Eligible Professional Types

The following types of healthcare practitioners are eligible to apply for the NY Medicaid EHR Incentive Program:

• Physicians (M.D. or D.O.)
• Nurse Practitioners
• Certified Nurse Midwives
• Dentists
• Physician Assistants who practice in a Federally Qualified Health Center (FQHC) that is led by a Physician Assistant or Rural Health Clinic that is led by a Physician Assistant

Medicaid Patient Volume (MPV) Requirements

Eligible Professionals (EP) who enroll in the Medicaid EHR Incentive Program must demonstrate each year that at least 30% of their patient volume is attributed to Medicaid during a 90–day reporting period they choose (see section below for more details). EPs must also attest to the Medicaid patient volume requirement by attesting to either the standard or alternative patient volume methods in the attestation portal.

Additionally, EPs in groups have an option to combine the totals of all EPs in the group and attest using aggregate totals. There is assistance available for those who have difficulty assembling their Medicaid Patient Volume. Medicaid encounter types which can be counted towards both methods:

• ✓ Medicaid Fee–For–Service
• ✓ Medicaid Managed Care

For more information on Medicaid Patient Volume visit:
Medicaid Patient Volume Overview

Medicaid Patient Volume (MPV) Reporting Period

The patient volume reporting period may be any consecutive 90–day period within the calendar year (CY) prior to the payment year attesting to or preceding 12–month period from the date of the attestation*. The patient volume recorded within this 90–day period must be "representative" of the provider´s overall practice.

*Expanded Reporting Period Disclaimer: Please be aware that it may take an additional 90 days to validate your attestation if you select a 90–day reporting period up to the date of attestation.

For more information on Medicaid Patient Volume visit:
Medicaid Patient Volume Overview

Pre–Payment Requirements

Eligible professionals (EP) participating in the NY Medicaid EHR Incentive Program must maintain all program requirements in each participation year. The requirements include the following:

• ✓ Must be enrolled as a NY Medicaid fee–for–service provider
• ✓ Payee must be enrolled as payable NY Medicaid Provider
• ✓ Maintain ETIN association either personally or with a group/hospital

For a full list of pre–payment requirements, visit:
Participation Checklist

For more information on common pre–payment review scenarios, visit:
Pre–Payment Review Scenarios

EHR Reporting Period

Any continuous 90–day period within 2018.

Certified EHR Technology (CEHRT) Requirements

To meet Stage 3 requirements, all providers must use 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.

Providers must attest that they have not restricted the compatibility or interoperability of their CEHRT. For more information, please review the Prevention of Information Blocking Attestation Fact Sheet.

Reminder: Stage 3 Reporting is not required until Program Year 2019

All providers are required to attest to a single set of objectives and measures. For eligible professionals (EPs) and eligible hospitals there are 8 objectives for 2018 Stage 3 Reporting:

1. Protect Patient Health Information
   For additional information, please review the Security Risk Assessment page.
2. Electronic Prescribing (eRx)
3. Clinical Decision Support (CDS)
4. Computerized Provider Order Entry (CPOE)
5. Patient Electronic Access
6. Coordination of Care Through Patient Engagement
7. Health Information Exchange
8. Public Health Reporting

Additional Resources:

• Eligible Professional Medicaid EHR Incentive Program Stage 3 Objectives and Measures
• Guide for Eligible Professionals in the Medicaid Promoting Interoperability Program Practicing in Multiple Locations

In addition to the required objectives and measures, EPs must report on clinical quality measures (CQMs) for the full year of 2018. EPs in their first year of meaningful use have a CQM reporting period of any continuous 90 days.

For 2018, EPs must report on 6 (of 53) CQMs from any National Quality Strategy (NQS) domain, relevant to the EP´s scope of practice.

For more information on 2018 Clinical Quality Measure Requirements, visit:
Clinical Quality Measure Basics

For Post Payment Audit Guidance, visit:
Post–Payment Audit Home