October 2011 
EHR Incentive Program
Medicaid Adopt, Implement, Upgrade (AIU) Option  
Even if you are not ready to attest to meeting all of the requirements for stage one of Meaningful Use, you may be eligible for a portion of the Medicaid payment immediately. Hospitals and eligible providers who meet the thresholds for Medicaid may be eligible for the first-year payment through the “Adopt, Implement, Upgrade” provision.  
Through this provision, a hospital or eligible provider merely needs to purchase certified EMR technology within the first payment year. For hospitals, that year is the Federal fiscal year which ends September 30. For eligible providers, it’s the first year is the calendar year that ends December 31.  
For AIU, a provider does not have to have installed certified EHR technology. The definition of AIU in 42 CFR 495.302 allows the provider to demonstrate AIU through any of the following: (a) acquiring, purchasing or securing access to certified EHR technology; (b) installing or commencing utilization of certified EHR technology capable of meeting meaningful use requirements; or (c) expanding the available functionality of certified EHR technology capable of meeting Meaningful Use requirements at the practice site, including staffing, maintenance, and training, or upgrading from existing EHR technology to certified EHR technology per the EHR certification criteria published by the Office of the National Coordinator of Health Information Technology (ONC). Thus, a signed contract indicating that the provider has adopted or upgraded would be sufficient.  
Medicaid payments will occur no later than 5 months after attestation.  
The chart below shows criteria for an eligible provider or hospital. Note that hospitals must have a 10% volume of Medicaid discharges.  
The equation is used to determine the Medicaid volume. For hospitals, discharges are used in place of encounters.
In order to receive your Medicaid payment you will need to follow these steps.  
  1. Ensure your state is a participant in the Medicaid EHR incentive program.
  2. Obtain a CMS EHR Certification ID
  3. Obtain an Incentive and Attestation login and password
  4. Register for the EHR Incentive Program
    • Select the “Registration” Tab
    • Select “Hospital” for hospitals. You will be prompted to select Medicare, Medicaid, or both. Also you will be prompted to select AIU (Adopt, Implement, Upgrade)
  5. Attest for the EHR Incentive Program
    • Select the “Attestation” Tab
“Haven’t implemented all stage one Meaningful Use requirements yet? If at least 10% of your hospital discharges are Medicaid patients, you still may be eligible for early incentives through the Medicaid Adopt, Implement, Upgrade (AUI) provision.”
Jeff Bell
Strategic IT Planning
CareTech Solutions