Medicaid EHR Incentive Program Eligible Hospitals Payment Years 1 and 2

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1 Medicaid EHR Incentive Prgram Eligible Hspitals Payment Years 1 and 2 New Hampshire Department f Health and Human Services Office f Medicaid Business and Plicy

2 NH Medicaid EHR Team Andrew Chalsma (Chief, Office f Medicaid Business and Plicy, New Hampshire Department f Health and Human Services) Eve Fralick (Prject Directr, UNH Institute fr Health Plicy and Practice) 2

3 Tpics EHR Incentive Prgram Gvernance Eligibility Criteria Supprting Dcumentatin Registratin and Attestatin Payment Schedule Resurces 3

4 EHR Incentive Prgram Gvernance Federal guidelines changed in 2012 Final Rules are regulatins that gvern the administratin f federal prgrams In 2012, the Final Rule was updated t revise sme prgram criteria This presentatin will utline all criteria (ld and new) needed t attest fr a Medicaid EHR Incentive Prgram payment in New Hampshire 4

5 ELIGIBILITY CRITERIA 5

6 THE FOLLOWING ELIGIBILITY REQUIREMENTS HAVE NOT CHANGED IN THE 2012 RULE UPDATE 6

7 Eligible Hspital Types NO CHANGE EH Type Hspital Criteria Patient Vlume General Acute Care Hspitals (including critical access hspitals) Average Length f Stay 25 days r less CMS Certificatin Number r Medicaid Patient Encunters: 10% A multi site hspital with ne CMS Certificatin Number is cnsidered ne hspital fr purpses f calculating the Medicaid EHR Incentive Prgram payment 7

8 Reprting Perid Medicaid Patient Vlume NO CHANGE Any cntinuus 90 days during the PRIOR hspital fiscal year Exact start and end dates required Calculated using Medicaid (numeratr) divided by all (denminatr) inpatient hspital discharges and Emergency Department discharges Patient Vlume Calculatin Medicaid Patient Encunters Ttal Patient Encunters X 100 8

9 Average Length f Stay NO CHANGE Reprting Perid: 12 mnth perid f the mst recently filed Medicare Cst Reprt Calculated using ttal (acute) inpatient bed days divided by ttal discharges = must be 25 days r less Includes bed days fr Nenatal Intensive Care Unit (NICU) Excludes nn acute bed days fr Nursery, Observatin, Labr, and Delivery Average Length f Stay Calculatin Ttal Inpatient Bed Days Ttal Discharges 9

10 Dually Eligible Hspital Requirements NO CHANGE Definitin: hspitals that are Meaningful Users under the Medicare EHR Incentive Prgram are deemed t be dually eligible, i.e., Meaningful Users fr the Medicaid EHR Incentive Prgram as well Dually eligible EHs attest t Meaningful Use criteria n the CMS website; CMS audits the attestatins t determine cmpliance Dually eligible EHs must als attest t eligibility criteria in New Hampshire n epip (Electrnic Prvider Incentive Payment System) fr each year that payment is requested; New Hampshire Medicaid audits these attestatins: Patient Vlume Average Length f Stay EHR technlgy certificatin Payment cmpnents (Payment Year 1 nly) 10

11 THIS ELIGIBILITY REQUIREMENT HAS CHANGED IN THE 2012 RULE UPDATE: NEW Medicaid encunter definitin 11

12 Medicaid Encunter Definitin ** CHANGE ** BEGINNING 2012 IN RULE 2013 CHANGES AND FUTURE NOTED PAYMENT IN RED YEARS All services prvided in a day by a specific prvider t a MEDICAID ENROLLED INDIVIDUAL. This includes: Services in which Medicaid (including the prgram frmerly knwn as Healthy Kids Gld and ut f state Medicaid and Medicaid managed care prgrams) paid fr part r all f the services (including premiums, c payments, and/r cst sharing); r Encunters in which Medicaid paid zer dllars where Medicare (in the case f patients that are dually eligible fr bth Medicaid and Medicare) r anther third party paid fr the encunter; r Encunters prvided t Medicaid beneficiaries fr which n payments were received; r Medical services prvided t Medicaid beneficiaries that were nt cvered under New Hampshire's Medicaid prgram. 12

13 Patient Vlume Encunter Examples ** CHANGE ** THESE ENCOUNTERS CAN NOW BE INCLUDED: THESE ENCOUNTERS CANNOT BE INCLUDED: Claims denied due t service limitatin audits Claims denied due t nn cvered services Claims denied due t timely filing Services rendered n Medicaid members that were nt billed due t the prvider's understanding f Medicaid business rules Claims denied due t the prvider being ineligible fr the date f service Claims denied due t the member being ineligible fr the date f service 13

14 SUPPORTING DOCUMENTATION 14

15 Payment Year 1 All EHs NO CHANGE Medicaid EHR Incentive Prgram payment, and average length f stay, data must be upladed nt epip Applicable pages f the mst current filed Medicare Cst Reprt (MCR) plus three previus year reprts Refer t the EH Payment Wrksheet and EH Eligibility Wrksheet n the Medicaid EHR Incentive Prgram website fr specific MCR data references 15

16 Payment Year 1 Medicaid nly EHs Prf f AIU NO CHANGE EHs attesting t a Medicaid EHR Incentive Prgram payment nly must shw prf that certified EHR technlgy has been adpted, implemented, r upgraded One f the fllwing must be upladed nt epip: vendr cntract, paid invice, purchase rder, r dcument shwing legal cntractual bligatin; all cntracts must be fully executed with signatures frm the EH and vendr and clearly indicate the EHR system Prf f payment (bank invice r credit card slip that matches the invice) must be upladed Retain all dcumentatin fr three years fllwing payment year 1 16

17 Payment Years 1 & 2 All EHs NO CHANGE Certified EHR Technlgy dcumentatin All certified mdules r EHRs that are available at the EH at the start f the EHR reprting perid must be added t the cart n the Office f the Natinal Crdinatr Certified Health IT Prduct List ( website t generate an accurate CMS EHR Certificatin ID EHs must uplad a screensht f the CHPL webpage with the CMS EHR Certificatin ID at the time f attestatin 17

18 Payment Years 1 & 2 Dually Eligible EHs Only NO CHANGE CMS Submissin Receipt When a dually eligible EH successfully attests fr the Medicare EHR Incentive Prgram n the CMS website, CMS prvides a submissin receipt as prf that the EH successfully attested fr Meaningful Use EHs must uplad a screensht f the CMS Submissin Receipt at the time f attestatin 18

19 Payment Year 2 All EHs NO CHANGE Medicaid EHR Incentive Prgram average length f stay data must be upladed nt epip Applicable pages f the mst current filed Medicare Cst Reprt (MCR) Refer t the EH Eligibility Wrksheet n the Medicaid EHR Incentive Prgram website fr specific MCR data references 19

20 REGISTRATION AND ATTESTATION 20

21 Registratin Fr First Time Users ** CHANGE ** Natinal Prvider Identifier (NPI) CMS Identity and Access Management (I&A) Username and Passwrd (same as PECOS) CMS Certificatin Number (CCN) Tax Identificatin Number (TIN) (Users wrking n behalf f an EH) Identity and Access Management System (I&A) web user accunt (User ID/Passwrd) assciated with the EH s NPI CMS Registratin ID EHR Certificatin Number 7 digit NH Medicaid Prvider ID 21

22 Registratin and Attestatin Prcess PAYMENT YEAR 1 PAYMENT YEAR 2 NO CHANGE STEP 1: register with CMS ( n) STEP 2: wait 24 t 48 hurs fr CMS t transmit data t NH CMS REGISTRATION NOT REQUIRED FOR MEDICAID EHR PAYMENT Update the CMS Registratin System nly when prir year data changes (such as payee, tax ID number, etc.) NOT REQUIRED STEP 3: navigate t the NH Medicaid EHR website ( STEP 4: select the Register and Attest in NH link in the menu bx n the right STEP 5: select the epip (Electrnic Prvider Incentive Payment System) lg t register and attest STEP 1: navigate t the NH Medicaid EHR website ( STEP 2: select the Register and Attest in NH link in the menu bx n the right STEP 3: select the epip (Electrnic Prvider Incentive Payment System) lg t attest; re registratin is NOT REQUIRED 22

23 epip Lg On Usernames ** CHANGE ** Username: 7 DIGIT Medicaid Prvider ID EHs that attested in 2012 Username: 8 DIGIT Medicaid Prvider ID NH Medicaid EHR staff prgrammatically linked the ld (8 digit) Medicaid Prvider IDs t the new (7 digit) Medicaid Prvider IDs EHs that attested t Payment Year 1 in 2012 will have access t review histrical payment data when lgged int epip with their 7 digit ID 23

24 epip Lg On Passwrds IS THIS YOUR FIRST TIME REGISTERING ON epip? epip will prmpt yu t set a passwrd that will remain active fr 6 mnths HAVE YOU ALREADY REGISTERED ON epip? epip will ask yu t enter yur ld passwrd and reset it t a new passwrd HAVE YOU FORGETTEN, OR DON T HAVE, YOUR OLD PASSWORD? 24

25 epip Lg On Frgtten Passwrds DO YOU HAVE THE SAME ADDRESS AS THE LAST TIME YOU LOGGED ON TO epip? Navigate t the epip Lg On webpage: ( Select the link belw the Accunt Infrmatin bx that says, Frgt yur passwrd? Click here t reset yur passwrd. epip will prmpt yu t enter the EH s 7 digit NH Medicaid ID and NPI Yu will receive an with instructins fr resetting the passwrd DO YOU HAVE A DIFFERENT OR DON T REMEMBER THE USED TO LOG ONTO epip? Send an t inf@nhmedicaidhit.rg NH Medicaid staff will cntact yu t verify identity; btain a new ; and send yu an with the new passwrd 25

26 EH Payment Schedule NO CHANGE NH Medicaid EHR incentive payments will be paid ver three years Year 1: 50% Year 2: 40% Year 3: 10% Cmplete the EH Payment Wrksheet (n the New Hampshire Medicaid EHR website) t determine yur estimated ttal incentive payment amunt (divided int the three annual payment amunts) 26

27 Medicaid EHR Incentive Prgram Resurces New Hampshire Medicaid EHR Incentive Prgram website ( EH Eligibility Wrksheet (calculate Patient Vlume and Average Length f Stay percentages) EH Payment Wrksheet (cmpleted in Payment Year 1 nly t determine the Medicaid EHR incentive payment amunt) EH Reference Guide (in develpment) CMS Medicare and Medicaid EHR Incentive Prgram website ( NH Medicaid EHR Office: inf@nhmedicaidhit.rg 27

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