http://www.cms.gov/EHRIncentivePrograms/

2011 HealthBridge Meaningful Use and Health Care Transformation Conference

Medicare & Medicaid EHR Incentive Programs

Registration and Attestation

http://www.cms.gov/EHRIncentivePrograms/

Session Overview

• Medicare and Medicaid Differences• Brief look: Medicare and Medicaid Registration• Attestation• Current Registration & Payment Data• Resources

http://www.cms.gov/EHRIncentivePrograms/

Notable Differences Between Medicare and Medicaid Programs

Medicare Medicaid

Federal Government will implement (will be an option nationally)

Voluntary for States to implement

Payment reductions begin in 2015 for providers that do not demonstrate Meaningful Use

No Medicaid payment reductions

Must demonstrate MU in Year 1 A/I/U option for 1st participation year

Maximum incentive is $44,000 for EPs (bonus for EPs in HPSAs)

Maximum incentive is $63,750 for EPs

MU definition is common for Medicare States can adopt certain additional requirements for MU with CMS approval

Last year a provider may initiate program is 2014; Last year to register is 2016; Payment adjustments begin in 2015

Last year a provider may initiate program is 2016; Last year to register is 2016

Only physicians, subsection (d) hospitals and CAHs

5 types of EPs, acute care hospitals (including CAHs) and children’s hospitals

http://www.cms.gov/EHRIncentivePrograms/

REGISTRATION FOR THE MEDICARE & MEDICAID EHR INCENTIVE PROGRAMS

http://www.cms.gov/EHRIncentivePrograms/

What is Needed to Participate

• Be enrolled in Medicare FFS, MA, or Medicaid (FFS or managed care)

• All Medicare providers and Medicaid eligible hospitals must have an enrollment record in the Provider Enrollment, Chain and Ownership System (PECOS)!!! They will not be able to complete registration if they do not have a PECOS enrollment record

• To determine if they have an enrollment record, they can go to http://www.cms.gov/MedicareProviderSupEnroll

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http://www.cms.gov/EHRIncentivePrograms/

What is Needed to Participate

• All providers must:• Use certified EHR technology • Medicaid providers may adopt, implement, or upgrade

in their first year• Register via the EHR Incentive Program website• Have a National Provider Identifier (NPI) and have

a National Plan and Provider Enumeration System (NPPES) web user account. The NPPES user ID and password will be used to log into the incentive program system.

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http://www.cms.gov/EHRIncentivePrograms/

One Front Door

• All eligible providers can register for both the Medicare and Medicaid EHR Incentive Programs at the CMS site

• For Medicare- registration was launched January 3rd and providers can now attest to meeting meaningful use of certified EHR technology. (As of April 18, 2011)

• For Medicaid- registration launched January 3rd and 15 states have launched their programs.

http://www.cms.gov/EHRIncentivePrograms/

Registration Hand-Off to States

• After registration, eligible providers who selected Medicaid (or eligible hospitals who selected “both”), are sent to a link to the States’ website URLs for States with live Medicaid EHR Incentive Programs

• They then log in at those URLs and complete the submission of required information and attest to AIU, etc

http://www.cms.gov/EHRIncentivePrograms/

ATTESTATION FOR MEANINGFUL USE FOR MEDICARE PROVIDERS

http://www.cms.gov/EHRIncentivePrograms/

As of April 18, 2011

• Medicare eligible professionals and eligible hospitals are demonstrating meaningful use through CMS' web-based Medicare and Medicaid EHR Incentive Program Registration and Attestation System.

• In the Registration and Attestation System, providers fill in numerators and denominators for the meaningful use objectives and clinical quality measures, indicate if they qualify for exclusions to specific objectives, and legally attest that they have successfully demonstrated meaningful use.

http://www.cms.gov/EHRIncentivePrograms/

http://www.cms.gov/EHRIncentivePrograms/

From here, the user can navigate to the Registration and Attestation tabs. By clicking the Status tab, the user can view the current status of their registration, attestation, and payment(s). To begin attestation, the user can click on the Attestation tab.

http://www.cms.gov/EHRIncentivePrograms/

http://www.cms.gov/EHRIncentivePrograms/

ATTESTATION REQUIREMENTS IN STAGE 1 MEANINGFUL USE

http://www.cms.gov/EHRIncentivePrograms/

What are the Requirements of Stage 1?

• Stage 1 Meaningful Use:• Reporting period is 90 days for first year and 1 year

for second year• Reporting through attestation• MU measures• Clinical Quality Measures

• Reporting may be yes/no or numerator/denominator attestation

• To meet certain objectives/measures, 80% of patients must have records in the certified EHR technology

http://www.cms.gov/EHRIncentivePrograms/

What are the Requirements of Stage 1?

• Eligible Professionals must complete: • 15 core objectives• 6 total Clinical Quality Measures (CQM)

(3 core or alternate core, and 3/38 from menu set)• 5 objectives out of 10 from menu set

• Hospitals must complete: • 14 core objectives• 15 CQM

• 5 objectives out of 10 from menu set

http://www.cms.gov/EHRIncentivePrograms/

Meaningful Use Denominators

• Two types of percentage based measures are included in demonstrating Meaningful Use:1. Denominator is all patients seen or admitted

during the EHR reporting period• The denominator is all patients regardless of whether

their records are kept using certified EHR technology

2. Denominator is actions or subsets of patients seen or admitted during the EHR reporting period• The denominator only includes patients, or actions

taken on behalf of those patients, whose records are kept using certified EHR technology

http://www.cms.gov/EHRIncentivePrograms/

Resources to Get Help and Learn More about MU and Attestation

Meaningful Use Specification Sheetswww.cms.gov/EHRIncentivePrograms/99_Meaningful_Use.asp#TopOfPage

Attestation User Guide

https://www.cms.gov/EHRIncentivePrograms/Downloads/EP_Attestation_User_Guide.pdf

http://www.cms.gov/EHRIncentivePrograms/

ATTESTATION FOR MEDICAID PROVIDERS

http://www.cms.gov/EHRIncentivePrograms/

Medicaid Attestation

• For the Medicaid EHR Incentive Program, providers will follow a similar process using their State's Attestation System.– Adopt, implement, upgrade of Certified EHR

Technology– Other Medicaid eligibility requirements– States that have launched also have users guides

online for their attestation systems

http://www.cms.gov/EHRIncentivePrograms/

Which States launched so far?• Alaska, Iowa, Kentucky, Louisiana, Michigan, Mississippi, North

Carolina, Oklahoma, South Carolina, Tennessee, Texas, Alabama, Missouri, Indiana and Ohio (15)

• Of these, Alaska, Indiana, Iowa, Kentucky, Louisiana, Oklahoma, South Carolina, North Carolina, and Texas issued EHR Incentive Payments between January- May– Kentucky and Oklahoma both made over $5m total in EHR incentive

payments in the 1st three days• Wondering about the status of your State?

– The CMS website lists our latest information (updated monthly) about States’ timelines (and States are posting their approved State Medicaid HIT Plans)

http://www.cms.gov/EHRIncentivePrograms/

Medicaid Hot Topics

• CMS is issuing a new State Medicaid Directors Letter providing States with further guidance about use of the 90/10 administrative matching funds for health information exchange (infrastructure development, interfaces, etc).– This builds off of the August 2010 SMD letter that

already indicated support for Medicaid contributions to core HIE components, such as Master Patient Indexes and Provider Directories

http://www.cms.gov/EHRIncentivePrograms/

3rd Annual CMS Medicaid HITECH Conference

• May 24-26th in Baltimore• If not attending in person, visit:

www.medicaidhitechconference.com to watch all of the plenary sessions and many of the concurrent sessions live (including the plenary that discusses what CMS will/won’t approve for HIE funding). Post-conference, all presentation will be available on that website.

http://www.cms.gov/EHRIncentivePrograms/

Timeline/What’s Next

• Additional CMS and ONC coordination:– Linked oversight of Federally-funded HIT efforts at the State

level– HIT Policy and Standards Committee– Quality Measure Development– Joint Site Visits– Collaboration on technical assistance effortsAnd of course….– The 2012 CMS and ONC NPRMs and Final Rules on Stage 2 of

Meaningful Use and the EHR Certification Criteria (ETA: January and June 2012)

http://www.cms.gov/EHRIncentivePrograms/

Current Registration & Payment Data as of April 30th, 2011

Medicaid -• Medicaid EPs registered: 2,014• Total Medicaid EPs paid: $17,000,003• Total Medicaid payments to EHs: $66,294,775Total as of May : $83,294,778 (and from only 7 States!)

Medicare-• Medicare EPs registered: 40,379• Medicare only EHs registered: 64• Dually-Eligible Hospitals registered: 1,149• First Medicare payments to be released by May 20th

http://www.cms.gov/EHRIncentivePrograms/

Other Resources

• EHR Information Center:1-888-734-64337:30 a.m. – 6:30 p.m. (Central Time) Monday –Friday

• Submit a question online at: http://questions.cms.hhs.gov/app/ask/p/21,26,1139

• Visit our website www.cms.gov/EHRIncenctivePrograms

• Review the Frequently Asked Questions-Select “Frequently Asked Questions (FAQs)” from the left hand menu on the website