Eligible professionals can receive up to $63,750 in Medicaid Promoting Interoperability Program payments over 6 years if they maintain program eligibility.
Pediatricians are allowed to participate with a reduced patient volume threshold (20% instead of 30%). If a pediatrician has a Medicaid (Title XIX fee-for-service and managed care ONLY) patient volume of between 20% and 30%, they will receive 2/3 of that year's full incentive payment. Pediatricians' payments can vary between 2/3 and full payments based on each individual year's Medicaid patient volume calculation.
Incentive payments issued to providers may be reduced if the provider owes other amounts to New Jersey Medicaid, the State of New Jersey, or other governmental entities. Providers will receive the balance of any given year's incentive payment once all other outstanding amounts owed to these entities are cleared.
If New Jersey Medicaid can establish that the patient volume and certified EHR technology eligibility requirements are met, the eligible professional will receive New Jersey Medicaid Promoting Interoperability Program payments based on the schedule below.
|
|
All EPs with Medicaid Patient Volume of 30% or higher |
Pediatricians with Medicaid Patient Volume between 20% and 30% |
|
Year 1 |
$21,250 |
$14,167 |
|
Year 2 |
$8,500 |
$5,667 |
|
Year 3 |
$8,500 |
$5,667 |
|
Year 4 |
$8,500 |
$5,667 |
|
Year 5 |
$8,500 |
$5,667 |
|
Year 6 |
$8,500 |
$5,667 |
Since New Jersey Medicaid processes provider payments on a weekly basis, a provider whose Promoting Interoperability Program attestation is approved can expect disbursement of their Promoting Interoperability Program payment 3-5 weeks after notification that their attestation has been accepted by the State. However, issues uncovered during the State's pre-payment review of the provider’s eligibility may impact the timing of incentive payment disbursement. If a delay occurs, New Jersey Medicaid will notify the provider promptly and work with them to clarify the information (or lack thereof) that prevented distribution of the payment.
Providers may submit and initiate a New Jersey Medicaid Promoting Interoperability Program anytime with a reporting period of up to December 31, 2016. Providers are not required to participate in consecutive years; however, the final year to receive a New Jersey Medicaid Promoting Interoperability Payment is 2021.
