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Nevada Medicaid EHR Incentive Program – FAQ for Ambulatory Setting

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Presentation on theme: "Nevada Medicaid EHR Incentive Program – FAQ for Ambulatory Setting"— Presentation transcript:

1 Nevada Medicaid EHR Incentive Program – FAQ for Ambulatory Setting

2 Information & Handouts
Accessing Handouts and Supporting Documents Asking Questions & Getting Answers

3 Agenda Medicaid Incentive FAQ Brief Q&A

4 Recap of First Webinar Eligibility and Incentives
Registering for PECOS Visit HealthInsight Event page to download the recorded webinar session: First Webinar from last Weds July 11th.

5 What Incentives are Available
Medicare OR Medicaid Incentives Available to Providers Eligible Providers may participate in only ONE of the two programs Medicaid Incentives may be paid out over 6 years. These years DO NOT have to be consecutive. Max $63,750 over 6 years First year $21,250 per provider $8,500 each subsequent year payment Year 1 2011 – 2016 Year 2 Year 3 Year 4 Year 5 Year 6 Total $21,250 $8,500 $63,750

6 When are Incentives Available
Nevada Medicaid EHR Incentive Program is currently scheduled to launch early August Expect Year 1 payment 4-6 weeks after attestation for Adoption, Implementation or Upgrade (AIU) Medicaid Incentive Payments will be made up to 2021

7 What is needed to Qualify for Incentives Year 1 Stage 1
Be active and in good standing with Nevada Medicaid Be a Medicaid Eligible Provider Not hospital-based MD, DO, PA*, NP, Certified Nurse Midwife, DDS Have a 20% - 30% Medicaid Patient Volume 30% patient volume attributable to Medicaid or needy individual 20% Medicaid for Pediatricians Adopt, Implement or Upgrade to a Certified EHR Solution Have a valid PECOS Username and Password for each provider

8 Qualifying for A,I,U What do I need to prove AIU to attest (Adopt, Implement & Upgrade)? EPs and EHs will need to be prepared to provide information and documentation about their EHR adoption efforts at the time of attestation including: EHR Certification Number which can be found at Medicaid Patient Volume Information including Numerator and Denominator Signed letter on practice letterhead stating Adopt, Implement or Upgrade methodology being used and how efforts support this methodology Copy of Purchase Order, Contract, Service Agreement, etc to prove the purchase or acquisition of a Certified EHR.

9 Calculating Patient Volume
Eligible Providers must have: 30% Patient Volume attributable to Medicaid 20% Patient Volume attributable to Medicaid for Pediatricians Patient Volume is computed on a 90-day period in the prior calendar year Any encounter an eligible professional has with a Medicaid recipient (whether it’s paid through a capitated arrangement with an MCO plan or fee-for-service claim to the Medicaid System) can and should be included in the patient volume calculation This includes Advantage Plans (such as Amerigroup) This includes border state Medicaid (such as MediCAL)

10 Do I need to have an EHR in place to register for the Medicaid EHR Incentive Program?
You may begin the registration process at CMS while you are evaluating the appropriate EHR for your office. However, you must demonstrate adoption, implementation, or a technology upgrade prior to receiving a Nevada Medicaid incentive payment.

11 How do I determine whether an EHR system has been approved for the incentive program?
CHPL web site ONC-ATCB certified CMS EHR Certification Number (screenshot)





16 How do I register in PECOS
PECOS - Provider Enrollment Chain and Ownership System Each provider will required to register individually

17 Register for Incentive Programs
Once a valid PECOS ID is obtained you will register using the Medicare and Medicaid EHR Incentive Program Site to indicate your intent to participate in Nevada Medicaid EHR Incentive Program

18 Can I enroll in both the Nevada Medicaid EHR Incentive Program and the Medicare EHR Incentive Program? No. Eligible Professionals must select either the Medicare or Medicaid Incentive Program. No Eligible Professional may participate in both.

19 Can I switch between the Medicare and Medicaid EHR Incentive Programs?
Eligible Professionals may change their EHR Incentive Program election once, but such change in election must occur before the end of Calendar 2014.

20 Can I continue to participate in the Nevada EHR Incentive Program even if I change practices mid-year?   Payment schedules are tied to the individual Eligible Professional not the practice. Therefore if an Eligible Professional leaves or arrives at a facility, the Eligible Professional may still participate, provided eligibility criteria is still met. This also applies to all Eligible Professionals who are transferring over state lines.

21 I work in a group practice
I work in a group practice. Is each provider in the practice eligible for incentive payments or do payments apply to the practice as a whole? The incentive program is based on the eligibility of individual practitioners, or eligible professionals(EPs), not the group practice. Each EP in your group will need to apply as an individual provider, although you may be able to attest to your Medicaid patient volume threshold as a group if you meet the criteria.

22 I have a group practice. How will I register and enroll the physicians in the group?
When setting up a group, the following guidelines apply: All participating members must agree to attest to patient volume as a group when they complete their individual enrollment process. All providers that are to be part of the group must be registered with CMS for the EHR Incentive program. If your group will be using the group patient volume methodology as a proxy for the EPs in the group, all Medicaid encounters can be used, even encounters with non-eligible providers.

23 I have a group practice. How will I register and enroll the physicians in the group? (Cont.)
If an eligible professional (EP) chooses not to participate in the group/clinic, the encounters generated by that EP are still used in the calculation for that particular group/clinic. The EP cannot use those encounters for calculating volumes for another practice or individually. The group will need to appoint one person to act as the designated lead enroller who will enroll the group at the state level. Then the individuals will attest to the group volumes and other criteria to complete the process.

24 Can I attest to Meaningful Use in year one even though AIU is all that is required?
No, in Payment Year 1 all Medicaid Incentive Participants have to attest to AIU requirements Clinical Compliance is not required in Year 1

25 What will the attestation process look like? How do I attest
Medicaid EHR Incentive Program Registration and Attestation is primarily a web based process. While certain supporting documents may be submitted via standard postal mail delivery methods participants will have to conduct a majority of the registration and attestation on-line. As the launch date for the Nevada Medicaid EHR Incentive Program approaches more specific instructions will be provided. 

26 Webinar Schedule HealthInsight will be hosting a series of Webinars through the month of July that will help to explain the Medicaid Incentive Requirements and the Registration and Attestation Process. Past Sessions July 11th & July 18th at 11am Future Sessions: July 25th at 12 pm – Registration/Attestation Process August 1st at 1pm – Repeat of Registration/Attestation Process

27 State of Nevada Medicaid
Contact Information HealthInsight State of Nevada Medicaid Erick Maddox Eileen Colen Catelyn Nguyen Nevada Medicaid Provider Support

28 Links & Resources HealthInsight: PECOS: Incentive Registration: CMS Medicaid FAQ: Nevada Medicaid FAQ: EHR Certification Information:

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