HIPAA Compliance Plan
« Previous PageEHR Incentives ContentsNext Page »

Download a FREE copy of the HIPAA Survival Guide 4th Edition.

§495.4 Definitions.

In this part, unless otherwise indicated--

Certified electronic health record technology means a qualified EHR that meets the certification requirements specified in 45 CFR 170.102.

Critical access hospital (CAH) means a facility that has been certified as a critical access hospital under section 1820(e) of the Act and for which Medicare payment is made under section 1814(l) of the Act for inpatient services and under section 1834(g) of the Act for outpatient services.

EHR reporting period means either of the following:

(1) For an EP--

(i) For the first payment year, any continuous 90-day period within a calendar year;

(ii) For the second, third, fourth, fifth or sixth payment year, the calendar year.

(2) For an eligible hospital or a CAH--

(i) For the first payment year, any continuous 90-day period within a fiscal year; and

(ii) For the second, third, fourth, fifth or sixth payment year, the fiscal year. Eligible hospital means an eligible hospital as defined under §495.100 or Medicaid eligible hospital under subpart D of this part.

Eligible professional (EP) means an eligible professional as defined under §495.100 or a Medicaid eligible professional under subpart D of this part. Fifth payment year means the fifth payment year that the EP, eligible hospital or CAH receives an incentive payment under this part.

First payment year means the first payment year that the EP, eligible hospital or CAH receives an incentive payment under this part.

Fourth payment year means the fourth payment year that the EP, eligible hospital or CAH receives an incentive payment under this part.

Hospital-based EP is an EP (as defined under this section) who furnishes 90 percent or more of his or her covered professional services in the CY preceding the payment year in a hospital setting. A setting is considered a hospital setting if it is identified by the codes used in the HIPAA standard transactions that identifies the site of service as an inpatient hospital, outpatient hospital, or emergency room.

Meaningful EHR user means --

(1) An EP, eligible hospital or CAH that, for an EHR reporting period for a payment year, demonstrates in accordance with §495.8 meaningful use of certified EHR technology by meeting the applicable objectives and associated measures under §495.6; and

(2) A Medicaid EP or Medicaid eligible hospital, that meets paragraph (1) of this definition and any additional criteria for meaningful use imposed by the State and approved by CMS under §495.316 and §495.332.

Payment year means--

(1) For an EP other than a Medicaid EP, a calendar year beginning with CY 2011; and

(2) For a CAH or an eligible hospital other than a Medicaid eligible hospital, a Federal fiscal year beginning with FY 2011.

(3) For a Medicaid EP,

(i) The timeframe specified in paragraph (1) of this definition; or

(ii) In accordance with subpart D of this part and with CMS approval, CY 2010.

(4) For a Medicaid eligible hospital,

(i) The timeframe specified in paragraph (2) of this definition; or

(ii) In accordance with subpart D of the part and with CMS approval, FY2010.

Qualified EHR means an electronic record of health related information on an individual that includes patient demographic and clinical health information, such as medical history and problem lists; and has the capacity to meet all of the following:

(1) Provide clinical decision support.

(2) Support physician order entry.

(3) Capture and query information relevant to health care quality.

(4) To exchange electronic health information with, and integrate such information from other sources.

Second payment year means the second payment year that the EP, eligible hospital or CAH receives an incentive payment under this part. Sixth payment year means the sixth payment year that the EP, eligible hospital or CAH receives an incentive payment under this part.

Third payment year means the third payment year that the EP, eligible hospital or CAH receives an incentive payment under this part.

The standards, implementation specifications, and certification criteria adopted in this part apply to Complete EHRs and EHR Modules and the testing and certification of such Complete EHRs and EHR Modules.

Download a FREE copy of our Breach Notification Training Module.

« Previous PageEHR Incentives ContentsNext Page »