Program Updates

Myers and Stauffer to Perform Post Payment Audits
 
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
 
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 Promoting Interoperability measures incorrectly. Providers should not attest to Meaningful Use with data they know to be incorrect. CMS advises states to establish a process for providers using Greenway CEHRT to begin their attestations during the state’s Program Year 2018 attestation period and attest to Medicaid patient volume. However, incentive payments should not be issued until providers can complete their Meaningful Use attestation following a patch or update from Greenway. Additional attestation information coming soon for Greenway providers only. For the complete list of the product 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

 

Required Documentation for MU:
Detailed Encounter Report  
Patient Volume Calculator  
Security Risk Assessment  
Screenshots for Y/N  
Documentation for Exclusions  
MU Summary Report/Dashboard