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Meaningful Use Registration & Attestation WV HFMA / WVHIMSS Fall Conference The Changing Seasons of Healthcare September 26-28, 2012.

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Presentation on theme: "Meaningful Use Registration & Attestation WV HFMA / WVHIMSS Fall Conference The Changing Seasons of Healthcare September 26-28, 2012."— Presentation transcript:

1 Meaningful Use Registration & Attestation WV HFMA / WVHIMSS Fall Conference The Changing Seasons of Healthcare September 26-28, 2012

2 Objectives 1.Understand steps to register – EH & EP 2.Understand steps to attest – EH & EP 3.Understand differences between Medicare and Medicaid for registration & attestation 4.Understand resources available to assist you 9/28/12 Kimberly F. Clarke, FHIMSS, CPHIMS 2

3 Registration – Eligible Hospital (EH) 9/28/12 Kimberly F. Clarke, FHIMSS, CPHIMS 3

4 Registration - EH  Obtain registration guide from CMS http://www.cms.gov/Regulations-and- Guidance/Legislation/EHRIncentivePrograms/RegistrationandAttestati on.html  There is a separate registration guide for EH’s & EP’s  You will need your hospital NPI number  You can apply for an NPI # through NPPES  You will need your hospital CCN (CMS Certification Number 9/28/12 Kimberly F. Clarke, FHIMSS, CPHIMS 4

5 Registration - EH  You must have an I&A (Identity & Access Mgmt) user web account to register.  You can register for one through the I&A website  A link is available in the CMS EH Registration Guide  EHR Certification Number. This is optional for the registration but is required during attestation. http://oncchpl.force.com/ehrcert 9/28/12 Kimberly F. Clarke, FHIMSS, CPHIMS 5

6 Registration - EH  You can register for Medicare and Medicaid incentive programs at the same time if:  You are a sub-section(d) hospital in the 50 U.S. States or the District of Columbia or CAH; and  You have a CMS Certification Number ending in 0001-0879 or 1300-1399; and  You have at least 10% Medicaid patient volume  Email address – the address entered during registration is where the registration confirmation will be sent. 9/28/12 Kimberly F. Clarke, FHIMSS, CPHIMS 6

7 Registration - EH  Print the registration confirmation receipt – retain for your records  EHR Incentive Program Information Center at 888-734-6433 9/28/12 Kimberly F. Clarke, FHIMSS, CPHIMS 7

8 Registration – Eligible Providers (EP) 9/28/12 Kimberly F. Clarke, FHIMSS, CPHIMS 8

9 Registration - EP  Obtain registration guide from CMS http://www.cms.gov/Regulations-and- Guidance/Legislation/EHRIncentivePrograms/RegistrationandAttestati on.html  There is a separate EP registration guide for Medicare & Medicaid  Medicare EPs  Doctor of Medicine or Osteopathy  Doctor of Dental Surgery or Dental Medicine  Doctor of Podiatric Medicine  Doctor of Optometry  Chiropractor 9/28/12 Kimberly F. Clarke, FHIMSS, CPHIMS 9

10 Registration - EP  Medicaid EPs  Physicians  Nurse Practitioner  Certified Nurse Midwife  Dentist  PAs who practice in a Federally Qualified Health Center (FQHC) or Rural Health Center (RHC) PLUS…  20% Medicaid volume if Pediatric based  30% Medicaid volume – all others 9/28/12 Kimberly F. Clarke, FHIMSS, CPHIMS 10

11 Registration - EP  A provider can attest for the Medicare OR Medicaid incentive program - not both  Medicaid – NLR & State  Delay of ~48 hours for registration to flow to state registration system for approval  Email address – the address entered during registration is where the registration confirmation for the provider will be sent. 9/28/12 Kimberly F. Clarke, FHIMSS, CPHIMS 11

12 Registration - EP Steps to determine EP Incentive Program Eligibility 1.Identify timeframe to Attest 2.Run claims data for the same time period but from the previous year. 3.Determine if provider is hospital based a.If => 90% activity hospital based, do not qualify as EP b.Based on place of service (POS) code on claims (21-Inpatient, 23-Emergency Dept) 9/28/12 Kimberly F. Clarke, FHIMSS, CPHIMS 12

13 Registration - EP 4.Calculate percent Medicare volume 5.Calculate percent Medicaid volume 6.Identify incentive program for provider  To register you will need  Provider PECOS / NPPES login  Provider NPI  Group practice NPI  I&A web account (each provider) 9/28/12 Kimberly F. Clarke, FHIMSS, CPHIMS 13

14 Registration – Lessons Learned  Save EVERYTHING!  Registration Confirmations  Data to determine program eligibility for providers  All information used to register  Provider consent to register/attest on his/her behalf  EH registration – easy; straightforward 9/28/12 Kimberly F. Clarke, FHIMSS, CPHIMS 14

15 Registration – Lessons Learned  EP Registration – not so easy   Begin collecting all PECOS logins EARLY  Character length of PECOS passwords changed so may have to log in to I&A system to reset password Provider must do this – it takes time!  Obtain signed consent from provider to register and attest on provider’s behalf Audits… 9/28/12 Kimberly F. Clarke, FHIMSS, CPHIMS 15

16 Registration – Lessons Learned  EP Registration – continued  Register all EPs as soon as possible. You can register as Medicare until you have your claims data Validates provider PECOS login Once provider incentive program determined, update registration to the correct program Prior to attestation, you can change between Medicaid and Medicare as many times as you need to After attestation, you can only switch the program ONE TIME  Easier to identify a specific timeframe to attest so claims data can be run – streamlines process 9/28/12 Kimberly F. Clarke, FHIMSS, CPHIMS 16

17 Registration – Lessons Learned  EP Registration – continued  Implement a process to track data and progress for each provider 9/28/12 Kimberly F. Clarke, FHIMSS, CPHIMS 17

18 Attestation – Eligible Hospital (EH) 9/28/12 Kimberly F. Clarke, FHIMSS, CPHIMS 18

19 Attestation - EH  Obtain attestation user guide from CMS http://www.cms.gov/Regulations-and- Guidance/Legislation/EHRIncentivePrograms/RegistrationandAttestati on.html  Medicare Attestation  If qualify for Medicare & Medicaid, attest for Medicare Will be deemed meaningful users for Medicaid  Medicare calculates a payment amount; Medicaid calculates a total amount that States may pay eligible hospitals. 9/28/12 Kimberly F. Clarke, FHIMSS, CPHIMS 19

20 Attestation - EH  Numerator & Denominator for Objectives & Quality Measures Worksheet on CMS website (link on previous page)  Attestation steps through each objective and quality measure (QM)  Summary of attestation for each objective & QM 9/28/12 Kimberly F. Clarke, FHIMSS, CPHIMS 20

21 Attestation - EH  Medicaid Attestation – data required  Workbook on MMIS website http://www.wvmmis.com/welcome.screen  Data from cost reports  Total # of discharges for the past 4 years (FFY) Does not include Observ, ED or Newborn  Total # of discharges for the most recent fiscal year  Total # of inpatient bed days for most recent fiscal year  Total # Medicaid inpatient (indemnity) days for most recent fiscal year 9/28/12 Kimberly F. Clarke, FHIMSS, CPHIMS 21

22 Attestation - EH  Total # of hospital charges for most recent fiscal year  Total # of Charity care charges for most recent fiscal year  Data from cost reports is used to calculate average annual growth rate and the Medicaid incentive payment calculation  Summary of calculated payments provided 9/28/12 Kimberly F. Clarke, FHIMSS, CPHIMS 22

23 Attestation – Eligible Provider (EP) 9/28/12 Kimberly F. Clarke, FHIMSS, CPHIMS 23

24 Attestation - EP  Obtain attestation user guide from CMS http://www.cms.gov/Regulations-and- Guidance/Legislation/EHRIncentivePrograms/RegistrationandAttestati on.html  The more providers, the more complex the process  Medicaid – straightforward for first year  AIU 9/28/12 Kimberly F. Clarke, FHIMSS, CPHIMS 24

25 Attestation - EP  Medicare – more prep work involved  Determination of quality measures for provider  If multi-specialty practice, consider QMs that apply to all providers in the specialty practice  Process to track QMs to attest to per provider  Medicaid  First year  AIU  Need claims data – same data gathered to determine if EP eligible for Medicaid incentives 9/28/12 Kimberly F. Clarke, FHIMSS, CPHIMS 25

26 Attestation - EP  Claims data entered as part of attestation  Attest through the WV MMIS (Molina) website  After attestation, takes approximately 48 hrs. to get status on attestation  Must keep checking the website for your list of providers to check their status  If claims data entered differs from the state’s claims data by more than 10%, attestation is rejected 9/28/12 Kimberly F. Clarke, FHIMSS, CPHIMS 26

27 Attestation - EP  WV Medicaid uses total of paid claims + reversed claims Do not include CHIP Do not include Carelink Do not include UniCare Do not include HealthPlan 9/28/12 Kimberly F. Clarke, FHIMSS, CPHIMS 27

28 Attestation – Lessons Learned  Save EVERYTHING!  Screen shots of attestations  Attestation confirmations  Proof of objectives requiring a yes/no attestation  Data extracted from certified EHR (numerator / denominator) and detail behind the numbers  Test plan/scripts to validate MU data  System design/build required to meet MU  Certified EHR vendor supporting documentation 9/28/12 Kimberly F. Clarke, FHIMSS, CPHIMS 28

29 Attestation – Lessons Learned  Take advantage of the MMIS and CMS help desks  Have cost report data ready prior to starting attestation for Medicaid (EH)  Medicaid Attestation – EPs  Check MMIS incentive attestation site regularly to confirm status of attestation  Use the MMIS “EDI Help Desk” to clarify reasons for rejected attestations 9/28/12 Kimberly F. Clarke, FHIMSS, CPHIMS 29

30 Attestation – Lessons Learned  Medicaid Attestation – Eps (continued)  Check MMIS incentive attestation site regularly to confirm status of attestation  Use the MMIS “EDI Help Desk” to clarify reasons for rejected attestations  If first year, determine the 90 day attestation period for the providers. Streamlines process – alleviates a lot of rework. 9/28/12 Kimberly F. Clarke, FHIMSS, CPHIMS 30

31 Resources  CMS Registration & Attestation Link http://www.cms.gov/Regulations-and- Guidance/Legislation/EHRIncentivePrograms/RegistrationandAttestati on.html  NPPES Help Desk (800) 465-3203 https://nppes.cms.hhs.gov/NPPES/Welcome.do  PECOS Help Desk (866) 484-8049 https://pecos.cms.hhs.gov/  WV Medicaid Molina EDI Help Desk 1-888-483-0793 (have your NPI# ready, then press selection “6”) edihelpdesk@molinahealthcare.comedihelpdesk@molinahealthcare.com 9/28/12 Kimberly F. Clarke, FHIMSS, CPHIMS 31

32 Resources  CMS FAQs http://www.cms.gov/Regulations-and- Guidance/Legislation/EHRIncentivePrograms/FAQ.html  Sign up for notifications when new FAQs or clarifications are posted! 9/28/12 Kimberly F. Clarke, FHIMSS, CPHIMS 32

33 9/28/12 33 Kimberly F. Clarke, FHIMSS, CPHIMS


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