not prohibit them from meeting the Stage 3 measures. However, a provider who has technology certified to the 2014 Edition only may not attest to Stage 3. ECs and EHs will attest to a 90-day reporting period in 2018.

Audit Information

It is important to maintain auditable records to support your attestation for six years.  In response to a prepayment review or post-payment audit, you may be asked to submit additional documentation after the incentive payment has been disbursed. Gulf Coast Regional Extension Center consultants are available to assist with submitting additional detailed records to verify eligibility and that MU requirements were met at the time the payment was received.

Timeframe for Incentive Payments

Medicaid incentive payments will continue until program year 2021.

Program Year Medicaid Incentive Available Pediatricians w/20%
Volume
2018 $8,500 $5,667
2019 $8,500 $5,667
2020 $8,500 $5,667
2021 $8,500 $5,667
Total $34,000 $22,668