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Medicaid and CHIP Health Information Exchange Advisory Committee Meeting January 12, 2012.

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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 Agenda Welcome Approval of Committee Minutes Committee Changes and Vacancies Committee Schedule for 2012 Introduction of new Health Information Technology (IT) team members State Legislative Activities and Federal Developments Update – Stephen Palmer Statewide Health Information Exchange (HIE) Activities Update – Tony Gilman Medicaid Project Updates: 5010 Update – Joe Graves Your Texas Medicaid Benefits Card / System – Noel Villarreal Electronic Health Record (EHR) Incentive Program – Deb Norris and Kristen Leone Health Information Exchange (HIE) Pilot and E-Prescribing – Jason Phipps

3 Health IT Team Members Ramdas Menon, Health IT Director
Thomas Colvin, Project Manager Deb Norris, Policy / Business Analyst Jason Phipps, Project Manager Noel Villarreal, Manager, Medicaid Benefits Card Julia Alejandre, Communications Sabrina Thomas, Administrative Assistant

4 State Legislative Activities and Federal Developments
Stephen Palmer, Director Office of e-Health Coordination 4

5 State Legislative Activities and Federal Developments
Update and discussion Questions Federal Developments

6 Statewide Health Information Exchange Activities
Tony Gilman, Executive Director Texas Health Services Authority (THSA) 6

7 Local HIE Grant Program
Quarterly Progress Reports Two 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 launched White Space Fact Sheet and Q&A posted. Voucher registration form and HISP profile and pricing sheets added to web page. Next Steps Soft 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 Status Monthly Collaboration Council and Task Force Meetings Texas HIE Interoperability Guidance Published Technical Standards Review Enterprise Architecture Blueprint (EAB) EAB Lifecycle Management Plan Technical Implementation Specifications Privacy and Security White Papers Published Next Steps Privacy and Security Guidance State-Level Trust Agreement Model Business Associate Agreement General Privacy and Security Guidelines and Procedures State-Level Shared Services THSA Web Site Redesign

10 5010 Update: ASC X12 Version 5010 and NCPDP Version D.0 Implementation
Joe Graves, Team Lead HHSC IT 10

11 Introduction The Health Insurance Portability and Accountability Act (HIPAA) requires electronic standards for health care organizations CMS Rule January 2009 HIPAA ASC X12 Version 5010 NCPDP Version D.0

12 5010 / D.0 Implementation Timeframe
Original Date – January 1, 2012 CMS published non-enforcement of standards for 90 days HHSC Implementation Dates: Managed Care Encounters – January 1, 2012 Pharmacy Transactions – February 1, 2012 Acute and Long-Term Care Transactions – April 1, 2012

13 MEHIS System MEHIS System Eligibility – Already compliant with Version 5010. MEHIS Pharmacy History – Uses different NCPDP Standard (not D.0). No other areas impacted.

14 5010 / D.0 Implementation

15 Your Texas Medicaid Benefits Card and System
Noel Villarreal, Project Director Medicaid and CHIP Division 15

16 Project Status On 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 Status Release 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 Roadmap JAN FEB MAR APR MAY IVR Enhancements Opt-Out Transition View Medicaid eligibility View THSteps reminders Request Card Replacement Print card image Change Opt-Out Election Client Portal (v1) Health History Summary Check-ins Visits (Claims/Encounter History) Diagnosis Detail views Provider Portal – Claims History Prescription Drug History Immunization History Reports Provider Portal (Enh) – Rx, Imm, Rpts View Claims/Encounter History View Prescription Drug History View Immunization History View Alerts Client Portal – Health History Help Desk Portal Data Access Portlet Access Electronic Data Interface IVR Enhancements e-Prescribing Lab Data IVR Enhancements 18 Last Updated: All release dates subject to change.

19 5010 Impacts The 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. SureScripts MEHIS 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 Impacts Area 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

21 Your Texas Medicaid Benefits Card

22 Medicaid EHR Incentive Program
Deb Norris, Business/Policy Analyst, Medicaid/CHIP Division Kristen Leone, Texas Project Manager, CGI 22

23 Status Update as of December 22, 2011
EHR incentives paid total $227.6 million 175 hospitals 1,967 eligible professionals 504 eligible professionals (EPs) from federally qualified health centers (FQHC) and rural health clinics (RHC) have enrolled 410 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 Type Registration Step Number of EPs Number of Hospitals Total CMS Registrations 4,689 263 4,952 Texas EHR Incentive Enrollment: Not Started 1,498 36 1,534 In Process 678 2 680 Payment Pending 355 46 2,214 Paid 1,967 175 2,142 Cancelled or Not Eligible 193 4 197

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.

27 Medicaid EHR Incentive Program

28 HIE Pilot and E-Prescribing
Jason Phipps, Project Manager Medicaid and CHIP Division 28

29 HIE Pilot Background: 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.

30 HIE Pilot

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.

32 Medicaid HIE Advisory Committee
Public Comment

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