CMS Registration & Attestation System/MS SLR Data Validation Process

This process will accept and parse the B-6 Interface. The purpose of the B6 Interface is to inform the states of new, updated, and inactivated Medicaid registrations. The CMS Registration & Attestation System will send batch feeds to the states of new EPs and EHs that registered for the EHR Incentive Program and selected or switched to Medicaid. The data also includes any updates/changes to the EP or EH entries and any registration inactivation events. A detailed description of this interface can be found in the document entitled “HITECH Interface Control Document.”

This process will perform the following actions:

• Accept new transactions;

• Handle duplicate transaction exception; and

• Send back the Provider Registration Confirmation Interface (B7 Interface) immediately after the first time a B6 Interface is received, parsed, and

stored for a given provider. The B-7 Interface will contain an Eligibility Status of “Pending” and allow CMS to record the fact the B6 Interface was received by DOM before DOM determines the provider’s registration status with the State.

Processes to manage transactions that do not pass Exception Handling are not described because the HITECH Interface Control Document states that CMS does not expect any exceptions from the B-6 Interface.

If the transaction passes Exception Handling and Duplicate Check processing, the process named “CMS Registration & Attestation System/MS SLR Data Validation” (described in this section) is executed.

The CMS Registration & Attestation System/MS SLR data validation process supports the requirements that provider data in the B-6 Interface be verified by the provider. Process execution logic depends on several different scenarios:

• NPI from a B-6 Interface transaction being processed does not match a MS SLR Provider Registration transaction: The B-6 transaction is stored in the MS SLR awaiting MS SLR Provider Registration using the same NPI.

• NPI from a B-6 Interface transaction being processed does match a MS SLR Provider Account transaction: The data from the B-6 transaction is matched against the data input by the provider during MS SLR provider account creation.

• NPI from a MS SLR Registration transaction being processed does not match a B6 Interface transaction: The MS SLR provider can create an account and can complete the “About You” step. The provider will receive a hard stop after the “About You” step and will be notified that he/she must complete his/her CMS Registration and Attestation System application before proceeding in the MS SLR. The receipt of the matching B-6 transaction will allow the provider to proceed in the MS SLR.

• NPI from a MS SLR Registration transaction being processed does match a B-6 Interface transaction: The data from the MS SLR Provider Registration is matched against the B-6 transaction. If all data matches, the provider can proceed with the completion of their attestation.

In the event that the information entered by the provider and transmitted through the B-6 Interface cannot be validated, the provider may be asked to correct information entered at the CMS Registration & Attestation System. The MS SLR will not allow any changes to the NPI, SSN, CCN or TIN entered at CMS Registration & Attestation System. If an EP or EH needs to change any of this information to proceed, the Help Desk staff will refer them to CMS Registration & Attestation System where the EP or EH will be responsible for correcting the information. Upon completion and update at the CMS Registration &

State Reason Codes received on the B-6 transaction will also be interrogated to determine if the provider eligibility should be rejected based on code values sent to the MS SLR from the CMS Registration & Attestation System. The following table lists the codes. The codes designated by a “Hard Stop” will cause the provider’s eligibility to be rejected. If the B-6 transaction includes one of the “Soft Stop” codes, it means the provider’s eligibility was rejected by another state. This will not exclude the provider from being eligible in Mississippi. Normal eligibility determination processes will still be performed.

Table 5: State Reason Codes State

Reason Code Description

Reason Code Key Hard Stop Soft Stop Eligible Hospitals

Excluded / Federal EH01

Excluded / State EH02

Not Licensed / Credentialed EH03

Failed Patient Volume EH04

No Certified EHR EH05

Failed A/I/U EH06

Failed MU EH07

Excluded / Federal / 2nd _{Check EH08}

Excluded / State / 2nd _{Check EH09}

Eligible Professionals

Excluded / Federal EP01

Excluded / State EP02

Dead EP03

Not Licensed / Credentialed EP04

Hospital Based EP05

Failed Patient Volume EP06

Failed Practices predominantly at a FQHC / RHC with 30% needy individual patient volume

EP07

No Certified EHR EP08

Failed A/I/U EP09

Failed MU EP10

Excluded / Federal / 2nd _{Check EP11}

Excluded / State / 2nd _{Check EP12}

Dead / 2nd _{Check EP13}

The B-7 Interface will be sent back to the CMS Registration & Attestation System the second time as the Provider Final Registration Status Interface (B-7). At this time, the B- 7 transaction will contain an Eligibility Status of “Accepted” or “Rejected” notifying the CMS Registration & Attestation System of the provider’s registration status with the MPIP. The rejection reason will be communicated back to the CMS Registration & Attestation System using one of several codes. Please refer to Table 5: State Reason Codes in Section 5.3.2. The Hard Stop/Soft Stop designation has no meaning in this

context; they all signify that provider eligibility was rejected. Mississippi may use any of the State-specific codes to specify the reason the provider was rejected.