Transcript Medicaid Incentive Program
Georgia Medicaid EHR Incentive Program Presentation to: Hometown Health Presented by: Tracy Sims, Director of Programs Date:
Agenda
• Discuss provider eligibility requirements • Review general program guidelines • Discuss AIU requirements • Discuss patient volume reporting • Discuss Meaningful Use
Introduction to the Medicaid EHR Incentive Program
Goals of Medicaid the Incentive Program
• Improve quality of patient care • Improve patient outcomes • Reduce disparities in care/treatment • Reduce redundancy and waste by promoting connectedness and interoperability • The goal of this program is to encourage Meaningful Use of Certified EHR Technology… not simply to dispense additional Medicaid funds • All materials used to arrive at patient volume attestations will be held by provider for 7 years after each payment.
Incentive Amounts
.
Georgia Medicaid EHR Incentive Program
Provides financial incentives to Medicaid providers who are Eligible Professionals (EPs) and Eligible Hospitals (EHs) as they adopt, implement, upgrade, or demonstrate meaningful use of certified electronic health record (EHR) technology.
Federal Assistance
• Funding • Guidance and leadership • Technical assistance • GA HITEC – Georgia’s resource for federal MU assistance 7 .
GA-HITEC
GA-HITEC is the federally and state endorsed expert
to assist providers in the achievement of Meaningful Use through EHR technology.
Located at Morehouse School of Medicine, National Center for Primary Care
ONC DCH Healthcare Systems GHIN Community and Professional Partnerships Statewide Tech Partnerships
GA-HITEC Supports Georgia Providers & Hospitals
EMR Implementation Resource & Support EHR Implementation Resource & Support
•Meaningful Use assistance - Stages 1-2 •EHR vendor selection •CMS/NLR •Registration and attestation
Outreach, Education & Training HIT Center Cloud-based Technical Solutions Outreach, Education & Training
•Boots on the ground •Distance learning / web-based training •Barrier mitigation/risk assessment
Practice Management
•Workflow assessment/MU GAP Analysis •PCMH, ACOs •Improve clinical outcomes
Practice Management Research
•EHR adoption, vendor utilization 51 Hospitals 4,000 Providers $40M Incentive Payouts
Georgia Medicaid EHR Incentive Program - General Information
Birth of the Collaborative
• Thirteen states collaborated to develop a “core” system with HP Enterprise Services: – Arkansas, Connecticut, Delaware, Florida, Georgia, Indiana, Kansas, Massachusetts, Oregon, Pennsylvania, Rhode Island, Vermont, and Wisconsin • Collaborate on “core” system, states develop custom systems (additional coordination) • States shared costs, processes, understanding of incentive program, and federal requirements
Medical Assistance Provider Incentive Repository - MAPIR • MAPIR is the state-level EHR incentive program repository • Interfaces with Medicare and Medicaid EHR Incentive Program Registration and Attestation System (R&A) • Interfaces with the Georgia Medicaid Management Information System (GAMMIS) • Core product that is customized for each state • Georgia launched on September 5, 2011
Eligible Professionals
• Physicians • Pediatricians – 20% - 29% Medicaid patient volume
and
is a pediatrician • Nurse practitioners • Certified nurse midwives • Dentists • Physician assistants (who furnish services in a rural health clinic led by a physician assistant) .
Patient Volumes
e RHC.
Path to Payment – Payment Year 1
• Federal-Level Registration • State-Level Registration AIU – Only EP Patient Volume Calculator .
Pre-State-Level Registration
1. Assemble your AIU documentation 2. Download and complete the applicable Patient Volume Calculator: http://dch.georgia.gov/ehr 3. Obtain the CMS EHR certification number for your certified EHR technology: http://healthit.hhs.gov/chpl
State-Level Registration
Log in to the GAMMIS secure Web Portal using your current ID and password.
Use your CMS confirmation number to access the MAPIR from GAMMIS.
AIU and Patient Volume Reporting
Required AIU Documentation
The definition of AIU in 42 CFR 495.302 allows the provider to demonstrate AIU through any of the following: • Acquiring, purchasing or securing access to certified EHR technology • Installing or commencing utilization of certified EHR technology capable of meeting meaningful use requirements • Expanding the available functionality of certified EHR technology capable of meeting meaningful use requirements at the practice site • A contract (signed by vendor and provider) that indicates that the provider has adopted or upgraded certified EHR technology would be sufficient
AIU- Expectations during an Audit
f requested.
• Providers must be able to furnish a copy of their AIU documentation for auditor review if requested.
• If providers have adopted free, web-based software, each provider must be able to furnish evidence that he/she has installed and activated the software.
• If the free software is provider based, each provider must be able to furnish AIU documentation and show evidence of installation/activation.
Patient Volume Expectation during an Audit
• All materials used to arrive at patient volume attestations must be available for the auditors’ reviews.
• All materials used to arrive at patient volume attestations will be held by provider for 7 years after each payment.
• Auditable data source must contain: patient name, date of service, primary payer, and secondary payer (if Medicaid or CMO).
• If using sign-in sheets as data source they must additionally identify: Medicaid eligible patients, cancellations and no-shows, and walk-ins.
auditors’
Patient Volume Reporting Video
DCH has created an in-depth online video to aid providers in completion of the Patient Volume Calculator: Step 1: Go to www.dch.georgia.gov/ehr Step 2: Look Under “Resources” Step 3: Click on 2014 Patient Volume Calculator Video Step 4: View applicable chapters
Border State
Border State Providers: • Include out-of-state Medicaid in numerator only if needed to meet full eligibility requirement of 30% Medicaid patient volume.
• All out-of-state encounters (including Medicaid, CMO, Medicare, Commercial and self-pay) will appear in the denominator.
Most Common Errors – Year 1
(continued)
Do not click the Submit button UNTIL you have uploaded a COMPLETED Patient Volume Calculator and ALL required documentation of the AIU (adopt, implement, upgrade) of certified EHR technology.
Do not modify your federal-level registration (CMS) AFTER your state level registration is in “Pended for Review” status.
Any changes to the federal-level registration can significantly delay processing of the provider’s application.
TIP:
When you reach the Review tab, please take the time to carefully review your application to ensure that you have included all required information and details.
Payment Years 2-4
• Meaningful Use Stages 1 and 2 • Eligible Providers – Log straight into MAPIR • New Tools – Complete the Eligible Professional Attestation Worksheet for Stage 1: https://www.cms.gov/Regulations-and Guidance/Legislation/EHRIncentivePrograms/Downloads/EP Attestation-Worksheet.pdf
– The Meaningful Use Attestation Calculator: http://www.cms.gov/apps/ehr/ e Meaningful Use Attestation Calculator:
Incentive Payments Disbursed
$227,398,414.12
Session Review
You should now know: • Year 1 AIU is EASY!
• New resources are prepared to assist providers • All applicants must upload their information in MAPIR • We’re Here to HELP!