Physicians who participate in the federal electronic health record (EHR) program for Medicare can begin qualifying this year for incentive payments; clinicians who do not join the program will face cuts in future Medicare reimbursements.

Physicians who opt to participate under the Medicaid version of the EHR program can wait until 2015 to begin their participation and still obtain the full incentive payment.

The payments for participating under either Medicare or Medicaid (physicians may select only one) differ sharply (see Don't Miss EHR Participation Deadline) and are dependent on meeting each year's qualification criteria. Physicians can qualify for a total of up to $44,000 over five years through Medicare or up to $63,750 over six years from Medicaid.

Physicians can receive up to one-third of the funds from either program in the first year they participate.

Any physician who declines to participate or fails to meet the program's submission requirements will undergo cuts in his or her total annual Medicare payments unless the physician participates in the Medicaid EHR program. These are the scheduled cuts:

There are no financial penalties under Medicaid.

Health care financing experts suggest physicians calculate the cost of these future cuts based on their recent annual Medicare billing to determine the amount of revenue they will lose if they do not participate in the Medicare program.

More information on EHR payments and deadlines is posted at <www.ama-assn.org/ama1/pub/upload/mm/472/ehr-medicare-incentive-summary.pdf> and <www.ama-assn.org/ama1/pub/upload/mm/472/ehr-medicaid-incentive-summary.pdf>.