C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER G—STANDARDS AND CERTIFICATION › PART 495—STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM › Subpart D—Requirements Specific to the Medicaid Program

42 C.F.R. § 495.312

Process for payments

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(a) General rule. States must have a process for making payments consistent with the requirements in subparts A and D of this part.

(b) Reporting data consistent with this subpart. In order to receive a payment under this part, a provider must report the required data under subpart A and this subpart within the EHR reporting period described in § 495.4.

(c) State's role. (1) Except as specified in paragraph (c)(2) of this section, the State determines the provider's eligibility for the EHR incentive payment under subparts A and D of this part and approves, processes, and makes timely payments using a process approved by CMS.

(2) At the State's option, CMS conducts the audits and handles any subsequent appeals, of whether eligible hospitals are meaningful EHR users on the States' behalf.

(d) State disbursement. The State disburses an incentive payment to the provider based on the criteria described in subpart A and this subpart.

(e) Timeframes. Payments are disbursed consistent with the following timeframes for each type of Medicaid eligible provider:

(1) Medicaid EPs. States disburse payments consistent with the calendar year on a rolling basis following verification of eligibility for the payment year.

(2) Medicaid eligible hospitals. States disburse payments consistent with the Federal fiscal year on a rolling basis following verification of eligibility for the payment year.

[75 FR 44565, July 28, 2010, as amended at 77 FR 54162, Sept. 4, 2012]
Notes of Decisions
Cited in 2 cases (2 in the last 5 years), 2021–2022 · leading case: MaineHealth v. Lambrew (Me. Super. Ct 2022).
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MaineHealth v. Lambrew (Me. Super. Ct 2022). · cites it 2× “" 42 C.F.R. § 495.312 (c); see also id. at §§ 495.”
Dignity Health v. Lightbourne (N.D. Cal. 2021). “8 Plaintiffs attempt to salvage their claims by arguing that the HITECH Act and the final rule 9 implementing it “unambiguously require inclusion of all inpatient bed days in the Medicaid Share 10 numerator,” and that state Medicaid agencies have “sole responsibility” to…”
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