Registration & AttestationFor WV Medicaid EHR Incentive

Medicaid Professionals

August 8, 2011

Agenda:

• Federal EHR Incentive Program and Timeline

• WV Medicaid EHR Incentive for Eligible Providers– Eligibility and requirements

– Medicaid incentive payment amounts

• WV Medicaid EHR Registration/Attestation Process

2

Why CMS Is Doing This—Desired Progression of EHR Use2010 2011 2013 2015

Source: DHHS, HIT Policy Committee, Meaningful UseWorkgroup Presentation, 7/16/09

ARRA EHR Incentives

• Available to eligible Providers and Hospitals

• Providers must select Medicare or Medicaid

• Medicare - $44,000 potential total payment per eligible provider

• Medicaid - $63,750 potential total payment per eligible provider

• First payments being provided this year (2011)

• Tied to achieving three progressively more complex“meaningful use” stages to be rolled out over the nextseveral years

Medicaid EHR IncentiveUnder Medicaid, Eligible Professionals (EPs) are:

• physicians (primarily doctors of medicine and doctors ofosteopathy),

• dentists,

• nurse practitioners,

• certified nurse midwives, and

• physician assistants (practicing in a Federally QualifiedHealth Center (FQHC) or Rural Health Clinic (RHC) ledby a physician assistant).

Must have 30% Medicaid patient volume. For thosepracticing in an FQHC or RHC, must have 30% “needyindividual” volume which includes Medicaid, WV-CHIP,sliding fee, and free care.

ARRA Incentive Payments- Medicaid

Meaningful Use

• Meaningful Use occurs in three stages, with Stage 1starting in 2011

• New rules will be published in 2013 and 2015 (Stages 2and 3) – each stage will be more comprehensive

• Focus areas for each stage

• Stage 1: Data capture and sharing

• Medicaid first-year: A/I/U

• Stage 2: Advanced clinical processes; exchange*

• Stage 3: Improved outcomes*

* Requirements for Stages 2 and 3 will be defined in future CMS rulemaking.

Medicaid - First Year:Adopt/Implement/Upgrade (A/I/U)

• Adopted – Acquired and Installed

• Ex: Evidence of installation prior to incentive

• Implemented – Commenced Utilization of

• Ex: Staff training, data entry of patient demographicinformation into EHR

• Upgraded – Expanded

• Upgraded to certified EHR technology or added newfunctionality to meet the definition of certified EHRtechnology

Year 1 investment relates to “up until now”; years 2-6updated each year

8

THE PROCESS

Medicaid EHR Registration/Attestation

Two-Step Process

1. National Registration

2. State BMS Portal

You must register before you can submit attestation

• https://ehrincentives.cms.gov/hitech/login.action

Process – Step 1

• Register at the CMS National Level Repository (NLR)https://ehrincentives.cms.gov/hitech/login.action

Note: You will need to be prepared to enter and select thefollowing information at the NLR:

• National Plan and Provider Enumeration System(NPPES) Logon and Password:https://nppes.cms.hhs.gov/NPPES/

• Provider Name• National Provider Identification (NPI)• Business Address and Phone

• Input “Incentive Payment To” Tax Identification Number (TIN)Note: Please call 1-888-483-0793 (Molina Provider Services)to have your information on file changed.

Process – Step 1

• Select Medicaid EHR incentive

• Select West Virginia as the “State” for Medicaid EHR incentiveparticipation

• Record CMS EHR Product Certification NumberNote: The NLR will walk you through on going to http://onc-chpl.force.com/ehrcert to obtain your CMS EHR ProductCertification Number if you do not already have one.

Process – Step 2

• Wait 2 business days…then access the WV EHRProvider Incentive Payment program secure site bygoing to:

www.wvmmis.com

• Select the WV EHR Incentive Program, and login tothe secure site using your web portal user name andpassword.NOTE: Providers without a user name and password who work in certain types

of clinics will need to first enroll via the web portal registration secure site toreceive an ID and location code.

WV Process-once NLR registration complete

Go to www.wvmmis.com, login, and select the W.V. Medicaid EHRIncentive Program. Providers are required to have a login user nameand password. Please call 1-888-483-0793 or use the following linkhttps://www.wvmmis.com/xjRegManage/tradingPartnerRegRight.screenfor a login user name and password.

WV Registration

WV Registration

WV Registration

Registration Verification

Information is verified based on the data entered in theNLR. Inaccuracies must be corrected through that system.

Process – Step 2• Attest that at least 30% of all encounters (20% if a Pediatrician)

within a consecutive 90-day period from the previous calendaryear were with Medicaid patients. To obtain this documentation,run a report for any consecutive 90-day period for the totalMedicaid encounters. An encounter is defined as anunduplicated personal direct contact (or series of contactsoccurring within the same day).

• Enter:• Total number of patient encounters in a consecutive 90-day

period.

• Total number of encounters for Medicaid patients in a consecutive90-day period.

Note: If practicing in an FQHC or RHC, use the number of encounters attributable to servicesprovided to “needy individuals”. Encounters for services rendered to needy individuals on anyone day include services paid for by Medicaid or Children’s Health Insurance Program(CHIP), furnished at no cost or paid for at a reduced cost based on a sliding scale determinedby the individuals ability to pay during a consecutive 90-day period.

Things To Keep In Mind

Providers Practicing in an FQHC:

A provider is considered an FQHC provider if more than 50% of theirencounters over a period of 6 months during the most recentlycompleted calendar year are in an FQHC or RHC. The Medicaidregistration system will allow for assignment of payment by a providerto any entity set up as a “pay to” entity in the provider’s profile.

Contracts often define the fiscal relationships between providers andthe organization, and these contracts will govern payment assignment.

The Medicaid registration system will allow for assignment of paymentby a provider to any entity set up as a “pay to” entity in the provider’sprofile.

Attestation Process Notes

• You do not need to complete the Attestation process in one sitting.Each screen in the Attestation flow has a Save and Continue button.This will save your changes and allow you to stop at any time withoutthe loss of data that was entered on that page. The attestationprocess does not allow you to skip forward to screens or jump past ascreen without entering data. You may edit answers until you havesubmitted the attestation.

• The BMS Provider Incentive Payment Manual includes a worksheetthat can be completed in advance of starting the online process.

• Even though eligible professionals are not required to provide MUobjectives measures during the first year, the online system will walkyou through al of the objectives before the actual attestation is made.

21

The topic listing identifies the completed topic by placing a check mark next to thetopic. A topic is completed when the required answers are entered and saved.

Topics become available as prerequisite topics are completed

Beginningof theattestationscreensequence

Moving into the AIU Attestation…

Things To Keep In Mind

AIU – Acquire, Implement, Upgrade

(a) acquiring, purchasing or securing access to certified EHRtechnology;

(b) installing or commencing utilization of certified EHR technologycapable of meeting meaningful use requirements; or

(c) expanding the available functionality of certified EHR technologycapable of meeting meaningful use requirements at the practicesite, including staffing, maintenance, and training, or upgrade fromexisting EHR technology to certified EHR technology per the ONCEHR certification criteria.

Things To Keep In Mind

A/I/U – Aquire, Implement, Upgrade

For the West Virginia Medicaid EHR Provider Incentive Paymentprogram a provider must demonstrate A/I/U for year 1 by simplyselecting within the West Virginia EHR Provider Incentive Program webportal whether they are going to adopt, implement, or upgrade.

However, providers should be prepared to provide proof of A/I/Uaccording to the West Virginia Medicaid Provider Manual CommonChapter Section 800.19 Maintenance of Records.

Attestation

The Submit Attestation button remains disabled if the eligibility checks failed or not allrequired questions have been answered. If the eligibility checks passed and allrequired questions are answered, selection of the Submit Attestation button willprovide the screen above.

Process – Final

• Electronically Sign and Submit Attestation to receive an EHRincentive payment. Upon submission of attestation, anAcknowledgement Page will display. Please print thecompletion screen and keep with EHR records.

• Medicaid EHR incentive payment will be issued by W.Va. BMSwithin 30 business days after successful registration andattestation.

THINGS TO KEEP IN MIND

Medicaid EHR Incentive Registration/Attestation

Final Thoughts

• For the West Virginia Medicaid EHR Provider Incentive Paymentprogram an eligible professional must demonstrate AIU for year 1 bysimply selecting within the West Virginia EHR Provider IncentiveProgram web portal that they are going to adopt, implement, orupgrade. However, they should be prepared to provide proof of AIUaccording to the West Virginia Medicaid Provider Manual CommonChapter Section 800.19 Maintenance of Records.

• All information submitted during the registration and attestationprocess is subject to verification and audit.

Going Back into the System…

Review Attestation Status/Payment

• Provides a screen that lists the registration IDs linked toyou and displays attestation and payment status.

• Emails will communicate status changes when theyoccur.

• Help Desk will be able to provide support.

Resources

W.Va. Regional HIT Extension Center – www.wvrhitec.org

- Independent, non-profit organization providing technical assistance,guidance, and information on best practices to support andaccelerate providers’ efforts to become meaningful users of certifiedelectronic health record technology;

- Made up of a team of experienced health information technology(HIT) and clinical professionals with intimate knowledge of WestVirginia’s medical community; and

- Has federal funds available to provide priority primary careproviders, generally those associated with FQHCs and small privatepractices, with subsidized training and services (electronic healthrecord selection and implementation, meaningful use, workflowredesign, privacy & security, etc.).

More Resources

• WV Medicaid EHR Incentive Program websitehttp://www.dhhr.wv.gov/bms/ehr

• CMS EHR Incentive

http://www.cms.gov/EHRIncentivePrograms/

• ONC Health Information Technology EHR product certificationhttp://onc-chpl.force.com/ehrcert

• WV Regional HIT Extension Center (WVRHITEC)http://www.wvrhitec.org

QUESTIONS?

Please submit questions by email to dhhrehr@wv.gov or call

1-888 483-0793 and select option 8 when prompted.