Sec. 10.25.16.03. Program Description

A. An EHR adoption incentive shall be available to a primary care practice that meets the requirements set forth in Regulation .04 of this chapter.

B. A payor may exclude from a primary care practice’s EHR adoption incentive calculation the payor’s patient members who were previously included in another primary care practice’s EHR adoption incentive calculation.

C. A payor may, upon notification to a primary care practice:

(1) Request additional information from a primary care practice to validate the primary care practice’s EHR adoption incentive request; and

(2) Reduce a remaining EHR adoption incentive to a primary care practice if the payor determines that a duplicate payment or an overpayment has been made under this chapter.

D. The MHCC may conduct audits to determine compliance with this chapter as follows:

(1) A payor shall cooperate with the MHCC’s audit process and file information required by the MHCC in a timely manner;

(2) A primary care practice shall cooperate with the MHCC’s audit process and report requested information in a timely manner; and

(3) If an audit reveals noncompliance with this chapter, the MHCC may require corrective action.

E. This chapter shall also apply to an entity that self-insures its health benefit plans, if federal law is amended to allow state regulation of such EHR payments.