Laws, Regulations and Key Players
1. What is HITECH?
2. Where can I find the full text of regulations and definitions regarding Certified Electronic Health Records, Meaningful Use and EHR Incentive Programs?
3. What entities have been charged with rolling out Federal Health Information Technology initiatives?
4. What are RECs and who do they support?

CERTIFIED ELECTRONIC HEALTH RECORDS AND MEANINGFUL USE
1. What is a Certified Electronic Health Record (EHR)?
2. What are the standards and certification criteria for EHRs? 
3. What EHRs are currently certified?

4. What is the definition of meaningful use? 

5. Why was meaningful use defined and what are policy goals behind it?

EHR INCENTIVE PROGRAMS AND PARTICIPATION
1. What are the CMS Incentive Programs for the Meaningful Use of EHR Technology?
2. What are the different stages of Meaningful Use? 
3. Who is eligible to participate in one of the CMS Incentive Programs?
4. What about mental health?!?
4.5 What should my organization be doing to take advantage of these opportunities?
5. What is the methodology for demonstrating adoption, implementation, or upgrade of certified EHR technology?

?6. How much is the incentive payment to adopt, upgrade, or meaningfully use certified EHR technology?
7. Are there penalties (reimbursement rate adjustments) for organizations serving Medicaid/Medicare clients if they do not demonstrate meaningful use of certified electronic health record technology?  If so, how much and when is the earliest date the penalties can be incurred?

8. How will providers report to CMS? How will providers demonstrate meaningful use of EHR technology?

9. What do the numerators and denominators mean in measures that are required to demonstrate meaningful use for the EHR Incentive Programs?
10. My organization does not typically collect information on any of the core, alternate core, and additional clinical quality measures (CQM) listed in the Final Rule on the Medicare and Medicaid EHR Incentive Programs.  Do I need to report on CQM for which I do not have any data?
?11. What role will the states play in these programs?

12. Where can I learn more?


IMPORTANT TIMELINES & DEADLINES
1. Is there a timeline of milestones related to the Medicare and Medicaid Incentive Programs?
2. What are the deadlines to initiate participation in the Medicare and Medicaid Incentive Programs? 
3. When will penalties (reimbursement rate adjustments) begin for organizations serving Medicaid/Medicare clients if they do not use certified electronic health record technology?
4. What is the reporting period for eligible professionals participating in the electronic health record (EHR) incentive programs? 

HEALTH INFORMATION TECHNOLOGY RESOURCES
1. Where can I learn more about certified EHR technology, meaningful use, incentive programs, and other HITECH activities underway? 
2. Where can I find information about certified EHR technology options? 


Laws, Regulations and Key Players
Q) 1. What is HITECH?

A) 1. On February 17, 2009 the $787 Billion, the American Recovery and Reinvestment Act  of 2009 (ARRA) was signed into law by the federal government. Included in this law is $22 Billion of which $19.2 Billion is intended to be used to increase the use of Electronic Health Records (EHR) by physicians and hospitals; this portion of the bill is called, the Health Information Technology for Economic and Clinical Health Act, or the HITECH Act. The government firmly believes in the benefits of using electronic health records and is ready to invest federal resources to proliferate its use.The HITECH Act established programs under Medicare and Medicaid to provide incentive payments for the “meaningful use” of certified EHR technology. Source: hitechanswers.net

Q) 2. Where can I find the complete laws and regulations regarding Certified Electronic Health Records, Meaningful Use and the EHR Incentive Programs?

A) 2. Click the links below to link to the full text for each:

Q) 3. What entities have been charged with rolling out Federal Health Information Technology initiatives? 

A) 3. The Office of the National Coordinator for Health Information Technology (ONC) is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information. The position of National Coordinator was created in 2004, through an Executive Order, and legislatively mandated in the Health Information Technology for Economic and Clinical Health Act (HITECH Act) of 2009.  The ONC was charged with the task of developing the Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology. Source: ONC website at healthit.hhs.gov

The Centers for Medicare and Medicaid has developed the regulations for the Electronic Health Record Incentive Programs for Medicaid and Medicare www.cms.org

?Q) 4. What are RECs and who do they support?

A) 4. The RECs (Regional Extension Centers) will support and serve health care providers to help them quickly become adept and meaningful users of electronic health records (EHRs). RECs are designed to make sure that primary care clinicians get the help they need to use EHRs.

RECs will:

  • Provide training and support services to assist priority providers in adopting EHRs
  • Offer information and guidance to help with EHR implementation
  • Give technical assistance as needed

The goal of the program is to provide outreach and support services to at least 100,000 priority primary care providers within two years.

ONC has funded 60 RECs in virtually every geographic region of the United States to ensure plenty of support to health care providers in communities across the country.

The Colorado Regional Health Information Organization (www.CORHIO.org) is the REC for Colorado.  This is unique in that Colorado’s REC and Regional Health Information Organization are the same entity, which is not the case in most states.  While some states have multiple RECs, CORHIO is the sole REC for our state.    Source:  healthit.hhs.gov ; www.co-rec.org

CERTIFIED ELECTRONIC HEALTH RECORDS AND MEANINGFUL USE
Q) 1. What is a Certified Electronic Health Record (EHR)?

A) 1. Certified EHRs are complete EHR or EHR Modules that have been certified by an Office of the National Coordinator for Health Information Technology-Authorized Testing and Certification Body (ONC-ATCB).  Standards and criteria for certified EHR technology were established in response to the Health Information Technology for Economic and Clinical Health Act (HITECH) to improve health care quality, safety, and efficiency through the promotion of HIT and electronic health information exchange.

Certified EHR Technology means: (1) A Complete EHR that meets the requirements included in the definition of a Qualified EHR and has been tested and certified in accordance with the certification program established by the National Coordinator as having met all applicable certification criteria adopted by the HHS Secretary as defined in the EHR Technology Final Rule; or (2) A combination of EHR Modules in which each constituent EHR Module of the combination has been tested and certified in accordance with the certification program established by the National Coordinator as having met all applicable certification criteria adopted by the HHS Secretary, and the resultant combination also meets the requirements included in the definition of a Qualified EHR. Complete EHR means EHR technology that has been developed to meet, at a minimum, all applicable certification criteria adopted by the HHS Secretary as defined in the EHR Technology Final Rule. Source: Federal Register /Vol. 75, No. 144, page 61

Q) 2. What are the standards and certification criteria for EHRs? 

A) 2.The following content exchange standards and associated implementation specifications have been adopted by HHS:

  • Patient summary record
  • Electronic prescribing
  • Electronic submission of lab results to public health agencies
  • Electronic submission to public health agencies for surveillance or reporting
  • Electronic submission to immunization registries
  • Quality reporting

The following certification criteria is required of complete EHRs or EHR Modules (Note – when When a certification criterion refers to two or more standards as alternatives, use of at least one of the alternative standards will be considered compliant. Complete EHRs and EHR Modules are not required to be compliant with certification criteria that are designated as optional.):

  • Computerized physician order entry (CPOE)
  • E-Prescribing (eRx)
  • Report ambulatory clinical quality measures to CMS/States
  • Implement one clinical decision support rule
  • Provide patients with an electronic copy of their health information, upon request
  • Provide clinical summaries for patients for each office visit
  • Drug-drug and drug-allergy interaction checks
  • Record demographics
  • Maintain an up-to-date problem list of current and active diagnoses
  • Maintain active medication list
  • Maintain active medication allergy list
  • Record and chart changes in vital signs
  • Record smoking status for patients 13 years or older
  • Capability to exchange key clinical information among providers of care and patient-authorized entities electronically
  • Protect electronic health information
  • Drug-formulary checks
  • Incorporate clinical lab test results as structured data
  • Generate lists of patients by specific conditions
  • Send reminders to patients per patient preference for preventive/follow up care
  • Provide patients with timely electronic access to their health information
  • Use certified EHR technology to identify patient-specific education resources and provide to patient, if appropriate
  • Medication reconciliation
  • Summary of care record for each transition of care/referrals
  • Capability to submit electronic data to immunization registries/systems
  • Capability to provide electronic syndromic surveillance data to public health agencies
    Source: www.cms.gov

Q) 3. What EHRs are currently certified?

A) 3. For a list of EHR Technology that has been expected by the Certification Commission for Health Information Technology (CCHIT), an Office of the National Coordinator – Authorized Testing and Certification Body (ONC-ATCB), in accordance with the applicable certification criteria adopted by the Secretary of Health and Human Services, CLICK HERE.

Q) 4. What is the definition of meaningful use? 

A) 4. The Recovery Act specifies the following 3 components of Meaningful Use:

1. Use of certified EHR in a meaningful manner (e.g., e-prescribing)
2. Use of certified EHR technology for electronic exchangeof health information to improve quality of health care
3. Use of certified EHR technology to submit clinical quality measures(CQM) and other such measures selected by the HHS Secretary Source: www.cms.gov

Q) 5. Why was meaningful use defined and what are policy goals behind it?

A) 5. The definition of meaningful use harmonizes criteria across CMS programs as much as possible and coordinate with existing CMS quality initiatives. It also closely links to the certification standards criteria in development by the Office of the National Coordinator (ONC) and provides a platform for a staged implementation over time. The definition informs everything that ONC and CMS do related to health IT, including product verification, funding, and technical support.  Source: www.cms.gov and www.thenationalcouncil.org

EHR INCENTIVE PROGRAMS AND PARTICIPATION
Q) 1. What are the CMS Incentive Programs for the Meaningful Use of EHR Technology?

A) 1. The Medicare and Medicaid EHR incentive programs will provide incentive payments to eligible professionals and eligible hospitals as they  adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology.  The programs begin in 2011. These incentive programs are designed to support providers in this period of Health IT transition and instill the use of EHRs in meaningful ways to help our nation to improve the quality, safety and efficiency of patient health care. Source: www.cms.org

?Q) 2. What are the different stages of Meaningful Use?

A) 2.   Stage 1 (2011 and 2012)

  • To meet certain objectives/measures, 80% of patients must have records in the certified EHR technology
  • EPs have to report on 20 of 25 MU objectives
  • Eligible hospitals have to report on 19 of 24 MU objectives
  • Reporting Period –90 days for first year; one year subsequently

Stage 2 (2013 and 2014)

  • Intend to propose 2 additional Stages through future rulemaking. Future Stages will expand upon Stage 1 criteria.
  • Will have greater focus on improved outcomes.
  • Stage 1 menu set will be transitioned into core set for Stage 2
  • Will reevaluate measures –possibly higher thresholds
  • Will include greater emphasis on health information exchange across institutional boundaries

Stage 3 (starting 2015)

  • Will focus on achieving improvements in quality, safety and efficiency, focusing on decision support for national high priority conditions, patient access to self management tools, access to comprehensive patient data, and improving population health outcomes.

Q) 3. Who is eligible to participate in one of the CMS Incentive Programs?

A) 3. Eligible Providers in Medicare FFS
Eligible Professionals (EPs):

  • Doctor of Medicine or Osteopathy
  • Doctor of Dental Surgery or Dental Medicine
  • Doctor of Podiatric Medicine
  • Doctor of Optometry
  • Chiropractor

Eligible Hospitals:

  • AcuteCare Hospitals*
  • CriticalAccess Hospitals (CAHs)

Medicare Advantage Eligible Providers
Eligible Professionals (EPs)
:

  • Must furnish,on average, at least 20 hours/week of patient-care services and be employed by the qualifying MA organization, OR
  • Must be employed by, or be a partner of, an entity that through contract with the qualifying MA organization furnishes at least 80 percent of the entity’s Medicare patient care services to enrollees of the qualifying MA organization

MA-Affiliated Eligible Hospitals:

  • Will be paid under the Medicare Fee-for-service EHR incentive program

Eligible Providers in Medicaid
Eligible Professionals (EPs):

  • Physicians
  • Nurse Practitioners (NPs)
  • Certified Nurse-Midwives (CNMs)
  • Dentists
  • Physician Assistants (PAs) working in a Federally Qualified Health Center (FQHC) or rural health clinic (RHC) that is so led by a PA

Eligible Hospitals:

  • Acute Care Hospitals (now includingCAHs)
  • Children’s Hospitals

    NOTE: Hospital-based EPs do not qualify for Medicare or Medicaid EHR incentive payments.

The Continuing Extension Act of 2010 modified the definition of a hospital-based EP as performing substantially all of their services in an inpatient hospital setting or emergency room. The rule has been updated to reflect this change.

A hospital-based EP furnishes 90% or more of their services in either the inpatient or emergency department of a hospital. Source: www.cms.gov

Q) 4. What about mental health?!? 

A) 4. Beyond those individuals that fall into one of the eligibility categories specified in the previous question, the incentive payments established under ARRA do not include many behavioral health providers and facilites as eligible entities for receiving payments.  The National Council for Community Behavioral Healthcare has worked to secure the introduction of legislation which would extend incentive payments to specified behavioral and mental health professionals, psychiatric hospitals, behavioral and mental health treatment facilities, and substance abuse treatment facilities.  Click the links below to learn more about the proposed legislation. Source:  www.thenationalcouncil.org

Q) 4.5 What should my organization be doing to take advantage of these opportunties?

A) 4.5.

  • Talk to the prospective eligible providers within your organization to determine which program is best suited for the individual to apply for (cannot participate in both Medicaid and Medicare EHR Incentive Programs, must select one).  Ensure they meet the eligibility requirements and discuss reassigning incentive payments to the employing organization.  Information on registration for EHR incentive programs will be available toward the end of 2010 on our website at http://www.cms.gov/EHRIncentivePrograms. Registration for the Medicare EHR Incentive Program will begin in January 2011 and will be available online. Registration for the Medicaid EHR Incentive Program may also begin in January 2011, but the timing will vary by State.  Organizations need to be aware of the reporting requirements and communicate with their EHR technology provider to make sure they are prepared to meet program requirements.
  • Contact your congressional delegation members to secure their support for H.R. 5040 and S. 3709 to expand the EHR Incentive Programs to include mental health professionals and Community Mental Health Centers/Clinics.  Click here for more information.
  • Talk to your current or prospective EHR technology provider.  It will be crucial that the EHR technology your organization utilizes be certified and that the appropriate objectives, measures and timelines are being met to satisfy the new meaningful use criteria.
  • Attend teleconferences and presentations offered through the CMS Incentive Program Educational Series.
  • Check this site for updates!  Also, visit the CMS Incentive Program page and the HIT Blog provided by the Office of the National Coordinator.

Q) 5. What is the methodology for demonstrating adoption, implementation, or upgrade of certified EHR technology to qualify for incentive payments?

A) 5. For Medicaid Incentive Program Only (Medicare Program will provide incentive payments to EPs, eligible hospitals, and critical access hospitals that are meaningful users of certified EHRs):

-First participation year only for Medicaid providers

-Adopted –Acquired and Installed (Ex: Evidence of installation prior to incentive)

-Implemented –Commenced Utilization of (Ex: Staff training, data entry of patient demographic information into EHR)

-Upgraded –Expanded (Upgraded to certified EHR technology or added new functionality to meet the definition of certified EHR technology)

-Must use certified EHR technology

-No EHR reporting period

?Q) 6. How much is the incentive payment to adopt, upgrade, or meaningfully use certified EHR technology?

A) 6. Medicare Incentive Payments for EPs

Health Professional Shortage Area (HPSA)* Bonus Payments for Medicare EHR Incentive Payments (available to EPs)

*Health Professional Shortage Area is defined as The amount of the annual Medicare EHR incentive payment limit for each payment year will be increased by 10 percent for EPs who predominantly furnish more than 50 percent of services in an area that is designated by the Secretary (under section 332(a)(1)(A) of the PHS Act) as a geographic health professional shortage area (HPSA). CMS will use the frequency of services provided over a one-year period from January 1 to December 31 rather than allowed charges to determine if an EP qualifies for an HPSA bonus.

Click here
to learn more about HPSAs and to search for HPSAs by state and care provider type.

Medicaid Incentive Payments for EPs

Incentive Payments for Eligible Hospitals

  • Federal Fiscal Year
  • $2M base + per discharge amount (based on Medicare/Medicaid share)
  • There is no maximum incentive amount
  • Hospitals meeting Medicare MU requirements may be deemed eligible for Medicaid payments
  • Payment adjustments for Medicare begin in 2015
  • No Federal Medicaid payment adjustments
  • Medicare hospitals: No payments after 2016
  • Medicaid hospitals: Cannot initiate payments after 2016
    Source: www.cms.gov

Q) 7. Are there penalties (reimbursement rate adjustments) for organizations serving Medicaid/Medicare clients if they do not demonstrate meaningful use of certified electronic health record technology?  If so, how much and when is the earliest date the penalties can be incurred? 

A) 7. Medicare payment adjustments will begin in 2015 for EPs and eligible hospitals that do not demonstrate meaningful use of certified EHR technology. The Medicare fee schedule for providers who are not meaningful users of certified electronic health record technology will be reduced by 1 percent in 2015, by 2 percent in 2016 and by 3 percent in 2017.

There are no payment adjustments associated with the Medicaid provisions under Section 4201 of the American Recovery and Reinvestment Act of 2009. Source: www.cms.gov

Q) 8. How will providers report to CMS? How will providers demonstrate meaningful use of EHR technology?

A) 8.  For 2011, CMS will accept provider attestations for demonstration of all the meaningful use measures. Participants will be asked to provide aggregate data for numerators, denominators and exclusions, and to attest that these numbers have been arrived at using certified EHR technology. In 2012, CMS will continue accepting attestation for most of the meaningful use objectives but plans to require electronic submission of the clinical quality measures and to develop audit systems to protect against fraud. States will also support attestation initially and then move to electronic submission of clinical quality measures for Medicaid providers’ demonstration of meaningful use. Source: www.aafp.org

For Stage 1, which begins in 2011, there are 25 meaningful use objectives/measures for Eligible Professionals and 24 clinical quality measures for eligible hospitals.  These objectives/measures have been divided into a core set and a menu set.

EPs and eligible hospitals must meet all measures in the core set (15 for EPs and 14 for eligible hospitals).  They can choose to defer up to five remaining measures from the menu set (out of 10).  Where it is impossible for an EP or eligible hospital to meet a specific measure, an exclusion is defined in the final rule.  If an exclusion applies to an EP or eligible hospital, then such professional or does not have to meet that measure in order to be determined a meaningful EHR user.  For example, if an EP has two exceptions (one for core and one for menu), the EP would need to meet the remaining 14 core measures and four of the remaining 9 menu set measures.

EPs – Core Set:

  1. Computerized physician order entry (CPOE)
  2. E-Prescribing (eRx)
  3. Report ambulatory clinical quality measures to CMS/States
  4. Implement one clinical decision support rule
  5. Provide patients with an electronic copy of their health information, upon request
  6. Provide clinical summaries for patients for each office visit
  7. Drug-drug and drug-allergy interaction checks
  8. Record demographics
  9. Maintain an up-to-date problem list of current and active diagnoses
  10. Maintain active medication list
  11. Maintain active medication allergy list
  12. Record and chart changes in vital signs
  13. Record smoking status for patients 13 years or older
  14. Capability to exchange key clinical information among providers of care and patient-authorized entities electronically
  15. Protect electronic health information

EPs – Menu Set

  1. Drug-formulary checks
  2. Incorporate clinical lab test results as structured data
  3. Generate lists of patients by specific conditions
  4. Send reminders to patients per patient preference for preventive/follow up care
  5. Provide patients with timely electronic access to their health information
  6. Use certified EHR technology to identify patient-specific education resources and provide to patient, if appropriate
  7. Medication reconciliation
  8. Summary of care record for each transition of care/referrals
  9. Capability to submit electronic data to immunization registries/systems*
  10. Capability to provide electronic syndromic surveillance data to public health agencies*

Eligible Hospitals – Core Set

  1. CPOE
  2. Drug-drug and drug-allergy interaction checks
  3. Record demographics
  4. Implement one clinical decision support rule
  5. Maintain up-to-date problem list of current and active diagnoses
  6. Maintain active medication list
  7. Maintain active medication allergy list
  8. Record and chart changes in vital signs
  9. Record smoking status for patients 13 years or older
  10. Report hospital clinical quality measures to CMS or States
  11. Provide patients with an electronic copy of their health information, upon request
  12. Provide patients with an electronic copy of their discharge instructions at time of discharge, upon request
  13. Capability to exchange key clinical information among providers of care and patient-authorized entities electronically
  14. Protect electronic health information

Eligible Hospitals – Menu Set

  1. Drug-formulary checks
  2. Record advanced directives for patients 65 years or older
  3. Incorporate clinical lab test results as structured data
  4. Generate lists of patients by specific conditions
  5. Use certified EHR technology to identify patient-specific education resources and provide to patient, if appropriate
  6. Medication reconciliation
  7. Summary of care record for each transition of care/referrals
  8. Capability to submit electronic data to immunization registries/systems*
  9. Capability to provide electronic submission of reportable lab results to public health agencies*
  10. Capability to provide electronic syndromic surveillance data to public health agencies*

*At least one public health objective must be selected

For Stage 2, clinical quality measurements will be expanded in the areas of disease management, clinical decision support, medication management support for patient access to their health information, transitions in care, quality measurement and research, and bi-directional communication with public health agencies.

Stage 3 would focus on achieving improvements in quality, safety and efficiency, focusing on decision support for national high priority conditions, patient access to self management tools, access to comprehensive patient data, and improving population health outcomes.

To see a list of all Clinical Quality Measurements, see the CMS Incentive Program Training PowerPoint

Source:  CMS Office of Public Affairs at www.cms.gov

Q) 9. What do the numerators and denominators mean in measures that are required to demonstrate meaningful use for the EHR Incentive Programs?

A) 9. There are 16 measures for EPs and 14 measures for eligible hospitals that require the collection of data to calculate a percentage, which will be the basis for determining if the Meaningful Use objective was met according to a minimum threshold for that objective.

Objectives requiring a numerator and denominator to generate this calculation are divided into two groups: one where the denominator is based on patients seen or admitted during the EHR reporting period, regardless of whether their records are maintained using certified EHR technology; and a second group where the objective is not relevant to all patients either due to limitations (e.g., recording tobacco use for all patients 13 and older) or because the action related to the objective is not relevant (e.g., transmitting prescriptions electronically). For these objectives, the denominator is based on actions related to patients whose records are maintained using certified EHR technology. This grouping is designed to reduce the burden on providers. Table 3 in the Medicare and Medicaid EHR Incentive programs final rule (FR 75 44376 – 44380) lists measures sorted by the method of measure calculation.

Q) 10. My organization does not typically collect information on any of the core, alternate core, and additional clinical quality measures (CQM) listed in the Final Rule on the Medicare and Medicaid EHR Incentive Programs.  Do I need to report on CQM for which I do not have any data? 

A) 10. EPs are not excluded from reporting clinical quality measures, but zero is an acceptable value for the CQM denominator. If there were no patients who met the denominator population for a CQM, then the EP would report a zero for the denominator and a zero for the numerator. For the core measures, if the EP reports a zero for the core measure denominator, then the EP must report results for up to three alternate core measures (potentially reporting on all 6 core/alternate core measures). For the menu-set measures, we expect the EP to report on measures which do not have a denominator of zero. If none of the measures in the menu set applies to the EP, then the EP must report on three of such measures, reporting a denominator of zero, and then attest that the remainder of the menu-set measures have a value of zero in the denominator. As we stated in the final rule (75 FR 44409-10): “The expectation is that the EHR will automatically report on each core clinical quality measure, and when one or more of the core measures has a denominator of zero then the alternate core measure(s) will be reported. If all six of the clinical quality measures in Table 7 have zeros for the denominators (this would imply that the EPs patient population is not addressed by these measures), then the EP is still required to report on three additional clinical measures of their choosing from Table 6 in this final rule. In regard to the three additional clinical quality measures, if the EP reports zero values, then for the remaining clinical quality measures in Table 6 (other than the core and alternate core measures) the EP will have to attest that all of the other clinical quality measures calculated by the certified EHR technology have a value of zero in the denominator, if the EP is to be exempt from reporting any of the additional clinical quality measures (other than the core and alternate core measures) in Table 6.”

?Q) 11.  What role will the states play in these programs? 

A) 11. States may voluntarily offer the Medicaid EHR Incentive Program to their Medicaid eligible professionals. Colorado is one of six states receiving federal matching funds for state planning activities necessary to implement the program. The HITECH Act provides 100 percent Federal financial participation (FFP to States for incentive payments to eligible Medicaid providers to adopt, implement, upgrade, and meaningfully use certified EHR technology, and 90 percent FFP for State administrative expenses related to the programming.

In order to qualify for the 90 percent FFP administrative match, a State must, at a minimum, demonstrate to the satisfaction of the HHS Secretary compliance with three components:

1 – Administration of Medicaid incentive payments to Medicaid EPs and eligible hospitals;
2- Oversight of the Medicaid EHR Incentive Program, including routine tracking of meaningful use attestations and reporting mechanisms; and,
3- Pursuit of initiatives that encourage the adoption of certified EHR technology for the promotion of health care quality and the electronic exchange of health information.

To learn more about these requirements, read letter to State Medicaid Directors issued by CMS

For a full list of state requirements listed on the CMS website, click here.

Additionally, States can seek CMS prior approval to require 4 Meaningful Use menu set objectives be added to the core set objectives for their state’s Medicaid providers:  States have the option to requ any or all of the following:

  • Functionality to generate lists of patients by specific conditions
  • Capability to submit electronic data to immunization registries/systems
  • Capability to provide electronic syndromic surveillance data to public health agencies
  • Capability to provide electronic submission of reportable lab results to public health agencies (for hospitals only)

Q) 12. Where can I learn more?

A) 12. Click the below links to find information about these various topics:  

IMPORTANT TIMELINES & DEADLINES
Q) 1. Is there a timeline of milestones related to the Medicare and Medicaid Incentive Programs?

A) 1. Click Here to see a timeline of major milestones for the EHR Incentive Programs.

?Q) 2. What are the deadlines to initiate participation in the Medicare and Medicaid Incentive Programs? 

A) 2. The last year to initiate participation in the Medicare EHR Incentive Program is 2014.  However, it is important to note that participation must be initiated (achieve certification) by 2012 to receive the maximum incentive payment of $44,000.  Incentive payments are reduced in subsequent years.  For participation initiated in 2013, maximum possible incentive payment will be $39,000.  For participation initiated in 2014, maximum possible incentive payment will be $24,000.

The last year to initiate participation in the Medicaid EHR Incentive program is 2016.

Q) 3. When will penalties (reimbursement rate adjustments) begin for organizations serving Medicaid/Medicare clients if they do not use certified electronic health record technology?

A) 3. Medicare payment adjustments will begin in 2015 for EPs and eligible hospitals that do not demonstrate meaningful use of certified EHR technology. The Medicare fee schedule for providers who are not meaningful users of certified electronic health record technology will be reduced by 1 percent in 2015, by 2 percent in 2016 and by 3 percent in 2017.

There are no payment adjustments associated with the Medicaid provisions under Section 4201 of the American Recovery and Reinvestment Act of 2009. Source: www.cms.gov

Q) 4. What is the reporting period for eligible professionals participating in the electronic health record (EHR) incentive programs?

A) 4. For demonstrating meaningful use through both the Medicare and Medicaid EHR Incentive Programs, the EHR reporting period for an EP’s first year is any continuous 90-day period within the calendar year. In subsequent years, the EHR reporting period for EPs is the entire calendar year. Under the Medicaid program, there is also an incentive for the adoption, implementation, or upgrade of certified EHR technology, which does not have a reporting period. Source: www.cms.gov

HEALTH INFORMATION TECHNOLOGY RESOURCES
Q) 1.
Where can I learn more about certified EHR technology, meaningful use, incentive programs, and other HITECH activities underway?

A) 1. Click the below links to find information about these various topics:  

Q) 2. Where can I find information about certified EHR technology options?

A) 2.  All EHR systems and technology must be certified specifically for this program. Currently, there are no certified EHR products that meet the certification requirements for this program in order to receive an incentive. Once a product is certified, the name of the product will be published on the ONC web site (http://healthit.hhs.gov). It is expected that the first EHRs will be certified and listed on the ONC web site in fall 2010.

Still have questions and need answers?!?  Let us know!!  CBHC’s website is a dynamic resource designed to help our members as best possible.  Your feedback and participation is crucial to ensuring this tool is informative and responsive to the needs of Colorado’s community mental health.  Contact Brian Turner, Public Policy Specialist, at bturner@cbhc.org

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