IMS Meaningful Use Webinar Presented on: May 9 – 11:00am – 12:00pm (PDT) May 13 – 12:00pm – 1:00pm (EST) This Webinar Will Be Recorded! Please send questions that you may have after the session to: info@suitemed.com
Meaningful Use: Today’s Topics • Meaningful Use in a Nutshell • EHR Incentive Programs • Meaningful Use Stage 1 Requirements • Eligibility Defined • Incentive Registration Overview • Incentive Attestation Overview • IMS Meaningful Use Report Overview • MU Requirements: Core and Menu • Additional Resources
Meaningful Use in a Nutshell • Introduced as part of American Reinvestment and Recovery Act 2009 • Focus to improve health care through use of health information technology • Three main EHR components – Use in a meaningful manner (ex: e-prescribing) – Use for electronic exchange of health information to improve quality of health care – Use to submit clinical quality and other measures
Meaningful Use in a Nutshell • Managed by the Centers for Medicare & Medicaid Services (CMS) • Five year program – Stage 1 sets the baseline for electronic data capture and information sharing (2011 and 2012). – Stage 2 (2013) and Stage 3 (2014-15) will continue to expand on this baseline and be developed through future rule making.
EHR Incentive Programs – Medicare • Provides incentive payments to eligible professionals (EP), eligible hospitals, and critical access hospitals (CAH) that demonstrate meaningful use (MU) of certified EHR technology. – Participation can begin as early as 2011 – EP can receive up to $44k over 5 years; additional incentives for Health Professional Shortage Areas – Maximize benefits; begin in 2011 – After 2015, adjusted reimbursements if not successfully demonstrating MU
EHR Incentive Programs – Medicaid • Provides incentive payments to EPs, eligible hospitals, and CAHs as they adopt, implement, upgrade, or demonstrate MU of certified EHR technology in their first year of participation and demonstrate MU for up to five remaining participation years. – Voluntarily offered by individual states and territories and may begin as early as 2011, depending on the state. – EP can receive up to $63,750 over the six years that they choose to participate in the program. – There are no payment adjustments under the Medicaid EHR Incentive Program.
EHR Incentive Programs – Terms • Adopted - Acquired and installed certified EHR technology. (For example, can show evidence of installation.) • Implemented: Began using certified EHR technology. (For example, provide staff training or data entry of patient demographic information into EHR.) • Upgraded: Expanded existing technology to meet certification requirements. (For example, upgrade to certified EHR technology or add new functionality to meet the definition of certified EHR technology.)
Eligibility Defined Eligibility Requirements for Professionals • Incentive payments for EPs are based on individual practitioners. • If part of a practice, each EP may qualify for an incentive payment if each eligible professional successfully demonstrates meaningful use of certified EHR technology. • Each EP is only eligible for one incentive payment per year, regardless of how many practices or locations at which he or she provide services. • Hospital-based eligible professionals are not eligible for incentive payments. An eligible professional is considered hospital-based if 90% or more of his or her services are performed in a hospital inpatient (Place Of Service code 21) or emergency room (Place Of Service code 23) setting.
Eligibility Defined - Medicare • In addition to the eligibility requirements above, Medicare eligible professionals must have Medicare Part B allowed charges and must be enrolled in an “approved status” for Provider Enrollment, Chain and Ownership System (PECOS). • EPs under the Medicare EHR Incentive Program include: – Doctor of medicine or osteopathy – Doctor of dental surgery or dental medicine – Doctor of podiatry – Doctor of optometry – Chiropractor
Eligibility Defined - Medicaid • In addition to the eligibility requirements above, to qualify for an incentive payment under the Medicaid EHR Incentive Program, an eligible professional must meet one of the following criteria: – Have a minimum 30% Medicaid patient volume* – Have a minimum 20% Medicaid patient volume, and is a pediatrician * – Practice predominantly in a Federally Qualified Health Center or Rural Health Center and have a minimum 30% patient volume attributable to needy individuals • EPs under the Medicare EHR Incentive Program include: – Doctor of medicine or osteopathy – Doctor of dental surgery or dental medicine * Children's Health Insurance – Doctor of podiatry Program (CHIP) patients do not – Doctor of optometry count toward the Medicaid – Chiropractor patient volume criteria.
Eligibility Defined – Both??? What if an EP can qualify for Medicare and Medicaid? • Professionals eligible for both the Medicare and Medicaid EHR Incentive Programs must choose which incentive program they wish to participate in when they register. Before 2015, an eligible professional may switch programs only once after the first incentive payment is initiated. Most eligible professionals will maximize their incentive payments by participating in the Medicaid EHR Incentive Program.
MU Stage 1 Requirements • In 2011 and/or 2012, EP must meet 20 of 25 MU objectives – 15 Core Objectives – EP must meet ALL of these to qualify – 10 Menu Objectives – EP must choose 5 from this list to qualify • EP is also required to report discipline specific clinical quality measures (CQM). EP must report on 6 total clinical quality measures: 3 required core measures (substituting alternate core measures where necessary) and 3 additional measures (selected from a set of 38 clinical quality measures). For more information on CQM, visit: http://www.cms.gov/QualityMeasures/
Incentive Registration Overview • Medicare registration opened January 3, 2011, so EPs may register at any time • Medicaid registration varies by state and open date can be found: http://www.cms.gov/apps/files/statecontacts.pdf • EP must either register personally or designate a third party to register on their behalf* – If a third party will be registering for one or more EP, they must first create an account at the Identity & Access Management System (I&A) site https://nppes.cms.hhs.gov/NPPES/IASecurityCheck.do * NOTE: Medicaid third-party registration availability may vary at the state level
Incentive Registration Overview Steps to Registration 1. Gather required information ahead of time a) NPI Number b) NPPES Number (also known as PECOS number) c) Payee Tax ID Number (if benefits to be reassigned) d) Payee NPI (if benefits to be reassigned) 2. Decide which program to register for – Medicare – Review the Medicare EP Registration User Guide – Medicaid – Review the Medicaid EP Registration User Guide 3. Follow the instructions within the appropriate guide above to complete the registration process
Incentive Attestation Overview • Medicare attestation opened April 18, 2011 • Medicaid attestation varies by state and information can be found: http://www.cms.gov/apps/files/statecontacts.pdf • EP must either attest personally or designate a third party to register on their behalf* – If a third party will be attesting for one or more EP, they must first create an account at the Identity & Access Management System (I&A) site https://nppes.cms.hhs.gov/NPPES/IASecurityCheck.do * NOTE: Medicaid third-party attestation may vary at the state level
Incentive Attestation Overview Medicare – Requirements for Incentive Payment • EP must be registered for the Medicare EHR Incentive Program • Must meet Meaningful User criteria using certified EHR technology • On the CMS Registration and Attestation System, EP must successfully attest to meeting meaningful use criteria using EHR technology Medicaid – Requirements for Incentive Payment • EP will follow a similar process to the above, using their state’s specific Attestation System
Incentive Attestation Overview When to Attest • Medicare – In the first year, must have met MU criteria for one consecutive 90-day reporting period – For all subsequent years, attestation must be met for the entire calendar year – IMPORTANT NOTE : If your initial attestation fails in the first year, you may select a different 90-day that may partially overlap a previously reported 90-day period and attest again. (Tip: Plan to attest initially no later than September 15, 2011 to allow 2 weeks to make EHR or clinic process adjustments if needed and still have a full 90-day period for qualification in case overlap is not possible.) • Medicaid – In the first year, must attest to adopting, implementing or upgrading EHR – Must check at the state level to find out when participation may begin
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