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Electronic Health Records (EHR) Incentive Program. HP Provider Relations October 2011. Agenda. Session Objectives EHR Incentive Program: What is it? Eligible Provider Types What is Meaningful Use? How do you register? Audits Certified Technology Helpful Tools Questions. Objectives.

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Electronic Health Records (EHR) Incentive Program

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Electronic health records ehr incentive program

Electronic Health Records (EHR) Incentive Program

HP Provider Relations

October 2011


Agenda

Agenda

Session Objectives

EHR Incentive Program:

  • What is it?

  • Eligible Provider Types

  • What is Meaningful Use?

  • How do you register?

  • Audits

    Certified Technology

    Helpful Tools

    Questions


Objectives

Objectives

Following this session, providers will:

  • Know if your provider type is eligible to receive EHR payments

  • Grasp a basic understanding of Meaningful Use

  • Understand how to register to receive EHR payments


Explain

Explain

EHR Incentive Program


Ehr incentive program

EHR Incentive Program

The American Recovery and Reinvestment Act (Recovery Act) of 2009 provides for incentive payments for eligible professionals (EPs) and eligible hospitals (EHs) for efforts to adopt, implement, upgrade, or meaningfully use certified EHR technology

To qualify for EHR payments, EHR technology must be tested and certified by an Office of the National Coordinator (ONC) Authorized Testing and Certification Body

EHR technologies that meet the certification requirements for the Medicare and Medicaid EHR incentive programs are listed on the ONC website: onc-chpl.force.com/ehrcert

What is it?


Ehr incentive program1

EHR Incentive Program

EHR incentive payments may be made to:

Eligible professionals (EPs)

  • Physicians – Primarily doctors of medicine and doctors of osteopathy

  • Dentists

  • Nurse practitioners

  • Certified nurse midwives

  • Physician assistants practicing in a Federally Qualified Health Center (FQHC) led by a physician assistant

  • Rural Health Clinic (RHC) led by a physician assistant

    Eligible hospitals (EHs)

  • Acute care hospital (includes cancer and critical access hospitals)

  • Children’s hospitals

Who can participate?


Ehr incentive program2

EHR Incentive Program

EPs must meet patient volume criteria as follows:

  • Minimum 30% patient volume attributable to Medicaid-funded services

    • For pediatricians, the patient volume minimum requirement is 20%

  • EPs that practice at an FQHC/RHC must demonstrate that more than 50% of their clinical encounters occurred at an FQHC/RHC over a six-month period, and that they had a minimum 30% patient volume attributable to needy individuals. Needy individuals are:

    • Those receiving medical assistance from Medicaid or the Children’s Health Insurance Program (CHIP)

    • Individuals who are furnished uncompensated care by the provider

    • Individuals furnished services at either no cost or reduced cost based on a sliding scale determined by the individual’s ability to pay

      Hospital-based providers are not eligible for the EHR incentive program

  • An EP is considered to be hospital-based when 90% of his or her services are furnished in a hospital inpatient or emergency room setting

Who can participate?


Understand

Understand

Meaningful Use


Meaningful use

Meaningful Use

Federal law specifies three main components of meaningful use:

  • The use of a certified EHR in a meaningful manner, such as e-prescribing

  • The use of certified EHR technology for electronic exchange of health information to improve quality of healthcare

  • The use of certified EHR technology to submit clinical quality and other measures

    Criteria for meaningful use will be staged in three steps over the next five years:

  • Stage 1 (2011 and 2012): Set the baseline for electronic data capture and information sharing

    • EPs must meet at least 20 of the 25 Stage 1 objectives to qualify for an EHR payment

    • EHs must meet at least 19 of the 24 Stage 1 objectives to qualify for an EHR payment

  • Stage 2 (2013): An expansion of the criteria set in Stage 1

  • Stage 3 (2015): A continued expansion of the criterion set in Stages 1 and 2. Development of future stage criterion will be communicated through future Rule making


Meaningful use1

Meaningful Use

To qualify for incentive payments, meaningful use requirements must be met in the following ways:

  • EPs and EHs must adopt, implement, upgrade, or demonstrate meaningful use in their first year of participation in the incentive program

    • Meaningful use must be successfully demonstrated during subsequent participation years

  • Adopted: Acquired and installed certified EHR technology

    • Provider must be able to show evidence of installation

  • Implemented: Began using certified EHR technology

    • Can include staff training and data entry of patient demographics into EHR

  • Upgraded: Expanded existing technology to meet certification requirements

    • An example includes adding new functionality to meet the definition of EHR technology


Meaningful use2

Meaningful Use

To demonstrate meaningful use successfully, EPs and EHs are required to report clinical quality measures

EPs must report on six total clinical quality measures

EHs must report on all 15 of their clinical quality measures

To review the list of clinical quality measures, providers may access cms.gov/QualityMeasures/03_ElectronicSpecifications.asp

Clinical quality measures


Electronic health records ehr incentive program

Act

EHR Incentive Program Registration


Ehr incentive program registration

EHR Incentive Program Registration

Eligible Professional (EP)

EPs and EHs register for the incentive program through a two-step process:

  • Providers must register at the CMS Registration and Attestation system at: https://ehrincentives.cms.gov/hitech/login.action

    • EPs enter:

      • National Provider Identifier (NPI)

      • National Plan and Provider Enumeration System (NPPES) User ID and Password

      • Payee Tax ID (if re-assigning EHR payments)

      • Payee NPI (if re-assigning EHR payments)

    • EPs receive a CMS registration number

  • Register EHR system using the Provider Profile feature of Web interChange


Ehr incentive program registration1

EHR Incentive Program Registration

Eligible Hospital (EH)

EPs and EHs register for the incentive program through a two-step process:

  • Providers must register at the CMS Registration and Attestation system at: https://ehrincentives.cms.gov/hitech/login.action

    • EHs enter:

      • National Provider Identifier (NPI)

      • CMS Identity and Access Management (I & A) User ID and Password

      • CMS Certification Number (CCN)

      • Hospital Tax ID

    • EHs receive a CMS registration number

  • Register EHR system using the Provider Profile feature of Web interChange


Electronic health records ehr incentive program

Click here to register for EHR


Helpful tools

Helpful Tools

Avenues of resolution


Helpful tools1

Helpful Tools

Avenues of resolution

Enter the CMS registration number and click Go


Ehr incentive program registration2

EHR Incentive Program Registration

EHR Incentive Program runs from 2011-2021

  • EPs must register for EHR incentive payments no later than calendar year (CY) 2016

    EHs must register for EHR incentive payments no later than federal fiscal year (FFY) 2016

  • FFY begins October 1 and ends September 30

    EPs eligible for both the Medicare and Medicaid EHR programs must choose which program they wish to participate

    • EPs may not receive EHR incentive payments from both Medicare and Medicaid programs in the same year

    • Before 2015, an EP may switch one time between Medicare and Medicaid to receive the EHR payment after the first EHR payment is received


  • Ehr incentive program3

    EHR Incentive Program

    Eligible Hospital (EH)

    • Per federal rule, EHs must register for EHR incentive payments no later than federal fiscal year (FFY) 2016

    • FFY begins October 1 and ends September 30

    • Acute care hospitals – including critical access hospitals (CAHs) – must have a minimum of 10% Medicaid patient volume for each year that the hospital seeks an EHR incentive payment

    • Children’s hospitals do not have a patient volume threshold

    • Payment calculation for EHs:

      • (Overall EHR Amount) x (Medicaid Share)

      • Payments are distributed over three years:

        • Year 1: 50%

        • Year 2: 40%

        • Year 3: 10%


    Ehr incentive program4

    EHR Incentive Program

    • The maximum incentive payment to an EP is $63,750 over a six-year period ($42,500 for pediatricians)

    • EPs must begin receiving payment no later than CY 2016

    • The last year an EP can receive payments is 2021


    Ehr incentive program5

    EHR Incentive Program

    EHR statistics

    During the period, May through October 19, 2011:

    • 424 EHR applications were processed

    • 269 EHR applications have been paid

    • HP has paid $9,503,881 million


    Examine

    Examine

    EHR Audits


    Ehr audits

    EHR Audits

    • Indiana providers receiving EHR incentive payments are subject to audit by CMS (dually eligibles) or the Office of Medicaid Policy and Planning Surveillance and Utilization Review

    • Providers that attested to receive EHR incentive payments should retain all supporting documentation (either paper or electronic format) used in the completion of the attestation responses

      • Retain documentation for six years post-attestation

    • Providers should also retain documentation to support the clinical quality measures reported to establish meaningful use


    Certified technology

    CertifiedTechnology


    Certified technology1

    Certified Technology

    • To qualify for EHR Incentive payments EHR technology must be tested and certified by:

      • The Office of the National Coordinator (ONC) Authorized Testing and Certification Body (ATCB)

      • Visit http://healthit.hhs.gov/portal/server.pt?open=512&mode=2&objID=3120to view a list of ONC ATCBs

    • Vendors found in the above link are authorized to perform EHR and/or EHR Module testing and certification

    • Certification by an ATCB signifies that an EHR technology product has the capabilities necessary to support efforts to meet the goals and objectives of meaningful use


    Certified technology2

    Certified Technology

    • The ONC ATCBs test and certify EHRs to the certification criteria adopted by the Secretary of the Department of Health and Human Services

      EHR certification criteria is found under subpart C of Part 170 Part II and Part III as stipulated in the Standards and Certification Criteria Final Rule


    Find help

    Find Help

    Resources Available


    Helpful tools2

    Helpful Tools

    Avenues of resolution

    IHCP EHR Manual available at indianamedicaid.com

    CMS Information Center

    • 1-888-734-6433

      HP EHR Customer Assistance

    • 1-855-856-9563, or

    • (317) 488-5137 in the Indianapolis local area

      HP Written Correspondence

      • P.O. Box 7263Indianapolis, IN 46207-7263

        Provider field consultant


    Electronic health records ehr incentive program

    Q&A


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