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Rebecca Farley

Director, Policy & Advocacy, National Council for Behavioral Health

Health IT Payments Available to Providers Working in Jails and Prisons

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Healthcare professionals working in correctional institutions are now eligible to receive federal health IT incentive payments for their use of electronic health records, according to guidance issued by the Centers for Medicare and Medicaid Services. Under the new policy, providers are eligible to receive the payments when 30 percent of their patient encounters are with patients enrolled in Medicaid – even if patients’ enrollment has been suspended due to their incarceration.

Previously, providers could only reach the 30% threshold when their patient encounters were paid by Medicaid. This excluded most providers working with inmates because Medicaid does not pay for services provided to patients in correctional institutions. Now, providers serving Medicaid-enrolled inmates in prisons and jails may count these patients toward their patient volume if they live in a state that suspends – not terminates – those patients’ Medicaid eligibility. CMS has repeatedly urged states to ensure timely reinstatement of inmates’ benefits by suspending rather than terminating their Medicaid eligibility upon incarceration.

Electronic health records play a key role in coordinated care. Wider adoption of EHRs in correctional institutions has the potential to improve healthcare for incarcerated individuals, a disproportionate number of whom live with a mental illness or substance use disorder. For more information about the EHR incentive program, visit www.cms.gov/ehrincentiveprograms