EHR Incentive Program 2018 Program Requirements

Overview Introduction to the EHR Incentive Program Brief Tutorial on How to Attest Supporting Documentation List Explanation of Meaningful Use Update on Program Year Changes Review Process Overview List of Common Attestation Mistakes Contact Information for Issues

EHR Incentive Program Government Program through Centers for Medicare and Medicaid Services (CMS) Encourage Uptake of Electronic Health Records Six Year Program Adopt, Implement, Upgrade (1 year) Meaningful Use Program continues through Program Year 2021 As of Program Year 2017, the EHR Incentive Program is no longer accepting first time attesters (AIU) into the program. In 2018, eligible hospitals and eligible professionals (EPs) that attest directly to a state for the state’s Medicaid Electronic Health Record (EHR) Incentive Program will continue to attest to the measures and objectives as finalized in the 2015 EHR Incentive Programs Final Rule.

Promoting Interoperability CMS is dedicated to improving interoperability and patients’ access to health information. To better reflect this focus, CMS is renaming the EHR Incentive Programs to the Promoting Interoperability (PI) Programs. Through this rulemaking, CMS is also streamlining the programs to reduce the time and cost required of providers to participate. Stay tuned for more information.

How to Attest Attest by visiting the MAPIR website System will prompt attester for certain necessary information Attester will need to select stage (for 2018, stage 2 or 3) Attester will need to upload supporting documentation Checklist of Supporting Documentation available on AIMS website https://www.ctdssmap.com/CTPortal/Provider/EHRIncentiveProgram/tabid/55/Default.aspx#mapir?PopUp=N

2018 Stage 2 All providers participating in the EHR Incentive Program have the option of attesting to Modified Stage 2 for 2018. 10 Meaningful Use Objectives Protect Patient Health Information  Clinical Decision Support  Computerized Provider Order Entry (CPOE)  eRx  Health Information Exchange  Patient Specific Education  Medication Reconciliation  Patient Electronic Access  Secure Messaging  Public Health Reporting  Certified EHR Technology from 2014 or 2015 edition, or a combination of the two. The EHR reporting period for Meaningful Use is 90 days and Clinical Quality Measures (CQMs) for all participants is 365 days (except for first time meaningful users).   For more information, see 2018 CMS Stage 2 Guidelines https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Stage2MedicaidModified_Require.html

2018 Stage 3 Meaningful Use 8 Meaningful Use Objectives Protect electronic protected health information ePrescribing (eRx) Clinical Decision Support (CDS) Computerized provider order entry (CPOE) Patient electronic access Coordination of care Health Information Exchange Public Health Reporting Certified EHR Technology from 2015 only Some exceptions made for a mix of 2014 and 2015 technology as long as MU requirements can be met The EHR reporting period for Meaningful Use is 90 days and Clinical Quality Measures (CQMs) for all participants is 365 days (except for first time meaningful users).   For more information, see 2018 CMS Stage 3 Guidelines https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Stage3Medicaid_Require.html

Review Process After submission, a review process begins: Reviewers: UConn HIT staff (ctmedicaidehr@uconn.edu) SRA: Myers and Stauffer LLC Email with issues will be sent to all listed contacts post-review Attester will revise attestation and resubmit if necessary Review continues until all issues resolved After issues are resolved, the review is considered complete Payment is typically issued in the next financial cycle which can be up to 2 weeks from the completion date.

Supporting Documentation CEHRT Page EHR Technology certification ID Generated by Office of National Coordinator (https://chpl.healthit.gov/#/search) 2014 edition or later for Stage 2 2015 edition only for Stage 3 Invoice or Purchase Order Shows proof of purchase NOT License Agreement Security Risk Analysis (SRA) Includes date of analysis done in 2018 Patient Encounter List (PEL)

Supporting Documentation Patient Encounter List (PEL) Excel file format Must contain all columns specified in template (see AIMS website) 90 Days of data No duplicate encounters “One provider, one patient, one day” Must contain 30% or more Medicaid patients by volume (20% for Pediatricians) If attesting as group, PEL must be same for entire group http://chatter.uconn.edu/ehr-incentive-program/ep/sd/

Meaningful Use Meaningful Use Documents Meaningful Use (MU) Objectives 90 days worth of information for all providers generated by CEHRT Clinical Quality Measures (CQMs) 365 days worth of data generated by CEHRT (can be 90 days for 1st time meaningful users Immunization Registry for EPs who administer immunizations to patients 0-6 MUST Portal certificate from previous program year (2015 or 2016) If EP does not have a MUST certificate from prior years, contact Diane Fraiter at DPH for registration: 860-509-7938 or diane.fraiter@ct.gov Registration Confirmation for additional specialized registries

Common Attestation Errors PEL is not in the required format (see AIMS website) PEL contains duplicate encounters (same patient, same day, same provider) Missing Supporting Documentation (see AIMS website for list) CEHRT ID put in MAPIR different than ONC provided CEHRT Page SRA from wrong program year or no SRA completed at all (SRA must be from 2018 for PY2018) Supporting documentation numbers do not match numbers entered into MAPIR (PEL and CEHRT Report) Objective 8: Patient Electronic Access Objective 9: Secure Messaging http://chatter.uconn.edu/ehr-incentive-program/ep/sd/

Common Errors: Patient Electronic Access Objective Objective 8 (Stage 2) Provide patients the ability to view online, download, and transmit their health information within 4 business days of the information being available to the EP. Providers that have trouble meeting this measure may use all 365 days worth of data for the numerator and a denominator from their 90 days. Providers may send information to patients during their appointment and have the patient open the information on their own devices. Measure 1: More than 50% of all unique patients seen by the EP during the EHR reporting period are provided timely access to view online, download, and transmit to a third party their health information subject to the EP’s discretion to withhold certain information Measure 2: For an EHR reporting period in 2018, more than 5% of unique patients seen by the EP during the reporting period view, download or transmit to a third party their health information during the reporting period.

Common Errors: Patient Electronic Access Objective (cont’d) Objective 5(Stage 3): Patient Electronic Access The EP provides patients with timely electronic access to their health information and patient-specific education Measure 1: For more than 80% of all unique patients seen by the EP: The patient is provided timely access to view online, download and transmit his/her health information; and The provider ensures the patient’s health information is available for the patient to access using any application of their choice that is configured to meet the technical specs of the Application Programming Interface (API) in the provider’s CEHRT Measure 2: The EP must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide electronic access to those materials to more than 35% of unique patients seen by the EP during the EHR reporting period.

Common Errors: Secure Messaging Objective Objective 9 (Stage 2) Use secure electronic messaging to communicate with patients on relevant health information. Providers that have trouble meeting this measure may use all 365 days worth of data for the numerator and a denominator from their 90 days. Providers need only send secure messages. The messages do not need to be opened by the patient. For more than 5% of unique patients seen by EP during reporting period, a secure message was sent using the electronic messaging function of CEHRT to the patient or in response to a secure message sent by the patient during the EHR reporting period. Exclusion: Any EP who has no office visits during the reporting period.

More Information Center for Medicaid and Medicare Service website (cms.gov) UConn HIT support website (AIMS) Department of Social Services (ctdssmap.com) If you have questions that those sites cannot answer contact: For MAPIR technical issues: DXC ctmedicaid-ehr@dxc.com 1 (855) 313-6638 For program and attestation issues: UConn HIT staff ctmedicaidehr@uconn.edu 1 (844) 607-7455. https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/index.html?redirect=/ehrincentiveprograms/ http://chatter.uconn.edu/ehr-incentive-program/ https://www.ctdssmap.com/CTPortal/Provider/EHRIncentiveProgram/tabid/55/Default.aspx

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