One voice for the Office of Sheriff

Deputy Sheriff

Attention Prison And Jail Administrators

Re: Correctional Health How Your Agency Can Receive Financial Incentives For Using Electronic Health Records
The 2009 Recovery Act included an Electronic Health Record incentive program known as the HITECH Act[i]. Put simply, the HITECH Act incentivizes hospitals and providers to meaningfully use electronic health records for Medicaid and Medicare patients. In the Medicaid program, an eligible provider (MD, DO, Nurse Practitioner, Certified Nurse Midwife, Dentist, and Physician Assistant, if in a Federally Qualified Health Center led by a Physician Assistant) whose patient volume consists of at least 30 percent Medicaid patients AND use a certified electronic health record[ii] is eligible for the incentive payments which, in Medicaid, can reach $63,750 per provider over 6 years ($21,250 the 1st year, $8,500 each subsequent year for 5 years). The incentive payment is made to the direct care provider, although the provider may assign the incentive payment to his/her employer, such as a correctional institution or correctional health care provider, pursuant to any existing contractual arrangements.
 
Previously, providers who practiced in prisons and jails were not eligible to receive incentive payments because eligibility requirements stated that demonstrating a Medicaid patient volume of 30 percent needed those encounters to be paid encounters.  However, in August 2012, a new regulation was published, Meaningful Use Stage 2[iii], and the requirement is now that providers need to have 30 percent of their encounters be with Medicaid enrolled patients, as opposed to paid encounters. The change makes it possible for providers at correctional facilities to participate in the incentive program, because prisoners can be enrolled in Medicaid, even though Medicaid cannot pay for medical services in correctional institutions (per Section 1905 of the Social Security Act). The EHR incentive payments are not payments for medical services.   
 
This small change means that providers who are seeing Medicaid enrolled inmates in prisons and jails can now count those patients towards their patient volume and as a result making them eligible for the incentive payments.  If the correctional facility is in a state that currently provides Medicaid services to childless adults or that in 2014 has chosen to expand Medicaid coverage under the Affordable Care Act in 2014 and the state “suspends” Medicaid eligibility rather than terminates when the person is incarcerated, it is possible that there could be a significant number of prison and jail health care providers who would be eligible to receive the EHR incentive payment. The Medicaid enrollment status of female inmates with children should also be determined as providers in some women’s prisons might be eligible already.
 
A list of electronic health records systems that meet the eligibility criteria for participation in the incentive program are described by the Office of the National Coordinator for Health IT.  They are known colloquially as the “Meaningful Use” standards for Health IT and can be found online at www.healthit.gov[iv].  Note that if a correctional health provider’s Electronic Health Record (EHR) isn’t on this list, it does not necessarily mean the EHR vendor is not aware of the program.  They may still have their Meaningful Use compliant version of their EHR in a testing phase (or this information will compel them to make their EHR compliant with the Meaningful Use standards). Please contact your current EHR vendor to discuss.
 
For more information about program eligibility, please contact your state Medicaid agency and visit www.healthit.gov and www.cms.gov/ehrincentiveprograms.