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Meaningful Use
Last Updated: September 23, 2011
Year 1, Stage 1 MU
• Information contained in this presentation pertains only to Year 1, Stage 1 of Meaningful Use
• Information was obtained from the CMS website and the IHS website
• All information is based on the Final Rule. (http://edocket.access.gpo.gov/2010/pdf/2010-17207.pdf)
Today’s Objectives
• Meaningful Use• EHR Certification• Eligible Professionals & Eligible Hospitals
• Incentives/Penalties• Patient Volume• Performance Measures• Clinical Quality Measures
• MU Resources• MU Reports• CMS Incentive Program Registration• Contacts
Electronic Health Record (EHR) Incentive Program Overview
MEANINGFUL USE
What is Meaningful Use?
• Meaningful Use is using certified EHR technology to:
• Improve quality, safety, efficiency, and reduce health disparities
• Engage patients and families in their health care
• Improve care coordination• Improve population and public health• All the while maintaining privacy and security
MEDICAREEHR Incentive Program
MEDICAIDEHR Incentive Program
Implemented by the Federal Government and started January 3, 2011
Voluntary for States to implement - Most are expected to start by late summer 2011
Program ends in 2016 Must initiate participation by 2014Must participate by 2012 to receive the maximum incentive payment
Program ends in 2021Must initiate participation by 2016Must participate by 2016 to receive the maximum incentive payment
Medicare payment reductions begin in 2015 for EH/EPs who do not demonstrate MU of certified EHR technology
No Medicaid payment reductions
Must demonstrate MU in Year 1 over a consecutive 90-day report period
A/I/U option for Year 1
No patient volume requirement Must meet patient volume thresholds
Meaningful Use: Definition of A/I/U
• Adopt: Acquire, purchase, or secure access to certified EHR technology
• Implement: Install or commence utilization of certified EHR technology capable or meeting MU requirements
• Upgrade: Expand the available functionality of certified EHR technology capable of meeting MU requirements at the practice site, including staffing, maintenance, and training or upgrade from existing EHR technology to certified EHR technology per the ONC EHR certification criteria
Meaningful Use: State Options
• May add 4 additional core performance measures:• Generate lists of patients by specific conditions for quality
improvement, reduction of disparities, research, or outreach (can specify particular conditions)
• Reporting to immunization registries• Reportable lab results• Syndromic surveillance (can specify for their providers how to
test the data submission and to which specific destination)
• May propose a different Patient Volume method is used instead of or in addition to the CMS-defined methods
NOTE: CMS must review and approve all performance measure and patient volume changes
Meaningful Use: Stages of Meaningful Use
• 3 stages of Meaningful Use• Requirements will increase over time…more work
lies ahead
Stage 12011-2012
Stage 22013-2014
Stage 32015+
EHR CERTIFICATION
EHR Certification: Process
Creates EHR Certification Test
Creates EHR Certification Requirements
Creates MU Requirements
Authorized Testing and Certification Body
EHR Certification: Key Points
• A certified EHR is required to demonstrate meaningful use
• EHR Certification demonstrates that the EHR is standardized and interoperable
• RPMS-EHR was certified by InfoGard on April 1, 2011
• The certified version RPMS-EHR was released in June 2011
• Further enhancements ongoing.
• The EHR certification number can be obtained at: http://onc-chpl.force.com/ehrcert
Name Space
Package or Application Version Patch Release Date
AG Patient Registration 7.1 9 12/3/10APCL Export 3.0 27 11/10/10APSP Pharmacy MOD-ePrescribing (eRx) 7.0 1010 4/29/11BGP Clinical Reporting System (CRS) 11.0 3 6/22/11
BJMD C32 1.0 1 6/24/11BJPC PCC Mgmt Reporting 2.0 6 6/2/11BMC Referred Care Information System
(RCIS)4.0 7 5/12/11
BQI iCare 2.1 3/11/11BRN Release of Information (ROI) 2.0 3 4/13/11BYIM Immunization Exchange Message 2.0 01 2/24/11BGO Electronic Health Record (EHR) 1.1 8 06/10/11LR Lab 5.2 1027 or 372 or 334 12/07/10
PXRM EHR Reminders 1.5 1007 4/13/10BPHR Personal Health Record (PHR) 1.0 6/22/11
Central Ensemble 2009.1.6 921.0.10414 2011GuardianEdge/ Symantec 8.0 3/31/11IPSEC (Windows) 2010VanDyke (AIX) 2010WinHasher 1.6 2011Universal Client or HIE Viewer The URL to access the application is http://ditdev4.d1.na.ihs.gov:9090/DocViewer
1.0 4/27/11
EHR Certification: EHR Certification Number*
• Inpatient Certification #: 30000002ELL6EAI
• Ambulatory Certification #: 0000002EJKDEAI
*The number will be entered during CMS registration and attestation
EHR Certification: Vendor Letter
• Request Vendor Letter on the IHS MU website at http://www.ihs.gov/meaningfuluse/index.cfm?module=steps_request_letter
• Enter information in each of the fields on the webpage• Click the “Submit” button• IHS will process the request for each facility• IHS will issue a letter to the requesting practice within 10
business days of the initial request• The facility will receive the signed IHS EHR Vendor
Letter via email• The letter will be emailed to the individual that made the
request
ELIGIBLE PROFESSIONALS
Eligible Professionals: Medicare & Medicaid Comparison
Medicare-only Eligible Professionals
Could be eligible for both Medicare &
Medicaid incentives
Medicaid-only Eligible Professionals
Professionals may be eligible for both Medicare & Medicaid, but can only
participate in one program at a time
Eligible Professionals: Overview
• Must choose the Medicare OR Medicaid incentive program; not eligible for both
• Payments for Eligible Professionals are based on a calendar year
• Incentives are based on the individual, not the practice
• Hospital-based EPs are NOT eligible for incentives
• 90% or more of their covered professional services in either an inpatient or emergency room (Place of Service codes 21 or 23) of a hospital
• Eligibility determined by law
• EPs may switch programs anytime prior to first payment
• After an EP receives a payment they may switch one time before 2015
Eligible Professional: Incentive Program Timeline
CY 2011 CY 2012
01/01/11 First day of calendar & EHR reporting year 01/01/12
09/30/11LAST day to establish clean-date for the Medicare
Incentive Program09/30/12
10/03/11LAST day to begin 90-day reporting period for
the Medicare Incentive Program10/01/12
12/31/11 Last day of calendar & EHR reporting year 12/31/13
02/29/12LAST day to register & LAST day to attest
02/28/13
ELIGIBLE PROFESSIONALS & MEDICAID
Eligible Professionals & Medicaid: Participation Requirements
• Year One• A/I/U• Meet patient volume threshold (previous year)
• Year Two+• Meet MU Requirements• Meet patient volume threshold (previous year)
Note: Medicare does not have a patient volume threshold
Eligible Professionals & Medicaid: Patient Volume Threshold
Eligible Professional (EP)
If EP does not practice predominantly at
FQHC/RHC: Minimum Medicaid patient
volume thresholds
If EP does practice predominantly at
FQHC/RHC*: Minimum needy individual patient volume thresholds
Physicians 30% 30%
- Pediatricians 20% 30%
Dentists 30% 30%
Certified Nurse-Midwives
30% 30%
NPs 30% 30%
PAs practicing at an FQHC/RHC that is led by a PA
N/A 30%
* All Tribal clinics are deemed FQHC/RHC for the CMS incentive program
Eligible Professionals & Medicaid: Medicaid Encounter
• For calculating Medicaid patient volume, a “Medicaid encounter” means services rendered to an individual on any one day where Medicaid (or a Medicaid demonstration project approved under section 1115 of the Act) paid for all or part of:
• The service; or
• Their premiums, co-payments, and/or cost-sharing
• Patient volume calculation options include: • Individual EP• Group Practice• Patient panel*
Eligible Professionals & Medicaid: Needy Patient Encounter
• For calculating needy individual patient volume, a “needy patient encounter” means services rendered to an individual on any one day where:• Medicaid or CHIP (or a Medicaid or CHIP demonstration project
approved under section 1115 of the Act) paid for all or part of:• The service; or• Their premiums, co-payments, and/or cost-sharing; or
• The services were furnished at no cost; or• The services were paid for at a reduced cost based on a sliding
scale determined by the individual’s ability to pay
• Patient volume calculation options include: • Individual EP
• Group Practice
• Patient panel*
ELIGIBLE PROFESSIONALS INCENTIVES
Eligible Professionals: Summary of Medicare & Medicaid Incentives
MEDICARE MEDICAID
Incentives Start
CY 2011 CY 2011
IncentivesEnd
CY 2016(max. 5 years, must start
by 2014)
2021(max. 6 years, must start
by 2016)
Incentive Amount
•Up to $44,000 total per provider
•Based on % Medicare claims
•Additional 10% bonus for EP’s in HPSAs
•Up to $63,750 total per provider
Reimbursement Reduced
CY 2015 No penalties
Eligible Professionals: Medicare Incentive Payments
• Incentive amount based on 75% Fee-for-Service allowable charges
• Maximum incentive is $44,000 over 5 years
• Extra 10% bonus amount available for practicing predominantly in a Health Professional Shortage Area (HPSA)
• HPSA identifies, by zip code or county, areas lacking sufficient clinicians to meet primary care needs
• Incentives decrease if starting after 2012
• Must begin by 2014 to receive incentive payments
• Last payment year is 2016
• Receive one (1) incentive payment per year
Eligible Professionals: Medicare Incentive Payment Example
Amount of Payment Each Year of Participation
Calendar Year EP Receives a Payment
CY 2011 CY 2012 CY 2013 CY2014CY 2015 and later
CY 2011 $18,000
CY 2012 $12,000 $18,000
CY 2013 $8,000 $12,000 $15,000
CY 2014 $4,000 $8,000 $12,000 $12,000
CY 2015 $2,000 $4,000 $8,000 $8,000 $0
CY 2016 $2,000 $4,000 $4,000 $0
TOTAL $44,000 $44,000 $39,000 $24,000 $0
Eligible Professionals: Medicaid Incentive Payments
• Maximum incentive is $63,750 over 6 years
• The first year payment is $21,250
• No extra bonus for health professional shortage areas available
• Incentives are same regardless of start year
• Must begin by 2016 to receive incentive payments
• Incentives available through 2021
• Receive one (1) incentive payment per year
Eligible Professionals: Medicaid Incentive Payment Example
Amount of Payment Each Year if Continues Meeting Requirements
1st Calendar Year EP Receives a Payment
CY 2011 CY 2012 CY 2013 CY 2014 CY 2015 CY 2016
CY 2011 $21,250
CY 2012 $8,500 $21,250
CY 2013 $8,500 $8,500 $21,250
CY 2014 $8,500 $8,500 $8,500 $21,250
CY 2015 $8,500 $8,500 $8,500 $8,500 $21,250
CY 2016 $8,500 $8,500 $8,500 $8,500 $8,500 $21,250
CY 2017 $8,500 $8,500 $8,500 $8,500 $8,500
CY 2018 $8,500 $8,500 $8,500 $8,500
CY 2019 $8,500 $8,500 $8,500
CY 2020 $8,500 $8,500
CY 2021 $8,500
TOTAL $63,750 $63,750 $63,750 $63,750 $63,750 $63,750
Eligible Professionals: Incentive Payments
• IHS EP’s must re-assign incentive payments to their facility; Tribal EPs should consult with their Tribal/facility leadership
• EP’s who achieve MU by combining services from multiple sites or states, may only assign their payment to one entity in one state
• Medicare payments, in the first year of demonstrating MU, a payment will be made when the EP reaches his/her minimum allowable charges or the end of the year, whichever comes first
• Medicaid payments, in the first year, will be issued within 5 months after registering
ELIGIBLE PROFESSIONALSPERFORMANCE MEASURES & CLINICAL QUALITY MEASURES
Eligible Professionals: Meaningful Use Requirements
STAGE 1: Meaningful Use Requirements
• 20 total Performance Measures• 15 core performance measures*• 5 performance measures out of 10 from menu set*
• 6 total Clinical Quality Measures• 3 core or alternate core clinical quality measures• 3 clinical quality measures out of 38 from menu set
* Most measures require achievement of a performance target
1. >30%: Computerized physician order entry (CPOE):
2. >40%: E-Prescribing (eRX)
3. Yes/No: Report ambulatory clinical quality measures to CMS or States
4. Yes/No: Implement one clinical decision support rule
5. >50%:Provide patients with an electronic copy of their health information, upon request
6. >50%: Provide clinical summaries for patients for each office visit
7. Yes/No:Implement drug-drug and drug-allergy interaction checks during the entire EHR reporting period
8. >50%: Record demographics
9. >80%: Maintain an up-to-date problem list of current & active diagnoses
10. >80%: Maintain active medication list
11. >80%: Maintain active medication allergy list
12. >50%: Record and chart changes in vital signs
13. >50%: Record smoking status for patients 13 years or older
14. Yes/No: Capability to exchange key clinical information (Test Performed)
15. Yes/No: Conduct or review a security risk analysis
Eligible Professionals: 15 Core Performance Measures
1. Yes/No: Implement drug-formulary checks for entire EHR reporting period
2. >40%: Incorporate clinical lab test results as structured data
3. Yes/No: Generate lists of patients by specific conditions
4. >10%:Use certified EHR technology to identify patient-specific education resources and provide to patient, if appropriate
5. >50%: Medication reconciliation at transitions of care
6. >50%: Summary of care record for each transition of care/referrals
7. Yes/No:Capability to submit electronic data to immunization registries/systems* (Test Performed)
8. Yes/No:Capability to provide electronic syndromic surveillance data to public health agencies* (Test Performed)
9. >20%:Send reminders to patients per patient preference for preventive/follow up care
10. >10%:Provide patients with timely electronic access to their health information (within 4 business days)
*At least 1 public health measure must be selected
Eligible Professionals: 10 Menu Performance Measures (Pick 5)
Eligible Professionals: Clinical Quality Measures
Core Set: If denominator = 0, must report on the Alternate Core measures
NQF Measure Number & PQRI Implementation Number
Clinical Quality Measure Title
NQF 0013 Hypertension: Blood Pressure Measurement
NQF 0028 Preventive Care and Screening Measure Pair: a) Tobacco Use Assessment, b) Tobacco Cessation Intervention
NQF 0421PQRI 128
Adult Weight Screening and Follow-up
NQF Measure Number & PQRI Implementation Number
Clinical Quality Measure Title
NQF 0024 Weight Assessment and Counseling for Children and Adolescents
NQF 0041PQRI 110
Preventive Care and Screening: Influenza Immunization for Patients 50 Years Old or Older
NQF 0038 Childhood Immunization Status
Alternate Core Set
Eligible Professionals: 38 Additional Clinical Quality Measures (Choose 3)
• Diabetes: (9)• Heart Failure (HF): (3)• Coronary Artery Disease (CAD): (3)• Pneumonia Vaccination Status for Older Adults• Anti-depressant medication management: (2)• Primary Open Angle Glaucoma (POAG): Optic Nerve Evaluation• Asthma: (3)• Appropriate Testing for Children with Pharyngitis• Cancer Prevention and/ or Oncology: (6)• Smoking and Tobacco Use Cessation,(3)• Ischemic Vascular Disease (IVD): (3)• Initiation and Engagement of Alcohol and Other Drug Dependence Treatment: (2)• Prenatal Care: (2)• Controlling High Blood Pressure• Chlamydia Screening for Women• Low Back Pain: Use of Imaging Studies
Eligible Professionals: Meaningful Use Summary Medicare Medicaid
• Year 1 (Stage 1): AIU to a certified EHR AND demonstrate MU for a 90 day consecutive period
• Year 2+: demonstrate MU for the entire year
• Year 1: AIU to a certified EHR• Year 2 (Stage 1): demonstrate
MU for a 90 day consecutive period
• Year 3+ (Stage 1): demonstrate MU for the entire year
• For Stage 1, report on a total of 20 performance measures • 15 core measures and 5 measures from menu set of 10
Note: There are performance targets on most measures• For Stage 1, report on a total of 6 clinical quality measures
• 3 core/alternate core measures and 3 menu set • If the denominator for any of the 3 core measures is zero, must
report on the 3 alternate core measures. • If all 6 of the measures have a denominator of zero, the EP must
still report on any 3 menu set measures shown in the menu set. Note: There are no performance targets
ELIGIBLE HOSPITALS
Hospitals only eligible for Medicare incentive
Could be eligible for both Medicare & Medicaid (most
hospitals)
Hospitals only eligible for Medicaid incentive
Eligible Hospitals: Medicare & Medicaid Comparison
Eligible Hospitals: Overview
• IHS hospitals are eligible to participate in both the Medicare and Medicaid incentive programs
• Payments for Eligible Hospitals are based on the federal fiscal year
• Eligible IHS Hospitals include:
• Subsection-D/Acute Care Hospitals
• Critical Access Hospitals
• CMS recommends hospitals register for both programs
• Even if the hospital is unsure if the will meet the Medicaid patient volume requirements
Eligible Hospitals: Incentive Program Timeline
FY 2011 FY 2012
First day of calendar & EHR reporting year 10/01/11
06/30/11 LAST day to establish clean-date for the Medicare Incentive Program
06/30/12
07/03/11 LAST day to begin 90-day reporting period for the Medicare Incentive Program
07/01/12
09/30/11 Last day of calendar & EHR reporting year 09/30/12
11/30/11 LAST day to register & LAST day to attest
11/30/12
Eligible Hospitals: Medicare Program Requirements
Medicare Program
Year Reporting period MU Stage
One 90 day S1-Y1
Two 365 day S1-Y2
Three 365 day S2- Y1
Four+ 365 day S2- Y2
Eligible Hospitals: Medicaid Program Requirements
Medicaid ProgramParticipation Year
Reporting period MU Stage
One N/A (A/I/U) N/A
Two 90 day S1-Y1
Three 365 day S1-Y2
Four+ 365 day S2- Y1
Eligible Hospitals: Dual-Eligible Hospital
Medicare & Medicaid (Same Year)
Year Medicaid EHR Reporting period
Medicare EHR Reporting period
MU Stage
One A/I/U 90 day S1-Y1
Two 365 day 365 day S1-Y2
Three 365 day 365 day S2- Y1
Four+ 365 day 365 day S2- Y2
Eligible Hospitals: Option Two
Start Medicaid & Delay Medicare
Year Medicaid EHR Reporting period
Medicare EHR Reporting period
MU Stage
One A/I/U Delay N/A
Two 90 day 90 day S1-Y1
Three 365 day 365 day S1-Y2
Four+ 365 day 365 day S2- Y1
Eligible Hospitals: Option Three
Start Medicare & Opt-Out A/I/U Medicaid
Year Medicaid EHR Reporting period
Medicare EHR Reporting period
MU Stage
One Opt-Out 90 day S1-Y1
Two 365 day 365 day S1-Y2
Three 365 day 365 day S2- Y1
Four+ 365 day 365 day S2- Y2
ELIGIBLE HOSPITALS & MEDICAID
Eligible Hospitals: Medicaid Patient Volume Requirement
Eligible Hospitals Minimum Medicaid patient volume threshold
Acute care hospitals, including Critical Access Hospitals
10%
Note: Medicare does not have a patient volume threshold
Eligible Hospitals: Medicaid Patient Volume Calculation
• 1 main option for calculating patient volume• Medicaid Encounters
• State picks can use this method or propose a new method for review and approval
• If CMS approves a method for one state, it may be considered an option for all states
Eligible Hospital: Medicaid Encounter Definition
• For calculating Medicaid patient volume, a “Medicaid encounter” means services rendered to an individual where Medicaid (or a Medicaid demonstration project approved under section 1115 of the Act) paid for part or all of:
• Service per inpatient discharges, • Premiums, co-payments, and/or cost-sharing per inpatient
discharge • Service in an emergency department* on any one day, or, • Their premiums, co-payments, and/or cost sharing in an
emergency department* on any one day.
*An emergency department must be part of the hospital under the qualifying CCN
HOSPITAL INCENTIVES
Eligible Hospitals: Medicare & Medicaid Incentive Summary
MEDICARE MEDICAID
Incentives Start
FY 2011 FY 2011
IncentivesEnd
FY 2016(max. 4 years, must start by
2015)
2021(max. 6 years, must start
by 2016)
Incentive Amount
•Varies, depending on % Medicare inpatient bed days
•CAHs based on EHR costs & % Medicare inpatient bed days
•Varies, depending on % Medicaid inpatient bed days
Reimbursement Reduced
FY 2015 No penalties
• IHS has created hospital incentive calculators
Hospital Incentive Payment Estimator
Eligible Hospitals: Incentive Calculators
ELIGIBLE HOSPITALSPERFORMANCE MEASURES & CLINICAL QUALITY MEASURES
Eligible Hospitals: Meaningful Use Requirements
STAGE 1: Meaningful Use Requirements
• 19 total Performance Measures• 14 core performance measures*• 5 performance measures out of 10 from menu set*
• 15 total Clinical Quality Measures
* Most measures require achievement of a performance target
1. >30%: Computerized physician order entry (CPOE):
2. Yes/No: Report hospital clinical quality measures to CMS or States
3. Yes/No: Implement one clinical decision support rule
4. >50%:Provide patients with an electronic copy of their health information, upon request
5. >50%:Provide patients with an electronic copy of their discharge instructions at time of discharge, upon request
6. Yes/No:Implement drug-drug and drug-allergy interaction checks during the entire EHR reporting period
7. >50%: Record demographics
8. >80%: Maintain an up-to-date problem list of current & active diagnoses
9. >80%: Maintain active medication list
10. >80%: Maintain active medication allergy list
11. >50%: Record and chart changes in vital signs
12. >50%: Record smoking status for patients 13 years or older
13. Yes/No: Capability to exchange key clinical information (Test Performed)
14. Yes/No: Conduct or review a security risk analysis
Eligible Hospitals: 14 Core Performance Measures
1. Yes/No: Implement drug-formulary checks for entire EHR reporting period
2. >40%: Incorporate clinical lab test results as structured data
3. Yes/No: Generate lists of patients by specific conditions
4. >10%:Use certified EHR technology to identify patient-specific education resources and provide to patient, if appropriate
5. >50%: Medication reconciliation at transitions of care
6. >50%: Summary of care record for each transition of care/referrals
7. Yes/No:Capability to submit electronic data to immunization registries/systems* (Test Performed)
8. Yes/No:Capability to provide electronic syndromic surveillance data to public health agencies* (Test Performed)
9. >50%: Record advanced directives for patients 65 years or older
10. Yes/No:Capability to provide electronic submission of reportable lab results to public health agencies* (Test Performed)
*At least 1 public health measure must be selected
Eligible Hospitals: 10 Menu Performance Measures (Pick 5)
Eligible Hospitals: 15 Clinical Quality Measures
1. Emergency Department Throughput – admitted patients• Median time from ED arrival to ED departure for admitted patients
2. Emergency Department Throughput – admitted patients• Admission decision time to ED departure time for admitted patients
3. Ischemic stroke – Discharge on anti-thrombotics
4. Ischemic stroke – Anticoagulation for A-fib/flutter
5. Ischemic stroke – Thrombolytic therapy for patients arriving within 2 hours of symptom onset
6. Ischemic or hemorrhagic stroke – Antithrombotic therapy by day 2
7. Ischemic stroke – Discharge on statins
8. Ischemic or hemorrhagic stroke – Rehabilitation assessment
9. VTE prophylaxis within 24 hours of arrival
10. Anticoagulation overlap therapy
11. Ischemic or Hemorrhagic stroke – Stroke Education
12. Intensive Care Unit VTE prophylaxis
13. Platelet monitoring on unfractionated heparin
14. VTE discharge instructions
15. Incidence of potentially preventable VTE
MEANINGFUL USE RESOURCES
Meaningful Use Resources
• National Site Tracker• For RPMS sites, can run it to see if you have complete
Certified EHR installed• MU Readiness Assessment Tool• MU Action Plan• MU Preparation Checklist• MU Performance Measure Cheat Sheets• EHR MU Guide
• Compares a list of RPMS applications installed at a facility with the official certified RPMS list
• Determines which versions/patches are needed• Automated tool
Meaningful Use Resources: National Site Tracker
Meaningful Use Resources: Privacy & Security
• IT staff attend 90 minute Risk Analysis WebEx Training• Obtain the OIT Security Risk Analysis (RA) template located at
http://www.ihs.gov/meaningfuluse/index.cfm?module=rsrc_toolkit• Complete the Risk Analysis Process
• Conduct risk analysis• Implement Risk Management• Ensure a sanction policy is adopted for the site.• Review logs and incident reports• Submit completed risk analysis
• Complete monthly Secure Fusion & Annual Risk Analysis survey• Attest to Privacy & Security when generating the RPMS MU Performance
Measure report. • 09/30/11- Medicare Eligible Hospital deadline• 12/31/11- Medicare Eligible Provider deadline
Meaningful Use Resources: MU Guide
• Objective• Type of Measure• Threshold• RPMS MU Report Logic• RPMS Configuration• EHR Use• RPMS roll & scroll
screenshots• GUI EHR screenshots• http://www.ihs.gov/
CIO/EHR/index.cfm?module=preparing_documents
Resources: Websites
MEANINGFUL USE REPORTS
MU Reports: EP & EH Performance Measures Reports
• PCC Management Report• All measures• Some yes/no measures need to be answered by person running report
• MU tab in iCare• Provides current progress (runs/generates report overnight)
• Shows performance on all MU measures that calculate a rate• e.g., CPOE rate, demographic rate, e-prescribing rate, etc.
• Includes measures that require a yes/no answer• e.g., performance of a test of facility’s ability to electronically exchange
key clinical information
• Summary Report provides information needed to attest with CMS or the respective State to receive incentive payment
MU Reports: EP & EH Performance Measures Reports
• New MU tab in iCare• RPMS Clinical Reporting System (CRS)
• 1st Release
• 9 EP measures• 3 core/3 alternate core/3 menu set (breast cancer screening, cervical
cancer screening, and colorectal cancer screening)
• CRS v11.0 Patch 2
• 2nd Release
• All 15 hospital measures
• CRS v11.0 Patch 3
• 3rd Release
• Remaining 35 EP measures
• CRS v11.1. Patch 1 – Estimated release October 2011
MU Reports: Clinical Quality Measures Report
MU Reports: Clinical Quality Measures Report
MU Reports : Patient Volume Report
• RPMS Third Party Billing (TPB)
• Developing software requirements/program logic
• EP individual and EH report released August 2011
• EP group report anticipated October 2011 release
• Calculates
• EP Medicaid patient volume rates
• EP Needy Individual patient volume rates
• Group practice rates (Medicaid and Needy Individual) in lieu of calculating the rate for each individual EP
• Hospital Medicaid patient volume rates Relies on information stored in RPMS TPB; sites using a COTS Billing package will not be able to run this report
CMS INCENTIVE PROGRAMS REGISTRATION
CMS Incentive Program Registration: Overview
MEDICARE hospitals & providers• Only register on CMS incentive program website
• Https://ehrincentives.Cms.Gov/hitech/login.Action • 3rd party registration available for providers
MEDICAID hospitals & providers• Register on CMS incentive program website
• Https://ehrincentives.Cms.Gov/hitech/login.Action • 3rd party registration available for providers
And
• Register on state Medicaid website• Http://www.Cms.Gov/apps/files/medicaid-hit-sites/ • Providers must self-register for Medicaid
CMS Incentive Program Registration: Eligible Hospitals Checklist
CMS & Medicare Registration Identify registration coordinator and timeline for hospital registration Login to I & A at https://nppes.cms.hhs.gov/NPPES/IACreateLogin.do
and Create “Certifying Official” and “End-User account Mail hospital copy of IRS Form CP-575 Obtain hospitals CMS Certification Number (CCN) Obtain hospital National Provider Identifier (NPI) Verify hospital has an enrollment record PECOS Identify the program(s) the hospital will participate in (should register for both) Identify state program hospital will participate in (MEDICAID ONLY) Identify type of hospital for Medicare & Medicaid hospital Obtain EHR certification number Obtain facility address from IRS form CP-575 Obtain facility work phone number Identify e-mail address to use for registration Print Submission Receipt
Medicaid Registration Create a state account (account varies by state) Obtain state ID number Identify contact person for application questions Obtain IHS RPMS EHR Vendor Letter at http://
www.ihs.gov/meaningfuluse/index.cfm?module=steps_request_letter Run hospital patient volume report Obtain cost report data for most recent 3-4 years
CMS Incentive Program Registration: Eligible Professional Checklist
CMS & Medicare Registration Identify who will register Medicare providers (third party registration or provider self registration) Login to I & A at https://nppes.cms.hhs.gov/NPPES/IACreateLogin.do and Create Third Party
Registration User ID & Password (if applicable) Identify how the Medicaid providers will register (Providers must self register on Medicaid website) Obtain each provider’s National Provider Identifier (NPI) Verify each provider has an enrollment record in PECOS Identify the program the provider will be participating in Identify state program provider will participate in (MEDICAID ONLY) Identify type of provider’s profession (physician, optometrist, etc) Obtain EHR certification number Obtain facility Payee TIN & NPI (for reassignment of benefits to facility) Obtain facility address from IRS form CP-575 Obtain providers work phone number & email address Print Submission Receipt
Medicaid Registration Create a state account (account varies by state) Obtain state Medicaid ID number Obtain Professional License number &issuing state (individual patient volume only) Obtain providers NPI and TIN information (group patient volume only) Identify contact person for application questions Obtain IHS RPMS EHR Vendor Letter at http://
www.ihs.gov/meaningfuluse/index.cfm?module=steps_request_letter Run Individual/Group provider patient volume report
Certifying Officials and Providers will use the NPPES/NPI web user account user name and password
CMS Registration: Login Page
One difference in registering is that hospitals must provide their CCN and pick an NPI. These must match the TIN as well.
CMS Registration: Hospital Registration
Here EP or staff registering on their behalf select program type (state for Medicaid providers),
provider type, and EHR #
CMS Registration: EP Program Selection
Unlike EPs, some hospitals can pick Medicare, Medicaid, or both
IMPORTANT: If a hospital is eligible for both programs, they should select both, even if they may not get an incentive for both in the 1st year.
CMS Registration: EH Program Selection
Hospitals/Providers will not receive email confirmations at this point in the program.
It is important that providers print this page or record the information in some other way.
Medicaid EPs and hospitals must continue with the State’s site to verify additional info.
CMS Registration: Submission Receipt
Area MU CoordinatorsArea MU Coordinator Email Phone Number
Aberdeen CAPT Scott Anderson [email protected] (605) 335-2504
Alaska Richard HallKimi GosneyErika Wolter
[email protected] [email protected] [email protected]
(907) 729-2622(907) 729-2642(907) 729-3907
Albuquerque Jacque Candelaria (Acting) [email protected] (505)988-9821
Bemidji Jason Douglas Alan Fogarty
[email protected]@ihs.gov
(218) 444-0550 (218) 444-0538
Billings CAPT James Sabatinos [email protected] (406) 247-7125
California Marilyn Freeman [email protected] (916) 930-3981, ext. 362
Nashville Robin Bartlett [email protected] (615) 467-1577
Navajo LCDR Andrea Scott [email protected]; (928) 292-0201
Oklahoma Amy Rubin [email protected] (405) 951-3732
Phoenix CAPT Lee Stern [email protected] (602) 364-5287
Portland CAPT Leslie Dye Donnie Lee, MD
(503) 326-3288 (503) 326-2017
Tucson Scott Hamstra, MD [email protected] (520) 295-2532
Area MU Consultants(contractors)Area MU Consultants Email Phone Number
Team Lead (ABQ) JoAnne Hawkins [email protected] (505) 382-4228
Regional #1(TUC) Troy Whaley [email protected] (520) 954-5025
Regional #2(NAS) Melissa Alford [email protected] (615) 260-4076
Regional #3(ABQ) Bevin Moon [email protected]
Aberdeen Carol Smith [email protected] (605) 484-7090
Alaska Karen SidellAudra Hill
[email protected]@ihs.gov
(907) 729-2624(907) 729-2679
Albuquerque Troy Whaley – Interim [email protected] (520) 954-5025
Bemidji Susanna Frenkel [email protected] (218) 444.0551
Billings Melissa Alford- Interim [email protected] (615) 260-4076
California Tim Campbell [email protected] (707) 889-3009
Nashville Robin Kitzmiller [email protected] (615) 467-1532
Navajo Donna Nicholls [email protected] (505) 205-9177
Oklahoma Ursula Hill [email protected] (405) 951-6036
Phoenix Rick Bowman [email protected] (520) 603-6817
Portland Angela Boechler [email protected] (971) 221-8057
Tucson Rick Bowman [email protected]
(520) 603-6817
IHS Meaningful Use: Contact Information
• Chris Lamer, MU Federal Lead, COTR, IHS (615) 669-2747 [email protected]
• Cathy Whaley, MU Project Manager, DNC(520) [email protected]
• JoAnne Hawkins, MU Field Team Lead, DNC(505) [email protected]
