NY Medicaid
EHR Incentive Program 1
NY Medicaid
EHR Incentive Program
Eligible Professionals
Participation Year 2 (MU1) Webinar
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
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
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
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
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
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Use certified EHR in a meaningful manner
•
Use certified EHR technology for electronic exchange of health information to
improve quality of health care
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Use certified EHR technology to submit clinical quality and other measures
Being a Meaningful User
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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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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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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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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
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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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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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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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
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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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 Functionality2 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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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
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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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 andAdolescents 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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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
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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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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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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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
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
thquarter of calendar year 2012 until March 31,2013
•
Providers must attest to the Medicaid patient volume to maintain eligibility in
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EHR Incentive Program 25
Meaningful Use Resources
CMS Meaningful Use State 1 Resources
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Meaningful Use Website
•
CMS Frequently Asked Questions (FAQs)
CMS Clinical Quality Measures (CQMs) Resources
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Clinical Quality Measures Website
•
Guide to Clinical Quality Measures
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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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EHR Incentive Program 27