Medicaid Incentive Program

Report
Georgia Medicaid EHR Incentive Program
Presentation to: Hometown Health
Presented by: Tracy Sims, Director of Programs
Date:
Agenda
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•
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Discuss provider eligibility requirements
Review general program guidelines
Discuss AIU requirements
Discuss patient volume reporting
Discuss Meaningful Use
Chapter Slide
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Title –or(feel
Chapter
Introduction
to
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needed)
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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
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•
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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.
ONC
DCH
Healthcare
Systems
Located at Morehouse School
of Medicine, National Center
for Primary Care
GHIN
Community
and
Professional
Partnerships
Statewide
Tech
Partnerships
GA-HITEC Supports Georgia
Providers & Hospitals
EMR
Implementation
Resource &
Support
Outreach,
Education &
Training
HIT
Center
Cloud-based
Technical
Solutions
EHR Implementation
Resource & Support
•Meaningful Use assistance - Stages 1-2
•EHR vendor selection
•CMS/NLR
•Registration and attestation
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
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Title –or(feel
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Georgia
Medicaid
EHR
Incentive
needed)
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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
• Nurse practitioners
• Certified nursemidwives
– 20% - 29% Medicaid
patient volume and is a • Dentists
pediatrician
• 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-andGuidance/Legislation/EHRIncentivePrograms/Downloads/EPAttestation-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!
Resources
Closing, Questions and Answers

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