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NY Medicaid. EHR Incentive Program

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NY Medicaid

EHR Incentive Program 1

NY Medicaid

EHR Incentive Program

Eligible Professionals

Participation Year 2 (MU1) Webinar

(2)

NY Medicaid

EHR Incentive Program 2

EHR Incentive Program Background

Original Legislation

The Health Information Technology for Economic and Clinical Health (HITECH) Act,

part of the American Recovery and Reinvestment Act of 2009 (ARRA).

The HITECH Act Established:

Medicaid EHR Incentive Program

Medicare EHR Incentive Program

Office of the National Coordinator for Health Information Technology (ONC)

Certified EHR Technology

Goals of the HITECH Act:

Improve patient quality of care

Promote the adoption and meaningful use of health information technology

Increase health information exchange

(3)

NY Medicaid

EHR Incentive Program 3

Medicaid EHR Incentive Program

Provides

incentive payments

to:

eligible professionals

eligible hospitals

as providers:

adopt,

implement, or

upgrade,

and subsequently:

demonstrate meaningful use

(4)

NY Medicaid

EHR Incentive Program 4

What are the patient volume criteria?

Eligible Professionals must meet one of the following conditions throughout

all

participation years:

Demonstrate a minimum 30% Medicaid patient volume, or

Be a pediatrician* and demonstrate a minimum 20% Medicaid patient

volume, or

Practice predominantly in a Federally Qualified Health Center or Rural Health

Center and demonstrate a minimum 30% patient volume attributable to

needy individuals

* For the purposes of the Medicaid EHR Incentive Program, NY defines a “pediatrician” as an M.D. or D.O. who satisfies at least one of the following:

1. Has a current board certification in pediatrics or a pediatric subspecialty from the American Board of Pediatrics (ABP) or the American Osteopathic Board of Pediatrics (AOBP)

2. Focuses on treating patients 18 years old and younger, and attests that the majority of care (at least 50% of encounters) were for patients 18 years old or younger

(5)

NY Medicaid

EHR Incentive Program 5

Meaningful Use Stage 1

Introduction to Meaningful Use

Meaningful Use Stage 1 Core Objectives

Meaningful Use Stage 1 Menu Objectives

Clinical Quality Measures

Public Health Reporting

(6)

NY Medicaid

EHR Incentive Program 6

What is Meaningful Use (MU)?

Meaningful Use

means providers need to show they're using certified EHR

technology in ways that can be measured significantly in quality and in

quantity.

Achieving Meaningful Use

Use certified EHR in a meaningful manner

Use certified EHR technology for electronic exchange of health information to

improve quality of health care

Use certified EHR technology to submit clinical quality and other measures

Being a Meaningful User

Have to have 50% of their total patient encounters at locations where certified

EHR technology is available

Would base all meaningful use measures only on encounters that occurred at

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NY Medicaid

EHR Incentive Program 7

Participation Year 2

Meaningful Use Requirements

EPs must attest to having met

20

out of

25

meaningful use stage 1 objectives:

15 required core objectives and,

5 objectives out of a menu set of 10

Requirement:

Must pick 1 of 2 public health reporting objectives

Participation Year 2 Attestation

Continuous 90 day period

within

the participation year

All Meaningful Use Stage 1 reporting should fall under the same reporting period

Meaningful Use reporting may be yes/no

or

numerator/denominator attestation

Attestation for participation year 2 ends on March 31, 2013

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NY Medicaid

EHR Incentive Program 8

EHR Reporting Periods

Meaningful Use Stage 1 begins in participation year 2 of the NY Medicaid EHR

Incentive Program and continues to participation year 3.

Participation Year 1

Must attest to Adopt/Implement/Upgrade to a certified EHR system

Participation Year 2

Report on Meaningful Use Stage 1 for any continuous 90 day period

during the participation year

Participation Year 3

Report on Meaningful Use Stage 1 for the

entire

participation year

Participation Year 4-6

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NY Medicaid

EHR Incentive Program 9

Meaningful Use Stage 1

Introduction to Meaningful Use

Meaningful Use Stage 1 Core Objectives

Meaningful Use Stage 1 Menu Objectives

Clinical Quality Measures

Public Health Reporting

(10)

NY Medicaid

EHR Incentive Program 10

MU Stage 1 Core Set Objectives

Eligible Professionals (EP) must attest to all 15 MU Stage 1 Core Set objectives.

MU Stage 1 Core Set Requirements

EPs must attest to

all 15

core

objectives:

10 core threshold objectives

5 core activity objectives

Participation Year 2:

90 day reporting period in the calendar year (2012)

Participation Year 3:

1 year reporting period in the calendar year (2013)

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NY Medicaid

EHR Incentive Program 11

MU Stage 1 Core Set Objectives

Core Objective Measure (1-9)

Min. Threshold

1 Use Computerized Provider Order Entry (CPOE) 30%

2 Implement drug interaction checks Enable EHR Functionality

3 Maintain problem list 80%

4 Generate E-prescribing (eRx) 40%

5 Maintain active medication list 80%

6 Maintain medication allergy list 80%

7 Record demographics 50%

8 Record vital signs 50%

9 Record smoking status 50%

MU Stage 1 Core Objectives 10-15 on next slide.

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NY Medicaid

EHR Incentive Program 12

MU Stage 1 Core Set Objectives (Cont’d)

Core Objective Measure (10-15)

Min. Threshold

10 Report clinical quality measures (CQMs) Report 6 CQMs

11 Implement clinical decision support rule Implement 1 Rule 12 Provide electronic copy of health information 50%

13 Provide clinical summaries 50%

14 Capability to electronic exchange of clinical information Performed 1 test 15 Protect electronic health information Security Risk Analysis

.

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NY Medicaid

EHR Incentive Program 13

Meaningful Use Stage 1

Introduction to Meaningful Use

Meaningful Use Stage 1 Core Objectives

Meaningful Use Stage 1 Menu Objectives

Clinical Quality Measures

Public Health Reporting

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NY Medicaid

EHR Incentive Program 14

MU Stage 1 Menu Set Objectives

In addition to meeting all MU Stage 1 Core Objectives, EPs must also attest to an

addition subset of MU Stage 1 Menu Set Objectives.

MU Stage 1 Menu Set Requirements

EPs must attest to

5

out of

10

menu set requirements:

PHR Requirement:

Must pick 1 of 2 public health reporting objectives

Participation Year 2:

90 day reporting period in the calendar year (2012)

Participation Year 3:

1 year reporting period in the calendar year (2013)

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NY Medicaid

EHR Incentive Program 15

MU Stage 1 Menu Set Objectives

Menu Objective Measure (1-10)

Min. Threshold

Public Health Rep.

1 Implement drug formulary checks Enable EHR Functionality

2 Incorporate clinical lab-test results 40%

3 Generate patient lists Generate 1 Report

4 Send patient reminders 20%

5 Provide patient electronic access 10% 6 Identify patient-specific education

resources 10%

7 Perform medication reconciliation 50% 8 Provide summary care record 50%

9 Submit immunization registries data Perform 1 test X 10 Submit syndromic surveillance data Perform 1 test X

.

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NY Medicaid

EHR Incentive Program 16

Meaningful Use Stage 1

Introduction to Meaningful Use

Meaningful Use Stage 1 Core Objectives

Meaningful Use Stage 1 Menu Objectives

Clinical Quality Measures

Public Health Reporting

(17)

NY Medicaid

EHR Incentive Program 17

Clinical Quality Measures (CQMs)

Clinical Quality Measures (CQMs) can be measures of processes, experiences

and/or outcomes of patient care, observations or treatment that relate to one or

more quality aims for health care such as effective, safe, efficient,

patient-centered, equitable, and timely care.

CQMs Requirements

EPs must attest to

6

out of

41

CQMs:

3 Core / Alternate Core Clinical Quality Measures, and

3 Clinical Quality Measures out of 38 from menu set

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NY Medicaid

EHR Incentive Program 18

CQM Core Objectives

Core Objective Measure (1-3)

NQF / PQRI Number

1 Hypertension: Blood Pressure Measurement NQF 0012

2 Preventive Care and Screening Measure Pair:

• Tobacco Use Assessment

• Tobacco Cessation Intervention

NQF 0028

3 Adult Weight Screening and Follow-up NQF 0421 / PQRI 128

If the EP has a zero denominator for any above measures then select an alternate core objective measure to satisfy the three core objective requirement

requirement.

Alternate Core Objective Measure (1-3)

NQF / PQRI Number

1 Weight Assessment and Counseling for Children and

Adolescents NQF 0024

2 Preventive Care and Screening: Influenza Immunization for

Patient >= 50 Years Old NQF 0041 / PQRI 110

3 Childhood Immunization Status NQF 0038

.

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NY Medicaid

EHR Incentive Program 19

Meaningful Use Stage 1

Introduction to Meaningful Use

Meaningful Use Stage 1 Core Objectives

Meaningful Use Stage 1 Menu Objectives

Clinical Quality Measures

Public Health Reporting

(20)

NY Medicaid

EHR Incentive Program 20

Public Health Reporting

CMS Meaningful Use Stage 1 Menu Set objectives require EPs to select one of

two Public Health Reporting (PHR) objectives.

– EP must perform at least one test of certified EHR technology's capacity to submit electronic

data to the public health agency

– EP is then required to perform a follow-up submission if the test is successful

EPs must attest to

1

of

2

PHR objectives:

 Submit immunization registries data  Submit syndromic surveillance data

Frequently Asked Questions

 CMS allows providers to use fictional data for testing if the public health agency allows it  Initial testing can be done once at the group level to suffice for all EPs under that group  Follow up submissions must be by individual EP

 Failing the test still meets the CMS objective for MU Stage 1

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NY Medicaid

EHR Incentive Program 21

Immunizations Registries

Immunization exchange must be reported to one of the two NYS Immunization

Registries based on where the immunization is administered.

Measure: Performed at least one test of certified EHR technology's capacity to submit electronic data to immunization registries and follow up submission if the test is successful.

New York State Immunization Information System (NYSIIS)

– For NYS providers outside of the five boroughs of New York City – Meaningful Use and Data Exchange Testing Resources

– NYSIIS Frequently Asked Questions

Technical Support: nysiishelpdesk@hp.com or 866-389-0371 – Program Support: nysiis@health.state.ny.us or 518-473-2839

Citywide Immunization Registry (CIR)

– For NYS providers inside the five boroughs of New York City – Meaningful Use and Data Exchange Testing Resources

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NY Medicaid

EHR Incentive Program 22

Syndromic Surveillance

Syndromic Surveillance Reporting must be reported to one of the two NYS

Immunization Registries based on where the surveillance takes place.

Measure: Performed at least one test of certified EHR technology's capacity to provide electronic syndromic surveillance data to public health agencies and follow-up submission if the test is successful.

Electronic Clinical Laboratory Reporting System (ECLRs)

– Currently only supporting Hospitals outside of the five boroughs of New York City – Meaningful Use and Syndromic Surveillance Resources

– Future support for Eligible Professionals

Support: eclrs@health.state.ny.us or 866-325-7743

Primary Care Information Project (PCIP)

– For NYS providers inside the five boroughs of New York City – Meaningful Use and Syndromic Surveillance Resources (NYC) – Support: pcip@health.nyc.gov

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NY Medicaid

EHR Incentive Program 23

Meaningful Use Stage 1

Introduction to Meaningful Use

Meaningful Use Stage 1 Core Objectives

Meaningful Use Stage 1 Menu Objectives

Clinical Quality Measures

Public Health Reporting

(24)

NY Medicaid

EHR Incentive Program 24

MEIPASS and Meaningful Use

Medicaid EHR Incentive Program Administrative Support Service (MEIPASS)

Providers do not need to re-register to the NY Medicaid EHR Incentive Program

All MEIPASS prerequisites are still valid for participation year 2

All Eligible Professional (EP) MU Stage 1 attestations will be reported in MEIPASS

• Providers must print, sign, and return (by mail) an attestation form before payment

may be issued

NY Medicaid will start accepting participation year 2 attestations in the 4

th

quarter of calendar year 2012 until March 31,2013

Providers must attest to the Medicaid patient volume to maintain eligibility in

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NY Medicaid

EHR Incentive Program 25

Meaningful Use Resources

CMS Meaningful Use State 1 Resources

Meaningful Use Website

CMS Frequently Asked Questions (FAQs)

CMS Clinical Quality Measures (CQMs) Resources

Clinical Quality Measures Website

Guide to Clinical Quality Measures

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NY Medicaid

EHR Incentive Program 26

Program Resources

State Resources

Provider Information on eMedNY.org

https://www.emedny.org/meipass/

Application Process Overview

https://www.emedny.org/meipass/over_prof.aspx

MEIPASS: EP Login

https://meipass.emedny.org/ehr/jsp/ehr/pgLogin.jsp

Other Resources

New York State Medicaid HIT Plan (NY-SMHP)

http://nyhealth.gov/regulations/arra/docs/medicaid_health_information_technology_plan.pdf  CMS Website for the Medicare and Medicaid EHR Incentive Programs

http://www.cms.gov/ehrincentiveprograms/  ONC Home Page

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NY Medicaid

EHR Incentive Program 27

Questions?

CMS Help Desk

Program Registration, Meaningful Use, CQM

1 (888) 734-6433

MEIPASS Call Center

ePACES Password Resets, MEIPASS Access Assistance

meipasshelp@csc.com

1 (877) 646-5410

NY Medicaid EHR Incentive Program Support Team

Calculation, Registration, Eligibility

hit@health.state.ny.us

1 (800) 278-3960

References

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