eCQM Policies for the Performance Year 2020
The 2019 Physician Fee Schedule (PFS) Final Rule established that in 2019, Medicaid EPs who are returning participants must report on a one year eCQM reporting period, and first-time meaningful users must report on a 90-day eCQM reporting period. EPs are required to report on any six eCQMs related to their scope of practice. In addition, Medicaid EPs are required to report on at least one outcome measure. If no outcome measures are relevant to that EP, they must report on at least one high-priority measure. If there are no outcome or high priority measures relevant to an EP’s scope of practice, they must report on any six relevant measures.
The list of available eCQMs for EPs in 2020 is aligned with the list of eCQMs available for eligible clinicians under MIPS in 2020. Click here to find those eCQMs.
Meaningful Use Applications for Program Year 2020
Eligible Professionals will be able to submit MU applications for PY20 starting September 1, 2020. The deadline to submit these applications is May 31, 2021.
2020 Medicaid Promoting Interoperability Program Requirements
- All EPs, EHs and CAHs are required to use 2015 Edition CEHRT.
- Meaningful Use Requirements for 2020
- All EPs must report on a 90-day minimum EHR reporting period and meet the Stage 3 Meaningful Use requirements.
- Stage 3 requirements can be found here.
- eCQM Requirements for 2020
- The list of eCQMs can be found here.
- All returning EPs must report on a minimum 90-day eCQM reporting period.
- EPs are required to report on any six eCQMs related to their scope of practice.
- In addition, EPs are required to report on at least one outcome measure. If no outcome measures are relevant, EPs must report on at least one high-priority measure. If there are no outcome or high priority measures relevant to an EP’s scope of practice, they may report on any six relevant measures.
- Program Year 2021 Policies
- In 2021 all EPs will have 90-day EHR and eCQM reporting periods to allow states to meet the statutory deadline of December 31, 2021, for all incentives to be paid.
Myers and Stauffer to Perform Post Payment Audits
The Georgia Department of Community Health (DCH) is contracted with certified public accounting firm Myers and Stauffer LC to perform post-payment audits for the Medicaid Promoting Interoperability (PI) Program (formerly EHR Incentive Program). Providers/hospitals who have been randomly selected for post-payment audits will be contacted by Myers and Stauffer LC. Clickfor more information.
For more information about payment adjustments and hardship information, click here. For more information on the Promoting Interoperability Programs, visit the Promoting Interoperability Programs website.
2015 Edition Certified EHR Technology
Beginning with the EHR reporting period in the calendar year 2019, all participants in the Medicaid Promoting Interoperability Program are required to use 2015 Edition CEHRT. The 2015 Edition CEHRT did not have to be implemented on January 1, 2019. However, the functionality must be in place by the first day of the EHR reporting period and the product must be certified to the 2015 Edition criteria by the last day of the EHR reporting period.
Click here for additional information.
QNet Information for Eligible Hospitals and CAHs
Dually eligible hospitals and Critical Access Hospitals (CAHs) attesting to CMS will submit their Meaningful Use attestations in the QualityNet Secure Portal (QNet). The Registration and Attestation System will continue to be available for Medicaid-only hospitals and CAHs. Click here for additional information or here for the QNet Secure Portal Enrollment and Login User Guide.
Medicaid PI Program Payment Adjustments and Hardships Information
If a health care provider is eligible to participate in the PI Program, they must demonstrate meaningful use each year to avoid a payment adjustment. Eligible Hospitals and CAHs who are eligible to participate in both PI Programs must demonstrate meaningful use each year to avoid the Medicare payment adjustment regardless of whether they participate in the Medicare or Medicaid PI Programs.
Medicaid health care providers who are only eligible to participate in the Medicaid PI Program are not subject to payment adjustments.
Hospital-based EPs are not subject to Medicare payment adjustments (and are ineligible to receive an EHR incentive payment under either Medicare or Medicaid) and are defined as providing 90 percent or more of his or her covered professional services in sites of service identified by the codes used in the HIPAA standard transaction as an inpatient hospital or emergency room setting.
Payment Adjustment Fact Sheets
- CAH payment adjustment information can be found here.
- EH payment adjustment information can be found here.
- Payment adjustments & hardship exceptions table from 2017 through 2019 can be found here.
If an eligible hospital or CAH receives notification that they are subject to a Medicare PI payment adjustment in error, based on the applicable performance year, they can apply for a reconsideration during the applicable application period.
Eligible professionals that used eClinicalWorks (eCW) can click here for the CMS FAQ6097.
All providers utilizing a Greenway product must provide documentation of a software upgrade and a verification of use letter from their vendor. Contact your Greenway representative to obtain this information.
DCH Medicaid Promoting Interoperability (PI) Program Audit Appeals & Administrative Review Policy
This policy applies to all providers enrolled in the PI Program. Clickfor the Audit Appeals and Administrative Review Policy.
ONC Certified HIT Product List (CHPL) Site
The updated version of the ONC Certified HIT Product List (CHPL) site is available. Please review the documents by clicking on the links below, which provide information for stakeholders/customers to update their URL links and web service definition language (WSDL) endpoints to access services at the new CHPL site.
2019 Medicaid Promoting Interoperability Program Requirements
Beginning in 2019, all eligible professionals (EPs), eligible hospitals (EHs), dual-eligible hospitals, and critical access hospitals (CAHs) are required to use 2015 edition certified electronic health record technology (CEHRT) to meet the requirements of the Promoting Interoperability Programs. Note that the requirements for EHs, dual-eligible hospitals, and CAHs that submit an attestation to CMS under the Medicare Promoting Interoperability Program were updated in the 2019 IPPS final rule.
Required MAPIR Documents
Eligible Professionals must upload documentation that support their MU applications. The documentation will vary based on the participation year. Also, Eligible Professionals cannot use the same Security Risk Assessment (SRA) or SRA update for Program Years. If you have questions regarding your application, contact the PI Program Call Center at 1-800-766-4456 or submit an inquiry on the web portal at www.mmis.georgia.gov.
- Posted 01/19/16
- Posted 03/03/16
|Required Documentation for MU:|
|Detailed Encounter Report|
|Patient Volume Calculator|
|Security Risk Assessment|
|Screenshots for Y/N|
|Documentation for Exclusions|
|MU Summary Report/Dashboard|