Program Updates

Eligible Hospital Information for the EHR Reporting Period in 2019

Dual-eligible hospitals and CAHs attesting to CMS for both the Medicare and Medicaid Promoting Interoperability Programs will register and attest to the QualityNet system. However, dual-eligible hospitals and CAHs new to the Promoting Interoperability Programs must register in the Registration and Attestation System and register in QualityNet. Click here for additional information.

For information on QualityNet account registration, please review the QualityNet User Guide. The User Guide includes step-by-step instructions for creating an account on QualityNet.

PY 2019 Objective 5 Measure 1 Process Clarification

The language in the Stage 3 regulation and 2019 specification sheet for Objective 5, Measure 1 is unclear. Therefore, CMS is allowing flexibility on the requirement to meet this measure for 2019 and clarify the requirement for 2020 in accordance with its original intention. Click  Download this pdf file.here  for PY 2019 Objectives and Measures. Click here for additional details.

eCQM Policies for the Performance Year 2019 

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 2019 is aligned with the list of eCQMs available for eligible clinicians under MIPS in 2019. Click here to find those eCQMs.

Meaningful Use Applications for Program Year 2019

The new deadline for Eligible Professionals to submit MU applications for Program Year 2019 is June 30, 2020.

Clinical Quality Measures

  • eCQM Policies for Program Year 2019
    • The list of available eCQMs for EPs in 2019 was aligned with the list of eCQMs available for eligible clinicians under MIPS in 2019. Those eCQMs can be found here.
    • In 2019, returning EPs 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, 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 2020 Polices
    • CMS will update its webpage with 2020 Medicaid Promoting Interoperability Program requirements once policies have been finalized in the Medicare Physician Fee Schedule final rule. Click here to check for updates. 
  • Program Year 2021 Policies
    • In 2021, all EPs will have 90-day reporting periods for MU and eCQM 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. Click here for 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

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.

Reconsideration Information

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.

eClinicalWorks Update

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).

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.

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