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NC Department of Health and Human Services
Health IT

Public Health and Meaningful Use


North Carolina Public Health and Meaningful Use

As a part of the federally‐funded Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, $36 billion was doled out for health information technology (HIT) infrastructure. Of that, $34 billion was allocated for the Medicare and Medicaid EHR Incentive Programs. The goal of these programs is to provide more effective health care by encouraging eligible professionals (EP), eligible hospitals (EH) and critical access hospitals (CAH) to adopt, implement, or upgrade (AIU) to a certified EHR technology, and then to demonstrate Meaningful Use (MU) of that technology.

There are two separate EHR Incentive Programs, Medicare and Medicaid. EPs in North Carolina may only participate in one of these programs and may switch between them one time. EHs in North Carolina are considered dually eligible and may participate in both the Medicare and Medicaid EHR Incentive Programs.

The NC Medicaid EHR Incentive Program made its first incentive payment in 2011 and is slated to continue through 2021.

EPs participating in the NC Medicaid EHR Incentive Program may receive up to $63,750 in incentive payments over six years of program participation. Participation years do not need to be consecutive, but EPs need to begin participating by Program Year 2016 to have the opportunity to earn the full incentive payment.

For EPs who meet all program requirements, the first incentive payment is $21,250. Five additional payments of $8,500 are available for providers who successfully demonstrate MU every subsequent year of participation. For the first program year, EPs only need to attest that they adopted, implemented, or upgraded (AIU) to a certified EHR technology. EPs may elect to bypass AIU and attest to MU in their first year of program participation, but every participant will be required to attest to MU in participation years two through six. The last year an EP may attest to, and receive a payment for, AIU is Program Year 2016.

EHs and CAHs will participate with the NC Medicaid EHR Incentive Program for three years. EH and CAH incentive payments are based on a number of factors, including annual growth rates and projected discharges. Their incentive payment is calculated by starting with a base payment, then using a precise formula to adjust up or down, depending on specific hospital activity. The payment is then divided into three annual installments. The first installment is 50 percent, the second is 40 percent, and the third is 10 percent of the total payment amount.

The Medicare EHR Incentive Program gives EPs the opportunity to earn $44,000 over five years if they meet all program requirements. There's an additional incentive for EPs who provide services in a Health Professional Shortage Area (HPSA). EH payments under Medicare’s EHR Incentive Program are based on a number of factors, but start at a $2 million base payment.

Beginning in 2015, Medicare EPs, EHs, and CAHs that do not successfully demonstrate MU will be subject to payment adjustments in their Medicare reimbursement. There are no Medicaid payment adjustments.

More information about the NC Medicaid EHR Incentive Program may be found by clicking here.

More information about the Medicare EHR Incentive Program may be found by clicking here.

Click here for CMS' Stage 1 Meaningful Use Final Rule

Click here for CMS' Stage 2 Meaningful Use Final Rule

In North Carolina, the NC Division of Public Health will provide the public health MU component in three areas:

Other Links:

For further information regarding MU requirements in North Carolina, please send an email to the North Carolina Division of Public Health at Ready NC Connect NC