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. Click here for more information.
2018 CAH Hardship Exception Submission Deadline is December 2, 2019
In 2018, the Centers for Medicare & Medicaid Services (CMS) required that all critical access hospitals (CAHs) use either the 2014 or 2015 Edition certified electronic health record technology (CEHRT) to meet the reporting requirements of the Medicare Promoting Interoperability Program and successfully demonstrate meaningful use. The law requires that downward payment adjustments be applied to CAHs that are not meaningful users of CEHRT.
CAHs may avoid the Medicare downward payment adjustments if they can show that meeting the requirements for being a meaningful EHR user would result in a significant hardship. To be considered for an exception, CAHs must complete a hardship exception application and select the reason for the hardship.
Hardship Exception Application Details
You may now submit hardship applications electronically here.
If an electronic submission is not possible, you may verbally submit your application over the phone by calling the QualityNet Help Desk at (866) 288-8912.
The deadline for CAHs to submit an application is December 2, 2019, at 11:59 p.m. ET
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.
2018 Medicaid Promoting Interoperability (PI) Program Requirements
To meet modified stage two requirements for a PI reporting period, all providers must attest to objectives and measures using EHR technology certified to the 2014 Edition. If it is available, providers may also attest using EHR technology certified to the 2015 Edition, or a combination of the two.
To meet stage three requirements for a PI reporting period, all providers must use technology certified to the 2015 Edition. A provider who has technology certified to a combination of the 2015 Edition and 2014 Edition may potentially attest to the stage three requirements if the mix of certified technologies would not prohibit them from meeting the stage three measures. A provider who has technology certified to the 2014 Edition may not attest to stage three.
Click here for additional information.
QNet Information for Eligible Hospitals and CAHs
Beginning January 2, 2018, dually eligible hospitals and Critical Access Hospitals (CAHs) attesting to CMS will submit their 2017 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 after December 31, 2017. 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.
Greenway Health Update: Measure Calculation Error
Greenway Health has alerted CMS and its customers that Greenway’s CEHRT is calculating PI measures incorrectly. According to Greenway, EPs who use SuccessEHS will not be able to attest to MU for 2018. All SuccessEHS customers who plan to participate in the Interoperability Programs for the 2019 reporting period must migrate to Intergy no later than Sept. 30, 2019. This will allow EPs to be on Intergy for a 90-day period to meet the reporting requirements. SuccessEHS customers who do not plan to participate in an Interoperability Program will have until Dec. 31, 2019, to migrate to Intergy.
Greenway provided information to EPs on the 23 eCQMs available for reporting. EPs should report on six measures relevant to their scope of practice that their CEHRT can produce. If an EP’s CEHRT is unable to report data on six relevant measures, the EP may report on a measure(s) that have been identified to have issues with a zero numerator and denominator. Providers should ensure that their attestation can be supported in the event of a program audit.
Additionally, Greenway has concluded that it's Prime Suite customers will not be able to accurately attest to MU. Contact your Greenway representative for more information about Prime Suite. For the complete list of the products reported by Greenway, click here.
DCH Medicaid Promoting Interoperability (PI) Program Audit Appeals & Administrative Review Policy
This policy applies to all providers enrolled in the PI Program. Click here for 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.
Public Health Reporting Measures
Eligible Professionals must attest to two out of three Public Health reporting measures to satisfy the MU Modified Stage 2 registry reporting for Program Year 2017. Eligible Professionals must be in active engagement with a registry to meet the measure. Click here for detailed information about reporting measures in 2017. Eligible Professionals seeking to determine if there is a specialized registry available for them, or if they should claim an exclusion can click here for more information.
The PI Programs in 2015 through 2017 (Modified Stage 2) and Stage 3 include a consolidated public health reporting objective for Eligible Professionals and Eligible Hospitals. Details on how to successfully demonstrate “active engagement” for public health reporting are available for Eligible Professionals (Modified Stage 2 and Stage 3) and Eligible Hospitals (Modified Stage 2 and Stage 3).
Modified Stage 2 Rule Change
CMS published a final rule that specifies criteria that Eligible Professionals, Eligible Hospitals, and critical access hospitals must meet in order to participate in the PI Program. The final rule’s provisions encompass 2015 through 2017 (Modified Stage 2) as well as Stage 3 in 2018 and beyond. Click here for details.
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.
Security Risk Assessment - Posted 01/19/16
EP Tips for Post Payments Audits - 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|