Vermont Medicaid EHR
Incentive Program
• Vermont Medicaid EHRIP status
• Overview of EHRIP changes
• MAPIR 5.0
• Vermont Medicaid EHRIP status
• Overview of EHRIP changes
• MAPIR 5.0
•
Maintain CMS guidelines for EHRIP
functions
•
Maintain the technical functioning of
attestation system
•
Develop Vermont program website
and other information resources
•
Process attestations
•
Pre-payment validation
•
Develop audit plan, conduct program
audits
•
Comply with CMS EHRIP reporting
requirements
Terry Bequette
State of Vermont HIT Coordinator
Lorraine Siciliano
Medicaid Operations Administrator
Timothy Tremblay
Medicaid Operations Administrator
Heather Kendall, PhD
• Vermont Medicaid EHRIP status
• Overview of EHRIP changes
• MAPIR 5.0
Changes as of Program Year 2013
• Medicaid Encounter definition for EPs
• Patient volume threshold reporting period
• FQHC/RHC ‘Practicing Predominantly’ calculation
New Definition of ‘Medicaid Encounter’ for EPs
Medicaid Encounter = services rendered on any one day to a
Medicaid-enrolled individual,
regardless of payment
liability
New Definition of ‘Medicaid Encounter’ for EPs
Examples of encounters that may now be included
• Claims denied due to service limitation audits
• Claims denied due to non-covered service
• Claims denied due to timely filing
New Definition of ‘Medicaid Encounter’ for EPs
New Definition of ‘Medicaid Encounter’ for EPs
• Medicaid encounter definition does not change for
Eligible Hospitals
Patient Volume Threshold Reporting Period
As of Program Year 2013, EPs and EHs have the option to
choose their patient volume threshold reporting period:
• Any consecutive 90-day period within the prior program
year
OR
Patient Volume Threshold Reporting Period
Program Year 2012
EPs
January 1, 2012
to
December 31, 2012
EHs
October 1, 2011
to
September 30, 2012
EPs
January 1, 2011
to
December 31, 2011
EHs
October 1, 2010
to
September 30, 2011
PY2012 90-day reporting period dates
EP attestation date of 12/1/12:
Patient Volume Threshold Reporting Period
Program Year 2013
EPs
January 1, 2013
to
December 31, 2013
EHs
October 1, 2012
to
September 30, 2013
Example: EP attestation date 12/1/13
Now has the option to choose a 90-day period
from 2012 OR a 90-day period from
Patient Volume Threshold Reporting Period
It is possible that using the preceding 12-month period and
choosing a 90-day period ending close to the date of the
attestation submission could delay the application processing.
If the state has not yet received claims or encounter data for that
period, the EHR Incentive Program Team may hold the attestation
FQHC/RHC Practicing Predominantly
For EPs to be practicing predominantly at an FQHC/RHC, more than 50 percent of their
patient encounters must be at the qualifying practice. Prior to PY2013, the patient
encounters had to be during 6-month period within the
previous calendar year
from the Program Year in which they were attesting.
FQHC/RHC Practicing Predominantly
The updated requirement allows EPs to use a
6-month period within the prior calendar year
or within the preceding 12-month period
from the date of attestation
for their practicing predominantly period
calculation
Example: EP attestation date 12/1/13
Now has the option to choose a 6-month
period from 2012 OR a 6-month period from
11/30/2012 - 11/30/2013
Meaningful Use Stage 1 Changes
•
Changes to measures and objectives for certain Meaningful
Use Stage 1 (MU1) reporting requirements
•
Changes to MU Core Measures #1, #4 and #8 include optional
exclusions and alternate measures.
•
MU Core Measures #10 – reporting ambulatory clinical quality
measures – and #14 – exchanging key clinical information – are
removed as separate reporting requirements.
•
These changes are optional in PY2013, but will become
mandatory for PY2014.
• Vermont Medicaid EHRIP status
• Overview of EHRIP changes
• MAPIR 5.0
The MAPIR Collaborative
•
Medical Assistance Provider Incentive Repository application
•
A group of 13 states with Hewlett-Packard as their common
Attesting for Program Year 2013
WARNING! DO NOT PROCEED
with a Program Year 2013
EHRIP attestation in MAPIR
before reading the information
here
.
• Vermont Medicaid EHRIP status
• Overview of EHRIP changes
• MAPIR 5.0
Information, Guidance, Answers
•
The MAPIR User Guides for EPs and EHs
•
The Vermont Medicaid EHRIP Website
http://hcr.vermont.gov/hit/ehrip
•
Vermont Information Technology Leaders (VITL)
http://www.vitl.net
─ REC Services
─ MyVITL Helpdesk
•
CMS EHRIP Website
IMPORTANT: If an Eligible
Professional’s Vermont Medicaid
enrollment lapses at any time after an
application is started and BEFORE A
PAYMENT IS RECEIVED, the application
will automatically ABORT from the
MAPIR system. All saved data for the
application will be eliminated. The
attestation must then be restarted
from the beginning in MAPIR after the
TO INSURE YOU ARE PREPARED FOR
A POTENTIAL AUDIT, SAVE ANY
ELECTRONIC OR PAPER
DOCUMENTATION THAT SUPPORTS
YOUR ATTESTATION.
PLEASE NOTE
: If there are multiple
lines for multiple locations, EACH LINE
must have either a “Yes” or “No”
answer in the column “Utilizing
Certified EHR Technology (Must Select
One).” At least one practice location
where you are utilizing certified EHR
technology must be selected as a
location for which you will provide
patient volume information.
PLEASE NOTE UPDATED
DOCUMENTATION
REQUIREMENTS FOR ALL GROUP
ATTESTATIONS
Group Attestation Documentation For each provider attesting as part of a group, please document the following and upload the information in a PDF file as part of each provider’s attestation:
• Applicant’s name and individual NPI
• The set of Group Practice IDs (billing NPIs) used to define the group
• A complete list of all individual provider names and individual NPIs for all attending or rendering
providers associated with the group, regardless of whether they are Eligible Professionals attesting for an incentive payment.
Please note that for each provider
attesting to Adoption,
Implementation or Upgrade, you
must upload a copy of an invoice,
contract, purchase order, license
agreement or similar document
related to your EHR system.
Upload instructions are on page
214 in the Submit section of the
attestation instructions.
Page 77 – Core Measure 1
Choose if you would like to attest to the
Original Core Measure 1 or the Optional
Core Measure 1.
Page 85 – Core Measure 4
New exclusion added.
(Measure Code EPCMU04)
Page 90 – Core Measure 8
Choose if you would like to attest to the
Original Core Measure 8 or the Optional
Core Measure 8.
(Measure Code EPCMU08)
Old measure: Vital signs must be recorded for more than 50 percent of all unique patients ages 2 and over.
Supporting documentation is
required to be uploaded with your
attestation …
Supporting documentation is
required to be uploaded with your
attestation …
Post Submission – Page 228
IMPORTANT: If an Eligible
Professional’s Vermont Medicaid
enrollment lapses at any time after an
application is started and BEFORE A
PAYMENT IS RECEIVED, the application
will automatically ABORT from the
MAPIR system. All saved data for the
application will be eliminated. The
attestation must then be restarted
from the beginning in MAPIR after the
Common issues
encountered when
accessing MAPIR, and
CMS
CMS Guidance for EHR Incentive Program audits
Providers who receive an EHR incentive payment for either the Medicare or Medicaid EHR Incentive Program potentially may be subject to an audit.
• Retain ALL relevant supporting documentation used in the completion of your attestation, including documentation to support data for meaningful use objectives and clinical quality measures (CQMs), for six years post-attestation. • Retain documentation that is in either paper or
electronic format – to include screenshots. • Download and/or print a copy your MU report at
•
Vermont Medicaid EHRIP status
Program Team Members and Activities
•
Overview of EHRIP changes
Medicaid Encounter Definition
Patient Volume Threshold Reporting Period
Practicing Predominantly
MU1 Measures
•
MAPIR 5.0
Attestation begins May 1st, 2013 for EHRIP PY2013 changes
•
Resources for EHRIP applicants
• A provider can only switch once after receiving a payment. Once the switch occurs, the provider is in the Program to which he or she switched for the remainder of program participation.
• The switch will only count once the attestation is successfully completed. If the provider started in Medicaid and switched to Medicare, it will only be considered “switched” with approved attestation and payment.
• A provider is allowed to switch back if no attestation is completed. If the provider tries to attest and is unsuccessful, the provider may switch back.
• It is the successful attestation that triggers the switch, because that is when the payment process starts.
• The National Level Registry (NLR) is not currently coded to allow this. If a provider is paid by one Program and switches registration to the other Program, then the provider cannot switch back.
• CMS is working to enhance the system to allow a switch back until a successful attestation is completed. Until that system enhancement comes online, the provider would have to contact the NLR help desk to have it switched manually.
• CMS is working on a FAQ that will be added to their website and FAQ documentation.
