5/11/2015 AGENDA ROUNDTABLE PARTICIPANTS TALES FROM THE FRONTLINES OF MEANINGFUL USE: FOCUS ON OPTOMETRY

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1 TALES FROM THE FRONTLINES OF MEANINGFUL USE: FOCUS ON OPTOMETRY Best Practices, Lessons Learned and the Road Ahead June 25, 2015 The CMS EHR Meaningful Use program brings special challenges to the field of Optometry. Join us for a deep dive into the real life experiences of providers who have successfully achieved and attested to Meaningful Use. AGENDA April Jasper, OD Mary Ann Murphy, OD Jim Tate, Founder EMR Advocate, Inc. ROUNDTABLE PARTICIPANTS 1

2 CMS EHR Incentive Program Certified EHRs Achieving Meaningful Use Stage 2 Challenges Proposed Changes to MU: Documenting Meaningful Use Attestation Audits - Appeals Proposed Stage 3 Rules MU: Beyond the Incentives TOPICS Why an EHR in Optometry? What makes a good EHR? Is it possible for an optometrist to achieve MU? What happens if you don t participate? Challenges and solutions to Stage 2 MU. What is proposed for ? What about Stage 3? What is beyond MU? QUESTIONS History of the program The need for EHR incentives Medicare vs. Medicaid EHR incentive programs Primary care vs. Specialists CMS EHR INCENTIVE PROGRAM 2

3 The Stages of MU Carrots and Sticks CMS EHR INCENTIVE PROGRAM Where are we headed? The risk of the Leading Edge. CMS EHR INCENTIVE PROGRAM General vs. Specialty EHRs Peer recommendations Editions: 2011, 2014, 2015, 20XX? CERTIFIED EHR 3

4 What to expect from your EHR vendor? Cloud based? MU resource? Current certifications? CERTIFIED EHR Make it part of workflow Advantages of the portal Take full advantage of exclusions ACHIEVING MEANINGFUL USE Security Risk Assessment What is it? Who should do it? What does it cost? ACHIEVING MEANINGFUL USE 4

5 Resources Vendors Associations Regional Extension Centers ACHIEVING MEANINGFUL USE Core Measures not excludible View, Download, Transmit (portal) Secure Messages CURRENT STAGE 2 CHALLENGES Applies to Medicare and Medicaid 90 Days of MU Patient Engagement View, Download, Transmit Secure Messaging PROPOSED MU MODIFICATIONS: 2015/2017 5

6 Timeline Changes 2015: Attest to modified version of Stage 2 (accommodations for Stage 1 EPs 2016: Attest to modified version of Stage : Attest to either modified version of Stage 2 or full version of Stage : Attest to full version of Stage 3 PROPOSED MU MODIFICATIONS: 2015/2017 Can staff document in the EHR? CPOE? CMS states that Any licensed healthcare professionals and credentialed medical assistants, can enter orders into the medical record for purposes of including the order in the numerator for the objective of CPOE if they can originate the order per state, local and professional guidelines. Credentialing for a medical assistant must come from an organization other than the organization employing the medical assistant. CMS FAQ states that the credentialed medical assistant requirement of the CMS rule applies to entry of orders under Stage 1 and Stage 2 of the EHR Incentive Programs, and will apply to Stage 3 when it goes into effect. The denominators/numerators generated by the CEHRT is what is required for attestation. Run reports on a regular basis to stay on track DOCUMENTING MEANINGFUL USE Common mistakes Patient Lists Security Risk Assessment Menu Selections Other DOCUMENTING MEANINGFUL USE 6

7 Book of Evidence documents every attestation Percentage based measures Non-percentage based measures Document assumptions and exclusions. DOCUMENTING MEANINGFUL USE Based on telling the truth Data behind every attestation is unknown except by audit Print out attestation submission Develop a strategy Someone must know the rules Exclusions ATTESTATION Sample Stage attestation for Optometry Post Final Rule Any consecutive 90 days Patient Portal only one patient Secure Messaging enabled SRA Statement for out of scope exclusions ATTESTATION 7

8 5-10% will be audited Failure rate 20%+ for EPs What triggers an audit? The audit process: Medicare vs. Medicaid AUDITS OIG Oversight on both Medicare and Medicaid CMS Figliozzi and Company Audits based on individual attestation All or nothing AUDITS The appeal process Alice in Wonderland Less communication than at the audit level Black Box Inconsistent decisions APPEALS 8

9 Stage 3 is expected to be the final Stage 2017: optional year for Stage : full calendar year reporting 2018: all providers must be at Stage 3 for entire year PROPOSED STAGE 3 RULES CEHRT leveraged for other purposes Physician Self Referral Law exception and Anti kickback Statute safe harbor for certain EHR donations CMS chronic care management services MIPS MU: BEYOND THE INCENTIVES Contact: April Jasper, OD, Mary Ann Murphy, OD Jim Tate, Founder EMR Advocate, Inc. Q/A 9

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