Request for Proposal Implementation Agents of Health Information Technology: Behavioral Health, Primary Care, and other Specialty Healthcare Providers

Transcription

1 Request for Proposal Implementation Agents of Health Information Technology: Behavioral Health, Primary Care, and other Specialty Healthcare Providers ISSUE DATE: April 26 th, 2013 RESPONSE DUE DATE: May 22 nd, 2013 REGION: NEW YORK CITY 1

2 Table of Contents I. Introduction...3 A. HEAL 22 (Behavioral Health) Program Overview... 3 B. Meaningful Use (Primary Care and Specialist) Program Overview... 3 II. RFP Purpose...4 III. Scope of Service and Application Timeline...5 A. HEAL 22 (Behavioral Health) Program Scope of Service... 5 B. Meaningful Use (Primary Care and Specialist) Program Scope of Service... 5 C. Application Timeline... 5 IV. Application Process...6 A. Required Components Section Section Section B. Evaluation Point Distribution... 7 V. Submission Information...7 A. Submission Date, Time, and Format... 7 B. RFP Communications and Pre-Proposal Q&A Conference Call... 7 VI. Implementation Agent Selection Information...8 VII. General Disclosures...8 VIII. APPENDIX A

3 I. Introduction This Request for Proposal (RFP) is issued by the Fund for Public Health in New York, Inc. (FPHNY), on behalf of the New York City Regional Electronic Adoption Center for Health (NYC REACH). NYC REACH is a program within the Primary Care Information Project (PCIP) in the New York City Department of Health and Mental Hygiene (NYC DOHMH). FPHNY is a 501(c)(3) nonprofit that exists for the purpose of soliciting, administering, and receiving funds and using such funds to assist the NYC DOHMH in fulfilling its mission to implement programs that address public health needs. NYC REACH is a health information technology (HIT) Regional Extension Center (REC) for the geographic region of New York City, as designated by the United States Department of Health and Human Services (USD HHS) Office of the National Coordinator for Health Information Technology (ONC). NYC REACH s mission is to support and serve healthcare providers as they adopt and use HIT. A. HEAL 22 (Behavioral Health) Program Overview In June 2012, the New York State Department of Health (NYS DOH) made funding available to New York State s two federally established RECs, NYC REACH and New York ehealth Collaborative (NYeC), to facilitate the adoption and use of HIT by behavioral health providers. This funding is part of the Healthcare Efficiency and Affordability Law and represents the 22nd scope (HEAL 22). In order to accomplish the objective of HEAL 22, NYC REACH and NYeC are facilitating technical assistance for behavioral health providers affiliated with Medicaid Health Homes. Beneficiaries of this initiative include individuals employed in certain behavioral health capacities including, but not limited to: Case Managers Case Coordinators Transitional Care Coordinators Certified Substance Abuse Counselors Social Workers Psychologists Therapists Counselors 3 Psychiatrists Physicians Nurse Practitioner Registered Nurse Physician Assistant The expansion of health information systems and technology and health information exchange (HIE) will allow behavioral health providers to better integrate care across settings and improve the quality and costs of care for Medicaid s most vulnerable and severely ill recipients. B. Meaningful Use (Primary Care and Specialist) Program Overview NYC REACH guides priority primary care providers (PPCP) through electronic health record (EHR) implementation to meet the federal Meaningful Use (MU) requirements and assists in the adoption, implementation, and upgrade (AIU) of electronic health records for improving health care and achieving Centers for Medicare and Medicaid Services (CMS) MU Stage One. PPCPs served by NYC REACH cross a variety of sites including community health centers, hospitals, outpatient clinics, small practices, correctional facilities, and homeless mobile vans. Separately, CMS has authorized funding to expand NY State s administration, oversight, and enhancement of Medicaid incentive programs. With these funds, NYC REACH is administering the Medicaid Specialist Program (MSP). MSP extends NYC REACH services to PPCPs not covered by existing federal funding, which was initially reserved for sites limited to ten or fewer PPCPs, and to specialists who are eligible for the Medicaid MU incentives offered by the CMS New York Medicaid EHR Incentive Program.

4 II. RFP Purpose The purpose of this RFP is to identify organizations best qualified to provide Implementation Agent services on behalf of NYC REACH. The primary goal of this RFP is to recruit Implementation Agents with expertise in providing HIT implementation services within behavioral health settings for NYC REACH s HEAL 22 program. This RFP will also serve to identify and recruit Implementation Agents interested in providing services to NYC REACH s Meaningful Use Program. Prospective Implementation Agents may apply for one or both programs. Response to either the HEAL 22 program or the Meaningful Use program will not impact consideration of response to the other. Implementation Agents identified through this RFP may work on behalf of one or both of the following NYC REACH programs to advance the use of HIT in New York City-based healthcare settings. Program HEAL 22 Program (Behavioral Health) Meaningful Use Program (Primary Care and Specialist) Target, Services, and Timeframe Target Behavioral health providers serving Medicaid patients within the Medicaid Health Home program Services Support for the implementation of EHR software and behavior health EHR components and HIE infrastructure Timeframe All services and documentation must be completed by October 31, 2013 Target Services Primary Care and Specialist Medicaid Eligible Provider (EP) Registration and attestation assistance for AIU; assisting providers with the achievement of MU Stage 1 measures and attestation to CMS or New York State Medicaid websites, as appropriate Timeframe Primary Care: services must be completed by December 31, 2013 Specialists: services must be completed by March 31, 2014 NYC REACH will review and evaluate responses to this RFP and identify Implementation Agents with whom NYC REACH may collaborate to support health care practices with the adoption of HIT, interoperability, HIE, or achievement of MU Stage 1. This RFP is the first invitation for individual consultants and companies who wish to serve as Implementation Agents on behalf of NYC REACH. 4

5 III. Scope of Service and Application Timeline A. HEAL 22 (Behavioral Health) Program Scope of Service Implementation Agents may be expected to perform any or all of the following tasks: Service Level One: a. Assess readiness for adoption of HIT and assist in the selection of an EHR solution relevant to each client s setting, practice, and needs b. Analyze and redesign a practice s workflows, processes, and procedures and adapt to HIT solutions as needed c. Support rollout and implementation of a selected solution d. Train users on a selected EHR solution Service Level Two: a. Support HIE interoperability and connectivity with a regional health information organization (RHIO) b. Provide troubleshooting and guidance for adopting best healthcare practices in key areas such as: i. privacy and consent processes ii. federal and state laws and regulatory requirements c. Monitor the project processes critical to the success of the organization d. Provide other trainings as required B. Meaningful Use (Primary Care and Specialist) Program Scope of Service Implementation Agents may be expected to perform any or all of the following tasks: Service Level One: a. Support providers in registering on the CMS website for MU Incentive Programs b. Assist providers in the calculation of Medicaid patient volume, as needed c. Assist providers in the administrative process of AIU attestation for AIU attestation and resolving issues to ensure achievement in attesting for AIU in the NY Medicaid EHR Incentive Program Service Level Two: a. Guide implementation and workflow redesign to help meet MU Stage 1 objectives. b. Assist providers with achievement of MU Stage 1 objectives c. Provide troubleshooting and guidance for adopting best healthcare practices in key areas such as: iii. privacy and consent processes iv. clinical quality improvement of MU clinical quality measures v. federal and state laws and regulatory requirements d. Assist with attestation of New York State Medicaid MU C. Application Timeline The deadline for submission is May 22 nd, :00 PM EST. Proposals must be submitted via to klugay@fphny.org. Below is a detailed timeline of events related to this Request for Proposals process. Unless otherwise specified, the time of day for the following events will be between 9:00am and 5:00pm EST. 5

6 Event Date Release of Request for Proposals April 26 th, 2013 Inquiry Period April 26 th to May 8 th, 2013 Deadline to receive questions regarding this RFP Pre-proposal Q&A Conference Call Call-in number: Access code: RFP Q&A Responses posted at May 16 th, 2013 Deadline for receipt of proposals Notice of selection June 17 th, 2013 Applicants not selected are notified June 21 st, 2013 IV. Application Process A. Required Components May 8 th, :59 PM EST May 15 th, :00 PM EST May 22 nd, :00 PM, EST Each response must be divided into three categories. Please refer to Appendix A for application instructions related to each section. Below is a description of the topics to be covered in each section. 1. Section 1 Subsection A: Proposal Cover Letter and Accompanying Documentation This subsection requests basic identifying information for your organization. In addition, you will be asked to append the following documents: Proof of liability insurance (including worker s compensation) If the respondent is a company, a copy of the company s organization certificate and doing business as (DBA) certificate, where applicable If the respondent is an independent consultant, a copy of the Tax Identification Number (TIN) or Tax ID issued as a sole proprietor/individual or as a personal service corporation Subsection B: Organization or Individual Profile This subsection seeks an outline of the organization or individual that will be providing implementation agent services. The respondent will be asked to address the following aspects of the organization or individual in the context of implementation agent services: Organizational chart (if available) Mission Core services Skillsets of agents likely to be assigned to this project Experience in the implementation of HIT and HIE for Behavioral Health, Primary Care, and Specialist providers Experience with MU and number of practices that have attested successfully (if applying to the MU Program) Subsection C: Market Segment This subsection will require the respondent to quantify its customer base, including by healthcare practice setting and size. 6

7 2. Section 2 Subsection D: Qualifications and Experience This subsection will require the respondent to describe previous experiences, major challenges encountered, and solutions for resolving the challenges related to the activities defined in the scope of services above. Subsection E: References This subsection will require the respondent to provide contact information for three customers with which respondent has worked and that may be contacted as references. 3. Section 3 Subsection F: Pricing This subsection will require respondent to outline and explain costs associated with Service Level One and Service Level Two. Failure to submit any of these elements may cause your response to not be reviewed. Respondents must follow the outline provided in Appendix A. Please be succinct in your responses and limit your response to the components indicated in Appendix A to no greater than 30 pages. Additional pages, in the form of attachments and appendices, may be considered at the discretion of NYC REACH. B. Evaluation Point Distribution There is no pre-determined number of Implementation Agents that may be selected through this RFP process. Proposals will be reviewed by a committee comprised of at least of three individuals. Proposals will be reviewed and scored according to the weighting detailed below. The maximum possible score is 100 points. Section Maximum Points Section 1 30 Section 2 50 Section 3 20 Maximum Points Awarded 100 V. Submission Information A. Submission Date, Time, and Format Responses must be submitted electronically. Please format all documents submitted in response to this RFP in.pdf (Portable Document Format). Proposals must be ed to the following address, no later than May 22 nd, 2013, 04:00 PM EST. Attn: Ms. Keisha Lugay, Grant Manager Subject: NYC REACH Implementation Agent RFP Submission klugay@fphny.org Responses received after May 22 nd, 2013, 04:00 PM EST may be reviewed at a later date at the discretion of NYC REACH. B. RFP Communications and Pre-Proposal Q&A Conference Call Potential respondents may send any questions or comments to: 7

8 Attn: Ms. Keisha Lugay, Grant Manager Subject: Inquiry: NYC REACH Implementation Agent RFP Pre-Proposal Conference Call All questions must be received by May 8 th, 2013, 11:59 PM EST. The pre-proposal conference call will be held on May 15 th, 2013 at 03:00 PM EST to answer all previously submitted programmatic and administrative questions and to discuss additional questions, as time permits. Information discussed during the pre-proposal conference will be made available by May 16 th, 2013 at: No other contact with FPHNY, DOHMH, or Partnership personnel regarding this project RFP is permitted in the period between the release of this RFP and the notice of award. Any oral communication shall be considered unofficial and non-binding with regard to this RFP and subsequent award. VI. Implementation Agent Selection Information Proposals will be evaluated based on the factors described in Section IV. Application Process. Selection of Implementation Agents made pursuant to this RFP are made contingent upon the availability of such funds and the successful negotiation of a formal contract between FPHNY and the recipient and the execution of such a contract by an authorized officer or agent of such applicant. FPHNY can rescind this RFP at any time and choose not to make an award. VII. General Disclosures A. Right to Reject Proposals NYC REACH may reject any or all proposals received and may ask for further clarification or documentation. Submitted information that does not respond to all items in this RFP may be excluded from further consideration and alternative information packages may not be considered. NYC REACH may decline to review an application in the event the respondent submits a response after the submission deadline and/or any disparity is found during the evaluation process. B. Costs The respondent will be solely responsible for any costs incurred in preparing, delivering, or presenting responses to this RFP. Respondents will not be reimbursed for any costs incurred in preparing proposals. C. Fulfillment of Requirements By submitting an information package, the respondent acknowledges that the respondent has read and understands this RFP and is capable of fulfilling all requirements. D. Submitted Information Once submitted, responses will be the property of NYC REACH and will not be returned. E. Right to Amend, Cancel this RFP, or Solicit a New RFP FPHNY or NYC REACH may amend or cancel this RFP at any time, without any liability to NYC REACH, FPHNY, and/or DOHMH. FPHNY or NYC REACH may solicit new requests for information and/or proposals regarding the services addressed in this RFP at any time. F. Amount of Business 8

9 NYC REACH does not guarantee to any specific amount of business or revenue as a result of this RFP. G. Security and Confidentiality Respondents should give specific attention to the identification of those portions of their proposals that they deem to be confidential, proprietary information, or trade secrets and provide appropriate justification for why such materials, upon request, should not be disclosed by FPHNY. Such information must be easily separable from the non-confidential sections of the proposal. All information not so identified may be disclosed by FPHNY. 9

10 VIII. APPENDIX A Instructions: Respondents must follow the outline provided in Appendix A. Failure to submit any of these elements may cause your response to not be reviewed. Please be succinct in your responses and limit your response to the components indicated in Appendix A to no greater than 30 pages. Additional pages, in the form of attachments and appendices, may be considered at the discretion of NYC REACH. If including additional documentation, please be sure to indicate to which section each attachment refers. Respondents must use text no smaller than 12-point, Times New Roman (or equivalent) font, and page margins may be no narrower than one-inch on each side. All respondents must complete Section 1. If applying for both programs, please complete Section 1 only once. If applying for the HEAL 22 Program, please complete Section 2a and Section 3a. If applying for the Meaningful Use Program, please complete Section 2b and Section 3b. Respondents may respond to one or both programs. 10

11 SECTION 1 1. Subsection A: Proposal Cover Letter and Accompanying Documentation A. Proposal Cover Letter Respondents must complete this Proposal Cover Letter and print the cover letter on respondent s official letterhead, if possible. This form must be signed by an authorized officer of the responding organization. Please complete if respondent is a company. Legal name DBA.name Federal Employer Identification Number Main address Website Private or public Year founded Executive director name Phone Project director name Phone Marketing and sales name Phone Technical contact Name Phone Please complete if respondent is an individual consultant. Consultant name DBA name (if applicable) Federal Tax Identification Number (SSN not allowed) Main address Website Phone(s) Fax Certification As an authorized officer, I certify that all information provided in this application is correct and accurate to the best of my knowledge. Organization Name and Title Signature Date 11

12 B. Additional Documentation Proof of liability insurance (including worker s compensation) If the respondent is a company, a copy (.pdf,.jpg, or.gif file) of the company s organization certificate issued by the secretary of state of the state in which the company is organized. For those entities operating under the condition of DBA, the DBA certificate must be provided if the company uses a trade name other than the name under which the company is organized. If the respondent is an independent consultant, a copy (.pdf,.jpg, or.gif file) of the TIN or Tax ID issued as a sole proprietor/individual or as a personal service corporation. Individual social security number will not be acceptable and may result in rejection. 12

13 Subsection B: Organization or Individual Profile 1. Provide a statement explaining the mission of your organization. 2. Describe the core services of your organization. 3. Provide an organizational chart and describe the unit or department that will provide the Implementation Agent services or act as implementation Agents. 4. Describe the skillset of the agents who are likely to be assigned to this project. 5. Provide examples of how you will assign Implementation Agents for the delivery of services. Please indicate the resources that will be made available to practices or providers that receive your assistance. 6. If applying for the Meaningful Use Program, please describe your experience with Meaningful Use. 7. If applying for the Meaningful Use Program, please estimate the number of providers whom you have helped to successfully attest. 13

14 Subsection C: Market Segment The following information is requested to better understand the existing services you provide to each market segment within New York City. If you know the number of NYC REACH member organizations and providers to whom you have provided service, please list that information in a separate table. Table 4.1 Please indicate the composition of your provider base, by percentage. Healthcare field % Years providing services Behavioral Health Primary Care Providers Specialty (please list) * * * Total 100% Table 4.2 Please indicate the number of providers by type of healthcare service in last two years. Behavioral Health Primary Care Providers Specialty Physicians Total Practices Practices Practices Practices or Agencies Individual Providers or Agencies Individual Providers or Agencies Individual Providers or Agencies Individual Providers Table 4.3 Please indicate the number of practices by size of practice in the last two years. Behavioral Primary Care Specialty Size of Practice Health Providers Physicians Solo Practice Small Practice (1-5 providers) Medium Size Practice (6-10 providers) Large Practice (more than 10 providers) Table 4.4 Please indicate the number of practices by setting in the last two years. Behavioral Primary Care Setting Health Providers Community Based Organization Private Clinics Hospitals Specialty Physicians Total Total 14

15 Table 4.5 Please indicate the number of staff available to assist with the following services. Behavioral Primary Care Specialty Type of Service Health Providers Physicians Rollout and Implementation Training Support Marketing and Sales Administrative Meaningful Use Other, please specify Total ===>> Table 4.6 Please identify your experience on products and versions Healthcare field Vendor name Product Release Total Certification Yes No 15

16 SECTION 2a Subsection D: Behavioral Health Qualifications and Experience This section contains two levels of service, with more specific requests beneath each level. Please respond to each lettered statement (Statement a, b, etc.) below, taking into account the more specific bulleted requests. Your response should be written in a way that will assist reviewers in evaluating your qualifications and experience within in the context of the HEAL 22 Program. Service Level One a. Assess readiness for adoption of health information technology and assist in the selection of an EHR solution relevant to each client s setting, practice, and needs. Describe your experience in assessing the readiness of the organization for adopting healthcare information technology. Provide examples of how you would approach a readiness assessment and provide assistance in selecting an EHR solution that best fits an organization s needs. b. Analyze and redesign the Practice s workflows, processes and procedures to adapt them into the electronic solution Describe your experience in analyzing and redefining healthcare workflows, processes and procedures List the steps and methodology on how you identify and analyze healthcare workflows, processes and procedures c. Rollout and implementation of a selected solution Describe your experience on the rollout and implementation of EHR solutions. Please provide examples Provide examples of major challenges you have encountered for implementation and how you overcame them. d. Train users on a selected solution. Describe the type of training that you have delivered in the past 2 years. Attach any training material you may have used or developed if applicable. e. Monitoring the project processes critical to the success of these organizations Describe the methodology you will use to manage and monitor healthcare projects. Please specify the steps that will be taken to ensure successful implementation and meaningful use achievement. Provide concrete examples of the methodology used to define milestones, critical paths and risk elements that might affect the development of the project, and how these will be managed Service Level Two f. Support HIE interoperability and connectivity with a regional health interoperability organization (RHIO). Describe your experience supporting practices and agencies for interoperability and health information exchange. Please specify the setting, the RHIO, and the steps you took to ensure connectivity Provide examples of the major challenges and successes you have faced on supporting interoperability and health information exchange 16

17 g. Troubleshooting and guidance for adopting best healthcare practices in key areas From your experience, please select five problems associated to the adoption of EHR and describe your approach for resolving the issues. For each problem, please indicate: o How did you identify it o How did you troubleshoot it o What did you learn from the experience Describe how you have helped practices meet these requirements. Please provide examples. o Privacy and consent processes o Federal and State laws and regulatory requirements 17

18 Subsection E: Behavioral Health References Please include, at minimum, three (3) customers that may be contacted as a reference. For each reference, provide the following information: Practice/organization name Contact name Phone number Software vendor Product Release Type of services provided Practice/organization name Contact name Phone number Software vendor Product Release Type of services provided Practice/organization name Contact name Phone number Software vendor Product Release Type of services provided 18

19 SECTION 2b Subsection D: Meaningful Use Qualifications and Experience This section contains two levels of service, with more specific requests beneath each level. Please respond to each lettered statement (Statement a, b, etc.) below, taking into account the more specific bulleted requests. Your response should be written in a way that will assist reviewers in evaluating your qualifications and experience within in the context of the Meaningful Use Program. Service Level One a. Assess readiness for adoption of health information technology and assist in the selection of an EHR solution relevant to each client s setting, practice, and needs: Describe your experience in assessing the readiness of the practice for adopting HIT. Provide examples of how you would approach a readiness assessment and provide assistance in selecting an EHR solution that best fits an organization s needs. b. Analyze and redesign the practice s workflows, processes, and procedures to adapt them into the electronic solution: Describe your experience in analyzing and redefining healthcare workflows, processes, and procedures. List the steps and methodology on how you identify and analyze healthcare workflows, processes and procedures. c. Rollout and implementation of a selected EHR solution: Describe your experience on the rollout and implementation of EHR solutions. Please provide examples. Provide examples of major challenges you have encountered with EHR implementation and how you overcame them. d. Train users on a selected EHR solution: Describe the types of trainings you have delivered in the past two years. Attach any training material you may have used or developed, if applicable. e. Describe your experience with Medicaid and Medicare MU. f. Describe your experience assisting providers with AIU and Year 1 Attestation. If you have experience supporting providers as they attest for AIU in the New York State Medicaid EHR Incentive Program, provide examples. g. Monitoring the project processes critical to the success of these organizations: Describe the methodology you will use to manage and monitor healthcare projects. Please specify the steps that will be taken to ensure successful implementation and MU achievement. Provide concrete examples of the methodology used to define milestones, critical paths and risk elements that might affect the development of the project, and how these will be managed Service Level Two h. Support HIE interoperability and connectivity with a regional health interoperability organization (RHIO): Describe your experience supporting practices and agencies for interoperability and health information exchange. Please specify the setting, the RHIO, and the steps you took to ensure connectivity 19

20 Provide examples of the major challenges and successes you have faced on supporting interoperability and health information exchange i. Troubleshooting and guidance for adopting best healthcare practices in key areas: From your experience, please select five problems associated to the adoption of EHR and describe your approach for resolving the issues. For each problem, indicate: o How you identified the described problem o How you resolved the described problem o What you learned from the experience Describe, with examples, how you have helped practices meet HIE and RHIO requirements. Describe, with examples, how you have assisted practices to meet the requirements for privacy and consent processes. Describe, with examples, how you have assisted practices to meet federal and state laws and regulatory requirements. 20

21 Subsection E: Meaningful Use References Please include three (3) customers that may be contacted as a reference. For each reference, provide the following information: Practice/organization name Contact name Phone number Software vendor Product Release Type of services provided Practice/organization name Contact name Phone number Software vendor Product Release Type of services provided Practice/organization name Contact name Phone number Software vendor Product Release Type of services provided 21

22 SECTION 3a Subsection E: Pricing For Behavioral Health Services 1 Please provide information about your costs per provider and per service level. Please provide a brief budget narrative that explains in further detail the allocation of costs associated with your services (e.g., percentage of costs for Direct Personal Services, OTPS, Fringe, etc.). Please explicitly state if your costs exclude any of the items within the Service Levels (e.g., does not include costs for training) Service Level One a. Assess readiness for adoption of health information technology and assist in the selection of an EHR solution relevant to each client s setting, practice, and needs b. Analyze and redesign a practice s workflows, processes, and procedures and adapt to HIT solutions as needed c. Support rollout and implementation of a selected solution d. Train users on a selected solution Service Level Two a. Support HIE interoperability and connectivity with a regional health interoperability organization (RHIO). b. Provide troubleshooting and guidance for adopting best healthcare practices in key areas such as: i. privacy and consent processes ii. federal and state laws and regulatory requirements c. Monitoring the project processes critical to the success of the organization d. Provide other trainings as required 1 For those healthcare practices in the HEAL 22 program that will NOT require the use of implementation agent services, NYC REACH will be distributing $1500/provider for demonstration of completion of all deliverables related to Service Level 1, and $500/provider for demonstration of completion of all deliverables related to Service Level 2. 22

23 SECTION 3b Subsection F: Pricing For Meaningful Use Program Please provide information about your costs per provider and per service level. Provide a budget justification that explains the allocation of costs associated with your services. Identify the percentage of direct personnel costs, fringe, and other than personnel services required. Explicitly state if your costs exclude any of the items within the Service Levels identified below. Service Level One: a. Support providers in registering on the CMS website for MU Incentive Programs b. Assist providers in the calculation of Medicaid patient volume, as needed c. Assist providers in the administrative process for AIU attestation and resolving issues to ensure achievement in attesting for AIU in the NY Medicaid EHR Incentive Program Service Level Two a. Guide implementation and workflow redesign to help meet MU Stage 1 objectives b. Assist providers on their achievement of MU Stage 1 objectives c. Provide troubleshooting and guidance for adopting best healthcare practices in key areas such as: i. privacy and consent processes ii. clinical quality improvement of MU clinical quality measures iii. federal and state laws and regulatory requirements d. Assist with attestation of New York State Medicaid MU 23