Program Updates

 

ONC's Interoperability Forum

ONC will host its 3rd Interoperability Forum on August 21-22. Key leaders and stakeholders will discuss the current and future direction of interoperability. Click here for additional information.

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.

 

Medicaid EHR Incentive Program Name Change

The Centers for Medicare and Medicaid (CMS) has overhauled and streamlined the Electronic Health Record (EHR) Incentive Programs and renamed it. This program is now known as the Promoting Interoperability (PI) Programs for eligible hospitals, critical access hospitals, and Medicaid providers. Click here for more information about PI Programs. 

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.

 

Submission Deadline for Meaningful Use Program Year 2018 Applications 

The deadline for Eligible Professionals to submit MU applications for PY18 is May 15, 2019. 

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.

Payment Adjustment Year 2017 Medicare PI Program CAH Reconsideration Application

 

 

To be reconsidered for the 2017 payment adjustment, the application must be submitted by February 22, 2019.

Hardship Exception Information

Eligible hospitals, and CAHs may be exempt from Medicare penalties if they can show that demonstrating meaningful use would result in a significant hardship. To be considered for an exception (to avoid a payment adjustment) health care providers must complete a hardship exception application and provide proof of the hardship. If approved, the hardship exception is valid for only one payment year. Health care providers need to submit a new application for subsequent years and in no case, may a health care provider be granted an exception for more than five years.

Hardship Exception Forms

  • 2019 EH hardship application
  • The deadline for eligible hospitals to submit hardship forms for the 2019 payment adjustment, based on the 2017 EHR reporting period was July 1, 2018.
  • 2017 CAH hardship application
  • The deadline for CAHs to submit hardship forms for the 2017 payment adjustment, based on the 2017 EHR reporting period was November 30, 2018.

 

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.

The CMS Medicaid HITECH FAQs for Calendar Year 2016

The CMS Medicaid HITECH team has developed FAQs in response to inquiries from state Medicaid administrators regarding participation in the PI Program for Calendar Year 2016. Click here to view the FAQs. 

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