NY Medicaid EHR Incentive Program

Eligibility

For a hospital to be eligible to receive an incentive payment with the NY Medicaid EHR Incentive Program, the entity must meet all program eligibility requirements.

Eligible Hospital (EH) Types

According to the rules of the Medicaid EHR Incentive Program, the following facilities may be eligible to receive direct incentive payments:

  • Acute Care Hospitals
  • Children´s Hospitals

For the NY Medicaid EHR Incentive Program definition of Acute Care and Children´s Hospital full definition please see FAQ EH05.

Even within an eligible acute care or children´s hospital, some units are not considered acute care and are not counted in the calculations for determining eligibility or calculating the incentive payment. The following types of services are considered sub–acute and should be excluded from all calculations:

  • Nursery care, although neonatal intensive care services are acute care and should be counted
  • Skilled nursing or long–term care
  • Rehabilitation
  • Psychiatric services

Medicaid Patient Volume

Eligible Hospitals (EH) enrolling in the Medicaid EHR Incentive Program must demonstrate, over a 90-day reporting period, that at least 10% of their patient volume is attributed to Medicaid (as shown below). Children's Hospitals have no minimum Medicaid patient volume to meet. The EHs will demonstrate their meeting the Medicaid patient volume requirement by attesting within the eligibility section of the attestation portal.

Type of Service Medicaid Encounter
Medicaid Fee–For–Service ✓
Medicaid Managed Care ✓
Family Health Plus ✓

90–day Reporting Period

Eligibility is always a 90-day reporting period (although the MU Reporting Period can be different in each participation year). The 90-day patient volume period used to determine a hospital's eligibility for the NY Medicaid EHR Incentive Program in a given payment year must be entirely within the hospital cost reporting year that ended during the Federal Fiscal Year (FFY) prior to that payment year.

Calendar Year January 1 to December 31
State Fiscal Year April 1 to March 31
Federal Fiscal Year October 1 to September 30
School Year July 1 to June 30

Hospital Workbook

The Hospital Workbook is a critical resource for all Hospitals that are new to the NY Medicaid EHR Incentive Program. The workbook features an eligibility requirement worksheet*, incentive payment calculation worksheet, glossary of terms, and class code guidance.

* Hospitals that are in Payment Year 2 or 3 of the Program should only complete the Eligibility Worksheet to aid in calculating the Medicaid patient volume.