Medicare and Medicaid Programs

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1 Achievg Meangful Use Stage 2 Copyright Notice Copyright 2013 CureMD.com Inc., All rights reserved. This document is for formational purposes only and may conta typographical errors and technical accuracies. CureMD and its affiliates cannot be held responsible for errors or omissions typography or photography. CureMD and the CureMD logo are registered trademarks of CureMD.com, Inc Purpose of this Document This document is a white paper on how practices can benefit from cloud based services.

2 Achievg Meangful Use Introduction Key timeles Meangful Use Timele & CMS Reportg 2014 Requirements of Stage 2 Reportg Clical Quality Measures Attest for Stage 2 with CureMD Stage 2 FAQs 1

3 Introduction The Medicare and Medicaid Programs offer fancial centives for the meangful use of certified technology to improve patient care. To receive an centive payment, providers have to show that they are meangfully usg their s by meetg thresholds for a number of objectives. CMS has established the objectives for meangful use that eligible professionals, eligible hospitals, and critical access hospitals (CAHs) must meet order to receive an centive payment. The Medicare and Medicaid Programs are staged three steps with creasg requirements for participation. All providers beg participatg by meetg the Stage 1 requirements for a 90-day period their first year of meangful use and a full year their second year of meangful use. After meetg the Stage 1 requirements, providers will then have to meet Stage 2 requirements for two full years. Eligible professionals participate the program on the calendar years, while eligible hospitals and CAHs participate accordg to the federal fiscal year. Stage 3 Stage Data Capturg & Sharg Stage Advanced Clical Processes 2015 Improved Outcomes 2

4 Key Timeles of Stage 2 CMS Nov 30, 2011 CDC Certified technology available & listed on ONC website JAN 2011 Registration for the Program Begs JAN 2011 For Medicade Providers, States may lauch their programs if they so choose May 2011 Payments beg Last day for eligible hospitals and CAHs to register and attest to receive an Payment for FY 2011 Feb 29, 2012 Last day for EPs to register and attest to receive and Payment for FY Medicare payment adjustments beg for EPs & eligible hospitals that are not meangful users to technology 2021 Last year to receive Medicaid Payment FALL WINTER SPRING FALL WINTER NOV/DEC RFI for additional public put 1-2Q11 Moniter Stage 1 submissions 2Q11 Draft recommendations to HIT Policy Committee late 2011 Fal recommendations to ONC 2014 Last year to itiate participation the Medicare Program 2016 Last year to receive a Medicare Payment Last year to itiate participation Medicaid Program New Criteria From 2014, providers participatg the Programs who have met Stage 1 for two or three years will need to meet Meangful Use Stage 2 criteria. Improvg Patient Care Stage 2 cludes new objectives to improve patient care through better clical decision support, care coordation and patient engagement. Savg Money, Time, Lives With this next stage, s will further save our healthcare system money, time for doctors and hospitals, and lives. 3

5 Meangful Use Timele & CMS Reportg 2014 CMS had previously established a timele the Stage 1 of the MU Program, requirg providers to ascend to the criteria for Stage 2 after two years of the program which meant that this timele required Medicare providers demonstratg Meangful Use 2011 to meet the 2013 criteria of Stage 2. CMS then had the criteria for Stage 2 delayed for a year, makg it effective the year For the year 2014, providers, regardless of their current Stage the Meangful Use timele, are required to demonstrate Meangful Use for three months that year. Medicare Providers: The 3 month reportg period has been fixed to the fiscal year for hospitals and critical access hospitals and the calendar year for eligible providers. Medicaid Providers: For those who are only eligible to receive the Medicaid s, the reportg period of 3 months is not fixed to any quarter and can be fulfilled at any time of the year with 3 consecutive months of MU demonstration. Requirements of Stage 2 Meangful use cludes both a core set and a menu set of objectives that are specific to eligible professionals or eligible hospitals and CAHs. For eligible professionals, there are a total of 24 meangful use objectives. To qualify for an centive payment, 19 of these 24 objectives must be met: 14 required core objectives 5 objectives chosen from a list of 10 menu set objectives For eligible hospitals and CAHs, there are a total of 23 meangful use objectives. To qualify for an centive payment, 18 of these 23 objectives must be met: 13 required core objectives 5 objectives chosen from a list of 10 menu set objectives 4

6 CMS provides Meangful Use Specification Sheets that brg together critical formation on each objective to help you understand what you need to do to meet the program requirements. Each specification sheet covers a sgle eligible professional core or menu set objective detail, cludg formation on: Meetg the measure for each objective How to calculate the numerator and denomator for each objective How to qualify for an exclusion to an objective In-depth defitions of terms that clarify objective requirements Requirements for attestg to each measure Stage Core Measures 6 Menu Measures (at least 3) 90 Days Reportg Period $8000- (MCR) Stage Core Measures 10 Menu Measures (at least 5) 90 Days Reportg Period Depends on the year of participation Reportg Clical Quality Measures Clical quality measures, or CQMs, are tools that help measure and track the quality of health care services provided by eligible professionals, eligible hospitals and critical access hospitals (CAHs) with our health care system. These measures use data associated with providers ability to deliver high-quality care or relate to long term goals for quality health care. CQMs measure many aspects of patient care cludg: Health outcomes Clical processes Patient safety Efficient use of health care resources Care coordation 5

7 Patient engagements Population and public health Adherence to clical guideles Measurg and reportg CQMs helps to ensure that our health care system is deliverg effective, safe, efficient, patient-centered, equitable, and timely care. To participate the Medicare and Medicaid Electronic Health Record () Programs and receive an centive payment, providers are required to submit CQM data from certified technology. Begng 2014, all providers must use technology that has been certified to the 2014 standards and capabilities that contas new CQM criteria. Providers will report usg the 2014 criteria regardless of whether they are Stage 1 or Stage 2 of meangful use. Please visit the 2014 Clical Quality Measure Page to learn more about 2014 CQMs and 2014 reportg options. To access the Program 2014 CQM electronic specifications please visit the ecqm Library page. To learn more about electronic reportg please visit the Electronic Reportg Specification page of the Program. 6

8 Attest for Stage 2 with CureMD MU Registration A session which CureMD will walk you through the registration process. Initial Assessment & Recommended Plan We will assess your current process flow, and determe the fastest path to achievg Meangful Use. MU Trag Trag Session on MU Compliance and Progress Trackg. Monitor Progress Towards MU Compliance A monthly session where your progress towards Meangful Use will be reviewed. MU Attestation A session which CureMD will walk you through the Meangful Use attestation process. 7

9 8

10 Stage 2 FAQs How will the Physician Payment be calculated under Medicare? The Medicare payments will be calculated by multiplyg the submitted allowable charges to Medicare by 75%, up to the capped amount for the year. So a physician aimg to collect the full centive payment of $18, will need to submit allowable charges of at least $24,000. Conversely, a physician submittg only $16,000 allowables would collect $12, , even though the cap is higher. Do providers register only once for the Medicare and Medicaid Electronic Health Record () Programs, or must they register every year? Providers are only required to register once for the Medicare and Medicaid Programs. However, they must successfully demonstrate that they have either adopted, implemented or upgraded (first participation year for Medicaid) or meangfully used certified technology each year order to receive an centive payment for that year. Additionally, providers seekg the Medicaid centive must annually re-attest to other program requirements, such as meetg the required patient volume thresholds. Providers will register usg the Medicare and Medicaid Program Registration & Attestation System, a web-based system. Providers who have elected to participate the Medicare Program will also use this system to attest to their program eligibility and meangful use. Providers who select the Medicaid Program will demonstrate their eligibility and attest via their State Medicaid Agency's system. If any basic registration formation changes, the provider will need to update their formation the Medicare and Medicaid Program Registration & Attestation System. When can I register and where do I register for the Medicare and Medicaid Electronic Health Record () Programs? 9

11 Registration for the Medicare Program began on January 3, 2011 and is available for eligible professionals (EPs), eligible hospitals and critical access hospitals (CAHs) onle at CMS. Please note that although the Medicaid Programs will beg January 3, 2011, not all states will be ready to participate on this date. Information on when registration will be available for Medicaid Programs specific States is posted at CMS Program. Can eligible professionals (EPs) receive electronic health record () centive payments from both the Medicare and Medicaid programs? Not for the same year. If an EP meets the requirements of both programs, they must choose to receive an centive payment under either the Medicare program or the Medicaid program. After a payment has been made, the EP may only switch programs once before How much are the Medicare and Medicaid Electronic Health Record () centive payments to eligible professionals (EPs)? Under the Medicare Program, EPs who demonstrate meangful use of certified technology can receive up to a total of $44,000 over 5 consecutive years. Additional centives are available for Medicare EPs who practice a Health Provider Shortage Area (HPSA) and meet the maximum allowed charge threshold. Under the Medicaid Program, EPs can receive up to a total $63,750 over the 6 years that they choose to participate program. EPs may switch once between programs after a payment has been made and only before Are there any special centives for rural providers the Medicare and Medicare Electronic Health Record () Programs? 10

12 We note that nothg the Act excludes such payments from taxation or as tax-free come. Therefore, it is our belief that centive payments would be treated like any other come. Providers should consult with a tax advisor or the Internal Revenue Service regardg how to properly report this come on their filgs. In order to receive payments under the Medicare and Medicaid Electronic Health Record () Programs, does a provider have to be enrolled the Provider Enrollment, Cha, and Ownership System (PECOS)? In order to receive Medicare centive payments, EPs, eligible hospitals, and critical access hospitals must have an enrollment record PECOS. Medicaid EPs do not have to be PECOS. There are three ways to verify that you have an enrollment record PECOS: Check the Orderg Referrg Report on the CMS website. If you are on that report, you have a current enrollment record PECOS. Go to CMS Provider, click on "Orderg Referrg Report" on the left. Use Internet-based PECOS to look for your PECOS enrollment record. If no record is displayed, you do not have an enrollment record PECOS. Go to CMS Provider, click on "Internet-based PECOS" on the left. Contact your designated Medicare enrollment contractor and ask if you have an enrollment record PECOS. Go to CMS Provider, click on "Medicare Fee-For-Service Contact Information" under "Downloads." If you are not PECOS, the best way to submit your application is through ternet-based PECOS. This formation is accurate, to the best of our knowledge. As more formation becomes available from HHS and other agencies, this page will be updated accordgly. Please check the CMS website. 11

13 About CureMD CureMD is an award wng provider of SMART Cloud, Practice Management, Patient Portal and Medical Billg service, designed to optimize outcomes, quality and fancial returns. With thousands of satisfied customers across the nation, CureMD has mataed a 99% customer retention rate sce In a recent KLAS Research publication "SaaS EMR, Is it for you ", CureMD was ranked number 1 SaaS EMR for its web-based, easy to use, quick go-live solution that delivers the highest ROI. For more formation: Please visit us at or call +1 (866)

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