How To Test For Meaningful Use In Minnesota

Transcription

1 MN EHR Incentive Program (MEIP) Update Meaningful Use Attestation in Minnesota: Qualifying, Registering, Attesting, and Preparing for Audits June 2014

2 Objectives 1. Highlight participation benefits in the Medicaid EHR Incentive Program (MEIP) 2. Present program participation levels 3. Review common attestation challenges 4. Anticipate issues on the horizon 5. Prepare for MEIP post payment audits Minnesota EHR Incentive Program MEIP 2

3 MEIP Attestation Benefits for Eligible Professionals (EPs) A. Higher incentives than under Medicare program B. Medicare excludes Mid-level Providers while Medicaid includes Nurse Practitioners, Nurse Midwives and Optometrists C. For Year one, EPs can attest to: Adopt/Implement/Upgrade (AIU) or Meaningful Use (MU) Stage 1 Minnesota EHR Incentive Program MEIP 3

4 EP Incentive Comparison #1 Year Medicare Attestation Medicaid Attestation CY ,000 - CY ,000 - CY ,000 - Option Path 1: No Change Path 2: Switch CY ,000 8,500 CY ,000 8,500 CY ,250 Total Incentive $ 44,000 $ 63,750 Minnesota EHR Incentive Program MEIP 4

5 EP Incentive Comparison #2 Year Medicare Attestation Medicaid Attestation CY ,000 21,250 CY ,000 8,500 CY ,000 8,500 CY ,500 CY ,500 CY ,500 Total Incentive $ 24,000 $ 63,750 Minnesota EHR Incentive Program MEIP 5

6 EP Advanced Practitioners Practitioner Type Paid for AIU in 2013 Paid for MU Stage 1 in 2013 Nurse Practitioners Nurse Midwives 64 0 Total Minnesota EHR Incentive Program MEIP 6

7 MEIP Attestation Benefits for Eligible Hospitals (EHs) A. Payment formula is weighted heavily on the Medicaid % of inpatient days Tip: A small EH can have a large Medicaid EHR incentive payment B. Medicaid portal receives dually eligible hospital registration and payment status from CMS daily Minnesota EHR Incentive Program MEIP 7

8 MEIP EP 2013 Participation EP Payment Year Count Incentive Payments AIU 1,203 $ 25,237,932 Meaningful Use Stage $ 1,430,835 Total 1,373 $ 26,668,767 Minnesota EHR Incentive Program MEIP 8

9 MEIP EH 2013 Participation EH Payment Year Count Incentive Payments AIU 7 $ 5,216, Meaningful Use Stage 1 59 $ 30,516, Total 66 $ 35,732, Minnesota EHR Incentive Program MEIP 9

10 Attestation Challenge 1 (For EPs) When attesting to Medicaid Patient Volume (MPV) review EP eligibility criteria A. Encounter percentage is not simply % of Patients B. EP volume reporting options: Individual or Group C. Numerator and Denominator definitions D. Unique rules for FQHC/RHC/IHSs & Pediatricians E. Validate MPV each payment year Tip: Report, Test, Validate, Repeat Minnesota EHR Incentive Program MEIP 10

11 Attestation Challenge 2 (For EPs & EHs) Meeting Meaningful Use (MU) Measures A. MU Measures are the same for both Medicare and Medicaid incentive B. Medicaid program includes 1st year AIU C. Most difficult measures to meet D. EHR Optimization Barriers Minnesota EHR Incentive Program MEIP 11

12 Attestation Challenge 3 (For EHs) EH Payment Formula Calculation A. Out of state Medicaid B. Internal database issues with managed care & traditional Fee for Service claims C. New hospitals, Changes in ownership Minnesota EHR Incentive Program MEIP 12

13 Issues On The Horizon 1. Transition to 2014 certified EHR systems 2. Stage 2 Meaningful Use 3. MEIP / CMS Deadlines for EP & EH 4. CMS Payment Reductions Includes National Provider Call Audio and PDF Minnesota EHR Incentive Program MEIP 13

14 CMS Post Payment Audits Completed by contracted auditor CMS EHR Audits Overview EHR Supporting Documentation Overview EP Meaningful Use Audits Common findings Reasons for recoupment OR adjustment EH Meaningful Use Audits Reasons for recoupment OR adjustment Minnesota EHR Incentive Program MEIP 14

15 Medicaid Post Payment Audits DHS internal staff for EP Audits Validate eligibility & meaningful use DHS internal staff for EH Audits Validate only non-dual eligible hospital AIU attestation year (CMS handles all others) DHS follows the guidance posted by CMS regarding post payment audits and supporting documentation Minnesota EHR Incentive Program MEIP 15

16 Medicaid Post Payment Audits continued DHS audit selection Legislation requires targeted and random audits Risk-based audit criteria DHS audit process Portal contact notified of audit by letter and Requests for additional documentation can be case specific Provider has the opportunity to review draft findings before the final report is issued Minnesota EHR Incentive Program MEIP 16

17 Meaningful Use Pyramid Minnesota EHR Incentive Program 17

18 Contacts Questions Business Services Help Desk Phone: MEIP Staff Dean Ewald, MEIP Team Lead LaDonna Morrison, MEIP Eligibility Auditor Minnesota EHR Incentive Program (MEIP) Home Page Minnesota EHR Incentive Program MEIP 18