medicaid and chip health information exchange advisory committee meeting january 12, 2012
TRANSCRIPT
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Medicaid and CHIP Health Information Exchange Advisory Committee Meeting
January 12, 2012
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Agenda
Welcome• 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
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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
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State Legislative Activities and Federal Developments
Stephen Palmer, Director
Office of e-Health Coordination
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State Legislative Activities and Federal Developments
State Legislative Activities
Update and discussion
Questions
Federal Developments
Update and discussion
Questions
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Statewide Health Information Exchange Activities
Tony Gilman, Executive Director
Texas Health Services Authority (THSA)
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Local HIE Grant Program
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• 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.
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White Space Strategy
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Current Status
•Five Health Information Service Providers (HISPs) formally qualified in December 2011. •THSA White Space web page launched www.thsa.org/white-space.aspx •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
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General-State Level Operations
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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
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5010 Update: ASC X12 Version 5010 and
NCPDP Version D.0 Implementation
Joe Graves, Team Lead
HHSC IT
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Introduction
• 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
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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
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MEHIS System
• MEHIS System Eligibility – Already compliant with Version 5010.
• MEHIS Pharmacy History – Uses different NCPDP Standard (not D.0).
• No other areas impacted.
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5010 / D.0 Implementation
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Your Texas MedicaidBenefits Card and System
Noel Villarreal, Project DirectorMedicaid and CHIP Division
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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).
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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.
• E-prescribing.
• On-line explanation of benefits verification.
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2012 Roadmap
JAN FEB MAR APR MAY
IVR Enhancements
Opt-Out Transition
Client Portal (v1)
Provider Portal – Claims History
View Medicaid eligibilityView THSteps reminders
Request Card ReplacementPrint card image
Change Opt-Out Election Health History SummaryCheck-ins
Visits (Claims/Encounter History)Diagnosis
Detail views Prescription Drug HistoryImmunization History
ReportsProvider Portal (Enh) – Rx, Imm, Rpts
View Claims/Encounter HistoryView Prescription Drug History
View Immunization HistoryView Alerts
Client Portal – Health History
Help Desk Portal
IVR Enhancements
Data Access Portlet AccessElectronic Data Interface
e-Prescribing
Lab Data
IVR Enhancements
All release dates subject to change.Last Updated: 01-02-2012 18
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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.
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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.
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Your Texas Medicaid Benefits Card
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Medicaid EHRIncentive Program
Deb Norris, Business/Policy Analyst, Medicaid/CHIP DivisionKristen Leone, Texas Project Manager, CGI
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Hospitals
$186,691,71582%
EligibleProfessionals
$40,934,62418%
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
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Provider Enrollment Statusas of December 22, 2011
Registration
Step
Number
of EPsNumber of Hospitals Total
CMS Registrations 4,689 263 4,952
Texas EHR Incentive Enrollment:
Not Started 1,498 36 1,534
In Process 678 2 680
Payment Pending 355 46 2,214
Paid 1,967 175 2,142
Cancelled or
Not Eligible193 4 197
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Centers for Medicare & Medicaid Services (CMS) Registration by
Provider Type
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Medicaid EHR Incentive Program: Payments by State
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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.
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Medicaid EHR Incentive Program
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HIE Pilot and E-Prescribing
Jason Phipps, Project Manager
Medicaid and CHIP Division
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HIE Pilot
Background:
• 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.
Status:
• 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.
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HIE Pilot
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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.
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Medicaid HIEAdvisory Committee
Public
Comment
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