1. Utah PRISM Project - Release 3 and ICD-10 Nursing Home Association Meeting 4/20/2015 Presented By: Division of Medicaid and Health Financing

2. Design, Development, and Implementation –March 2013 to March 2017 –Four Releases Release 1 (New Medicaid Website and Eligibility Lookup Tool) –Completed March 30, 2014 Release 2 (HealthBeat) –Completed August 1, 2014 Release 3 (Provider Portal and Enrollment, eMIPP, Provider Credentialing Service) –December 2015 Release 4 (Remaining MMIS) –Summer 2017 PRISM Project Overview

3. Release 3 is planned for December 2015 Three Major Components: 1.Provider Enrollment 2.Provider Credentialing Services (which is part of Provider Enrollment) 3.eMIPP (Electronic Medicaid Incentive Payment Processing) New Medicaid Providers: -Enroll online using PRISM Current Medicaid Providers: -Existing enrollment information will be converted to PRISM -Providers will need to validate their enrollment information and make any needed changes to their information using PRISM This will occur in the stages prior to Release 4 -Providers will be notified when they need to access PRISM to validate their enrollment information Claims will still be paid out of the Legacy MMIS until Release 4 (Summer 2017) PRISM Release 3 - Overview

4. The Provider Portal houses data to manage and maintain the status of all providers paid through and/or reporting services rendered to Medicaid members. Release 3 Providers enroll online Automated business processes Includes automated Provider Credentialing Services Includes Kofax®, imaging software for managing faxes in PRISM Includes Siebel, a customer relationship management (CRM) system used to capture notes from callers PRISM Release 3 – Provider Enrollment

5. Provider Credentialing Services (PCS) provides a real-time one- stop provider credentialing solution for complying with the ACA Provider Enrollment Screening requirement. Automatically checks various databases simultaneously to see if the provider has a valid license, and/or any sanctions, criminal charges, etc. Available in real-time for the provider enrollment specialist to review and make appropriate decisions Provides improved automation and reduced manual intervention PRISM Release 3 – Provider Credentialing Services

6. Electronic Medicaid Incentive Payment Processing (eMIPP) supports federal incentive payment programs to encourage providers and hospitals to adopt, implement, or upgrade certified electronic health record technology and use it in a meaningful manner. eMIPP will replace the current HIT (Health Information Technology) program PRISM Release 3 - eMIPP

7. PRISM Release 3 – Implementation Activities Provider Outreach Medicaid Information Bulletin (MIB) article in February introducing Release 3 functionality, PRISM webpages and prism@utah.gov email prism@utah.gov Attending meetings to solicit providers to participate in system testing (primarily), message input, and material review Provider review of training materials: June and July 2015 Provider testing: September 2015 Release 3 messages on the PRISM webpages Statewide Provider Training: July 28 – October 1 July and October MIB articles

8. ICD-10 is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD), a medical classification list by the World Health Organization (WHO). DMHF is on target to process claims for the October 1, 2015 ICD-10 deadline System testing will occur June – September An ICD-10 article has been included in the April MIB ICD-10

9. Provider participation is primarily requested for: Assistance with System Testing ICD-10: June through September 2015 PRISM Release 3: September 2015 Provider participation is also requested for: Input into Messaging for PRISM, Release 3 Ideas on how to word messages to providers Where the messages should be delivered (e.g., MIB article, other communication tool) April – November, intermittently with minimal time commitment Material Review for PRISM, Release 3 MIB articles, training materials, etc. April – November, intermittently with minimal time commitment PRISM Release 3 and ICD-10 Provider Participation

10. PRISM Release 3 and ICD-10 Implementation Timeline Implementation Timeline and Summary of Activities PRISM R3 ICD-10 April May June July August September October November December R3 UAT Provider Testing: September R3 Provider Training: Oct - Nov R3 Go- Live: Dec 2015 ICD-10 Provider Testing: June - September ICD-10 Go-Live: Oct 2015

11. If interested in participating in system testing for PRISM Release 3, or for questions about PRISM, contact: Email: prism@utah.govprism@utah.gov If interested in participating in system testing for ICD-10, contact: Email: utahmedicaidicd10@utah.govutahmedicaidicd10@utah.gov Participation will be greatly appreciated & beneficial to the implementation of the new systems. PRISM Release 3 and ICD-10