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Medicaid and CHIP Health Information Exchange Advisory Committee Meeting. January 12, 2012. Agenda. Welcome Approval of Committee Minutes Committee Changes and Vacancies Committee Schedule for 2012 Introduction of new Health Information Technology (IT) team members

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  • Approval of Committee Minutes
  • Committee Changes and Vacancies
  • Committee Schedule for 2012
  • Introduction of new Health Information Technology (IT) team members

State Legislative Activities and Federal Developments Update– Stephen Palmer

Statewide Health Information Exchange (HIE) Activities Update– Tony Gilman

Medicaid Project Updates:

  • 5010 Update – Joe Graves
  • Your Texas Medicaid Benefits Card / System – Noel Villarreal
  • Electronic Health Record (EHR) Incentive Program – Deb Norris and Kristen Leone
  • Health Information Exchange (HIE) Pilot and E-Prescribing – Jason Phipps
health it team members
Health IT Team Members
  • Ramdas Menon, Health IT Director
  • Thomas Colvin, Project Manager
  • Deb Norris, Policy / Business Analyst
  • Jason Phipps, Project Manager
  • Noel Villarreal, Manager, Medicaid Benefits Card
  • Julia Alejandre, Communications
  • Sabrina Thomas, Administrative Assistant
state legislative activities and federal developments

State Legislative Activities and Federal Developments

Stephen Palmer, Director

Office of e-Health Coordination


state legislative activities and federal developments1
State Legislative Activities and Federal Developments

State Legislative Activities

  • Update and discussion
  • Questions

Federal Developments

  • Update and discussion
  • Questions
statewide health information exchange activities

Statewide Health Information Exchange Activities

Tony Gilman, Executive Director

Texas Health Services Authority (THSA)


local hie grant program
Local HIE Grant Program
  • Quarterly Progress Reports
  • Two HIE Business and Operational Plan Approved in September 2011.
  • 14 HIEs submitted Business and Operational Plans:
    • Four HIEs have submitted plan amendments to address weaknesses and deficiencies.
    • Six HIEs developing plan amendment to address weaknesses and deficiencies.
    • Three HIEs will either merge with another HIE or become part of White Space.
    • One HIE will either continue or become part of the White Space.
  • All HIEs are transitioning from planning to implementation in January 2012.
white space strategy
White Space Strategy

Current Status

  • Five Health Information Service Providers (HISPs) formally qualified in December 2011.
  • THSA White Space web page launched
  • White Space Fact Sheet and Q&A posted.
  • Voucher registration form and HISP profile and pricing sheets added to web page.

Next Steps

  • Soft communications campaign through THSA, state-level professional associations, Medicaid, and regional extension centers (RECs), to inform providers of White Space Strategy and voucher request and payment process.
  • Timeline: January 2012
general state level operations
General-State Level Operations

Current Status

  • Monthly Collaboration Council and Task Force Meetings
  • Texas HIE Interoperability Guidance Published
    • Technical Standards Review
    • Enterprise Architecture Blueprint (EAB)
    • EAB Lifecycle Management Plan
    • Technical Implementation Specifications
  • Privacy and Security White Papers Published

Next Steps

  • Privacy and Security Guidance
    • State-Level Trust Agreement
    • Model Business Associate Agreement
    • General Privacy and Security Guidelines and Procedures
  • State-Level Shared Services
  • THSA Web Site Redesign
5010 update asc x12 version 5010 and ncpdp version d 0 implementation

5010 Update: ASC X12 Version 5010 and NCPDP Version D.0 Implementation

Joe Graves, Team Lead



  • The Health Insurance Portability and Accountability Act (HIPAA) requires electronic standards for health care organizations
  • CMS Rule January 2009
  • HIPAA ASC X12 Version 5010
  • NCPDP Version D.0
5010 d 0 implementation timeframe
5010 / D.0 Implementation Timeframe
  • Original Date – January 1, 2012
  • CMS published non-enforcement of standards for 90 days
  • HHSC Implementation Dates:
    • Managed Care Encounters – January 1, 2012
    • Pharmacy Transactions – February 1, 2012
    • Acute and Long-Term Care Transactions – April 1, 2012
mehis system
MEHIS System
  • MEHIS System Eligibility – Already compliant with Version 5010.
  • MEHIS Pharmacy History – Uses different NCPDP Standard (not D.0).
  • No other areas impacted.
your texas medicaid benefits card and system

Your Texas MedicaidBenefits Card and System

Noel Villarreal, Project Director

Medicaid and CHIP Division


project status
Project Status

On June 29, 2011, Your Texas Benefits Medicaid Card became operational (previously known as the Medicaid ID card system).

Release 1 implementation supports electronic eligibility verification and includes the following:

Card production and distribution.

Provider portal eligibility verification.

Help Desk – Medicaid Eligibility and Health Information Services (MEHIS).


project status1
Project Status

Release 2.1, scheduled to release in January 2011, will include an initial basic version of the client portal that will enable clients to print a copy of their Medicaid ID cards.

Subsequent 2.x releases are scheduled for completion in the first quarter of 2012 and will include the more robust applications associated with:

Electronic health history.


On-line explanation of benefits verification.


2012 roadmap
2012 Roadmap
  • View Medicaid eligibility
  • View THSteps reminders
  • Request Card Replacement
  • Print card image
  • Change Opt-Out Election
  • Health History Summary
  • Check-ins
  • Visits (Claims/Encounter History)
  • Diagnosis
  • Detail views
  • Prescription Drug History
  • Immunization History
  • Reports
  • View Claims/Encounter History
  • View Prescription Drug History
  • View Immunization History
  • View Alerts
  • Portlet Access
  • Electronic Data Interface






IVR Enhancements

Opt-Out Transition

Client Portal (v1)

Provider Portal – Claims History

Provider Portal (Enh) – Rx, Imm, Rpts

Client Portal – Health History

Help Desk Portal

Data Access


IVR Enhancements

Lab Data

IVR Enhancements


Last Updated: 01-02-2012

All release dates subject to change.

5010 impacts
5010 Impacts
  • The N5010 standard applies to X12 transactions from a MEHIS perspective.
  • The MEHIS system has two X12 transaction sets which both revolve around the X12 270/271 Eligibility Inquiry/Response transactions:
    • Texas Medicaid & Healthcare Partnership (TMHP)
      • MEHIS submits interactive X12 270 Eligibility Inquiries to TMHP to verify client eligibility.
      • This inquiry transaction already conforms with the 5010 standard.
      • The 271 Eligibility Response received from TMHP also conforms with 5010 as implemented.
      • No anticipated impacts to this interface.
    • SureScripts
      • MEHIS submits interactive X12 270 Eligibility Inquiries to SureScripts in support of the ePrescribing tool.
      • MEHIS is implementing the latest version of the e-prescribing system that already supports the 5010 standard with SureScripts.
      • No anticipated impacts after implementation.


5010 impacts1
5010 Impacts

Area of possible impact: If there are new requirements regarding the minimum set of client and provider data that is captured and submitted within the Eligibility Inquiry transaction.

Not likely as this is specific to program policies or business rules, and not necessarily requirements of the 5010 standard.

There are no other interfaces in MEHIS that use X12; therefore, no impact with the current implementation.

Other transactions supported by MEHIS are batch files, HL-7, and NCPDP SCRIPT 8.

These should not be impacted by the 5010 standard as none of these are candidates for the X12 specifications.


medicaid ehr incentive program

Medicaid EHRIncentive Program

Deb Norris, Business/Policy Analyst, Medicaid/CHIP Division

Kristen Leone, Texas Project Manager, CGI


status update as of december 22 2011
Status Updateas of December 22, 2011
  • EHR incentives paid total $227.6 million
    • 175 hospitals
    • 1,967 eligible professionals
  • 504 eligible professionals (EPs) from federally qualified health centers (FQHC) and rural health clinics (RHC) have enrolled
    • 410 EPs have been paid from 115 FQHC/RHCs
provider enrollment status as of december 22 2011
Provider Enrollment Statusas of December 22, 2011

Centers for Medicare & Medicaid Services (CMS) Registration by Provider Type

meaningful use attestation
Meaningful Use Attestation
  • Meaningful Use attestation portal for eligible hospitals in January 2012.
  • EPs begin attestation for meaningful use (payment year 2) in April 2012.
  • Meaningful use audit strategy under development based on guidance from CMS.
    • HHSC will contract with outside audit vendor.
hie pilot and e prescribing

HIE Pilot and E-Prescribing

Jason Phipps, Project Manager

Medicaid and CHIP Division


hie pilot
HIE Pilot


  • Two organizations are participating in the exchange of Medicaid medication history data – Sandlot and Texas Health Resources.
  • Pilot is limited to medication history.
  • Phase 2 will provide real-time connectivity between HHSC and two local HIEs.


  • Phase 1 completed in November 2011.
  • Phase 2 design finalized in December 2011.
  • Currently resolving design dependencies and investigating possible efficiencies.
  • Implementation to begin in February 2012.
e prescribing
  • Status:
  • Connectivity to Surescripts certified December 12, 2011.
  • Service went live December 21, 2011, in a “soft” rollout.
  • Eligibility checks, medication history, formulary.
  • Very few issues to troubleshoot.
  • Marketing / Communications underway soon.
  • Now planning long-term maintenance and usability improvements.