Presentation on theme: "Medicaid and CHIP Health Information Exchange Advisory Committee Meeting January 12, 2012."— Presentation transcript:
1 Medicaid and CHIP Health Information Exchange Advisory Committee Meeting January 12, 2012
2 AgendaWelcomeApproval of Committee MinutesCommittee Changes and VacanciesCommittee Schedule for 2012Introduction of new Health Information Technology (IT) team membersState Legislative Activities and Federal Developments Update – Stephen PalmerStatewide Health Information Exchange (HIE) Activities Update – Tony GilmanMedicaid Project Updates:5010 Update – Joe GravesYour Texas Medicaid Benefits Card / System – Noel VillarrealElectronic Health Record (EHR) Incentive Program – Deb Norris and Kristen LeoneHealth Information Exchange (HIE) Pilot and E-Prescribing – Jason Phipps
3 Health IT Team Members Ramdas Menon, Health IT Director Thomas Colvin, Project ManagerDeb Norris, Policy / Business AnalystJason Phipps, Project ManagerNoel Villarreal, Manager, Medicaid Benefits CardJulia Alejandre, CommunicationsSabrina Thomas, Administrative Assistant
4 State Legislative Activities and Federal Developments Stephen Palmer, DirectorOffice of e-Health Coordination4
5 State Legislative Activities and Federal Developments Update and discussionQuestionsFederal Developments
6 Statewide Health Information Exchange Activities Tony Gilman, Executive DirectorTexas Health Services Authority (THSA)6
7 Local HIE Grant Program Quarterly Progress ReportsTwo HIE Business and Operational Plan Approved in September 2011.14 HIEs submitted Business and Operational Plans:Four HIEs have submitted plan amendments to address weaknesses and deficiencies.Six HIEs developing plan amendment to address weaknesses and deficiencies.Three HIEs will either merge with another HIE or become part of White Space.One HIE will either continue or become part of the White Space.All HIEs are transitioning from planning to implementation in January 2012.
8 White Space Strategy Current Status Five Health Information Service Providers (HISPs) formally qualified in December 2011.THSA White Space web page launchedWhite Space Fact Sheet and Q&A posted.Voucher registration form and HISP profile and pricing sheets added to web page.Next StepsSoft communications campaign through THSA, state-level professional associations, Medicaid, and regional extension centers (RECs), to inform providers of White Space Strategy and voucher request and payment process.Timeline: January 2012
9 General-State Level Operations Current StatusMonthly Collaboration Council and Task Force MeetingsTexas HIE Interoperability Guidance PublishedTechnical Standards ReviewEnterprise Architecture Blueprint (EAB)EAB Lifecycle Management PlanTechnical Implementation SpecificationsPrivacy and Security White Papers PublishedNext StepsPrivacy and Security GuidanceState-Level Trust AgreementModel Business Associate AgreementGeneral Privacy and Security Guidelines and ProceduresState-Level Shared ServicesTHSA Web Site Redesign
10 5010 Update: ASC X12 Version 5010 and NCPDP Version D.0 Implementation Joe Graves, Team LeadHHSC IT10
11 IntroductionThe Health Insurance Portability and Accountability Act (HIPAA) requires electronic standards for health care organizationsCMS Rule January 2009HIPAA ASC X12 Version 5010NCPDP Version D.0
12 5010 / D.0 Implementation Timeframe Original Date – January 1, 2012CMS published non-enforcement of standards for 90 daysHHSC Implementation Dates:Managed Care Encounters – January 1, 2012Pharmacy Transactions – February 1, 2012Acute and Long-Term Care Transactions – April 1, 2012
13 MEHIS SystemMEHIS System Eligibility – Already compliant with Version 5010.MEHIS Pharmacy History – Uses different NCPDP Standard (not D.0).No other areas impacted.
15 Your Texas Medicaid Benefits Card and System Noel Villarreal, Project DirectorMedicaid and CHIP Division15
16 Project StatusOn June 29, 2011, Your Texas Benefits Medicaid Card became operational (previously known as the Medicaid ID card system).Release 1 implementation supports electronic eligibility verification and includes the following:Card production and distribution.Provider portal eligibility verification.Help Desk – Medicaid Eligibility and Health Information Services (MEHIS).16
17 Project StatusRelease 2.1, scheduled to release in January 2011, will include an initial basic version of the client portal that will enable clients to print a copy of their Medicaid ID cards.Subsequent 2.x releases are scheduled for completion in the first quarter of 2012 and will include the more robust applications associated with:Electronic health history.E-prescribing.On-line explanation of benefits verification.17
18 Request Card Replacement Health History Summary 2012 RoadmapJANFEBMARAPRMAYIVR EnhancementsOpt-Out TransitionView Medicaid eligibilityView THSteps remindersRequest Card ReplacementPrint card imageChange Opt-Out ElectionClient Portal (v1)Health History SummaryCheck-insVisits (Claims/Encounter History)DiagnosisDetail viewsProvider Portal – Claims HistoryPrescription Drug HistoryImmunization HistoryReportsProvider Portal (Enh) – Rx, Imm, RptsView Claims/Encounter HistoryView Prescription Drug HistoryView Immunization HistoryView AlertsClient Portal – Health HistoryHelp Desk PortalData AccessPortlet AccessElectronic Data InterfaceIVR Enhancementse-PrescribingLab DataIVR Enhancements18Last Updated:All release dates subject to change.
19 5010 ImpactsThe N5010 standard applies to X12 transactions from a MEHIS perspective.The MEHIS system has two X12 transaction sets which both revolve around the X12 270/271 Eligibility Inquiry/Response transactions:Texas Medicaid & Healthcare Partnership (TMHP)MEHIS submits interactive X Eligibility Inquiries to TMHP to verify client eligibility.This inquiry transaction already conforms with the 5010 standard.The 271 Eligibility Response received from TMHP also conforms with 5010 as implemented.No anticipated impacts to this interface.SureScriptsMEHIS submits interactive X Eligibility Inquiries to SureScripts in support of the ePrescribing tool.MEHIS is implementing the latest version of the e-prescribing system that already supports the 5010 standard with SureScripts.No anticipated impacts after implementation.19
20 5010 ImpactsArea of possible impact: If there are new requirements regarding the minimum set of client and provider data that is captured and submitted within the Eligibility Inquiry transaction.Not likely as this is specific to program policies or business rules, and not necessarily requirements of the 5010 standard.There are no other interfaces in MEHIS that use X12; therefore, no impact with the current implementation.Other transactions supported by MEHIS are batch files, HL-7, and NCPDP SCRIPT 8.These should not be impacted by the 5010 standard as none of these are candidates for the X12 specifications.20
22 Medicaid EHR Incentive Program Deb Norris, Business/Policy Analyst, Medicaid/CHIP DivisionKristen Leone, Texas Project Manager, CGI22
23 Status Update as of December 22, 2011 EHR incentives paid total $227.6 million175 hospitals1,967 eligible professionals504 eligible professionals (EPs) from federally qualified health centers (FQHC) and rural health clinics (RHC) have enrolled410 EPs have been paid from 115 FQHC/RHCs
24 Provider Enrollment Status as of December 22, 2011 Centers for Medicare & Medicaid Services (CMS) Registration by Provider TypeRegistrationStepNumberof EPsNumber of HospitalsTotalCMS Registrations4,6892634,952Texas EHR Incentive Enrollment:Not Started1,498361,534In Process6782680Payment Pending355462,214Paid1,9671752,142Cancelled orNot Eligible1934197
25 Medicaid EHR Incentive Program: Payments by State
26 Meaningful Use Attestation Meaningful Use attestation portal for eligible hospitals in January 2012.EPs begin attestation for meaningful use (payment year 2) in April 2012.Meaningful use audit strategy under development based on guidance from CMS.HHSC will contract with outside audit vendor.
28 HIE Pilot and E-Prescribing Jason Phipps, Project ManagerMedicaid and CHIP Division28
29 HIE PilotBackground:Two organizations are participating in the exchange of Medicaid medication history data – Sandlot and Texas Health Resources.Pilot is limited to medication history.Phase 2 will provide real-time connectivity between HHSC and two local HIEs.Status:Phase 1 completed in November 2011.Phase 2 design finalized in December 2011.Currently resolving design dependencies and investigating possible efficiencies.Implementation to begin in February 2012.
31 E-Prescribing Status: Connectivity to Surescripts certified December 12, 2011.Service went live December 21, 2011, in a “soft” rollout.Eligibility checks, medication history, formulary.Very few issues to troubleshoot.Marketing / Communications underway soon.Now planning long-term maintenance and usability improvements.