MaineCare Health Information Technology Meaningful Use Program

EHR Incentive Programs ? A program of the Centers for Medicare & Medicaid Services

What is the HIT Incentive/ Meaningful Use Program?

The Electronic Health Record (EHR) Incentive Program External site disclaimer was created by the Health Information Technology for Economic and Clinical Health Act (HITECH). CMS will administer the Medicare EHR Incentive Program and State Medicaid agencies will administer the Medicaid EHR Incentive Program.

The program pays 100% federally funded incentives to eligible professionals (EPs) and hospitals (EHs) for adopting, implementing, upgrading and demonstrating meaningful use of certified EHR technology.EPs may be eligible to receive up to $63,750. Payments for EHs are hospital-specific. Maine hospitals are eligible to receive an average of $750,000.

***CMS EHR Incentive Program Listserve***

Click this link to sign up for the EHR Incentive Programs listserv for program updates and new resources

The Medicare and Medicaid EHR Incentive Programs listserv provides timely, authoritative information about the programs, including registration and attestation updates and details about the payment process. The listserv messages are another CMS resource to provide you with the latest news about the Incentive Programs. On average, two messages are sent per week. This is the most reliable way to receive information directly from CMS to your inbox

***Reminder to all Providers***

Please be sure that all providers log into their accounts on the I&A site to update their information and passwords as required

How to receive your EHR Incentive Program Payments

Start by clicking your status below:

 

News Update from CMS 10/7/14-Hardship Exception Application

*****Hardship Exception Applications to Avoid the 2015 Medicare Payment Adjustment Due November 30, 2014*****

CMS is announcing its intent to reopen the submission period for hardship exception applications for eligible professionals and eligible hospitals to avoid the 2015 Medicare payment adjustments for not demonstrating meaningful use of Certified Electronic Health Record Technology (CEHRT). The new deadline will be November 30, 2014. Previously, the hardship exception application deadline was April 1, 2014 for eligible hospitals and July 1, 2014 for eligible professionals.

As part of the American Recovery and Reinvestment Act of 2009 (Recovery Act), Congress mandated payment adjustments under Medicare for eligible hospitals, critical access hospitals, and eligible professionals that are not meaningful users of CEHRT. The Recovery Act allows the Secretary to consider, on a case-by-case basis, hardship exceptions for eligible hospitals, critical access hospitals, and eligible professionals to avoid the payment adjustments.

This reopened hardship exception application submission period is for eligible professionals and eligible hospitals that:

  • Have been unable to fully implement 2014 Edition CEHRT due to delays in 2014 Edition CEHRT availability; AND
  • Eligible professionals who were unable to attest by October 1, 2014 and eligible hospitals that were unable to attest by July 1, 2014 using the flexibility options provided in the CMS 2014 CEHRT Flexibility Rule.

These are the only circumstances that will be considered for this reopened hardship exception application submission period. Applications must be submitted by 11:59 PM EST November 30, 2014.

 

HIT Timeline for Incentive Program

    • Review important dates for the EHR Incentive Programs on the HIT Timeline
    • The timelines listed for the Medicare program correspond closely to the Medicaid program.
    • Please contact us at: DHHS, EhrHelpdesk if you have questions

New Information for Program Year 2014

  • The start of Stage 2 for EPs who have already completed two years of Stage 1
  • All Meaningful Use reporting periods for 2014 will be a 90 day period
  • If 2014 is your first year demonstrating meaningful use you must have all documentation submitted and attested to before October 1, 2014 to avoid the Medicare payment adjustments. The EPs that are subject to the Medicare payment adjustments are: MD's, DO's and Dentist that bill Medicare part B that did not meet MU in 2013 or do not submit before October 1, 2014. Click here for more information regarding the Medicare Payment Adjustment.
  • If you have previously submitted Meaningful Use in 2011, 2012 or 2013 you can select any 90-day reporting period that falls within the 2014 calendar year for the 2014 MU reporting period.
  • All EHR software must be upgraded to 2014 Certified EHR technology; see message below for new information.
  • From FAQ # 2903 (https://questions.cms.gov/faq.php?faqId=2903): Starting in 2014 for both Stage 1 and Stage 2, meeting the exclusion criteria will no longer count as reporting a meaningful use objective from the menu set. An EP must meet the measure criteria for 5 objectives in Stage 1 (3 objectives in Stage 2) or report on all of the menu set objectives through a combination of meeting exclusion and meeting the measure.
  • The Medicaid Eligibility worksheet has been updated for 2014. Please use this worksheet:2014 Medicaid eligibility worksheet_(.xls*)

 

CMS Releases Final Rule Allowing CEHRT Flexibility for 2014 and Extending Stage 2

News Updates | August 29, 2014

Review Final Rule to Determine Your CEHRT Participation Options for Program Year 2014

CMS has released a final rule that allows providers participating in the EHR Incentive Programs to use the 2011 Edition of certified electronic health record technology (CEHRT) for calendar and fiscal year 2014.

The rule grants flexibility to providers who are unable to fully implement 2014 Edition CEHRT for an EHR reporting period in 2014 due to delays in 2014 CEHRT availability. Providers may now use EHRs that have been certified under the 2011 Edition, a combination of the 2011 and 2014 Editions, or the 2014 Edition for 2014 participation.

Beginning in 2015, all eligible providers will be required to report using 2014 Edition CEHRT

This rule only affects providers that are submitting MU in 2014. If a provider is submitting AIU it must include a 2014 CEHRT.

Please note: There are very specific acceptable reasons CMS will allow providers to use in the determining if they are eligible to use the CEHRT options. Please click here to review details

The Rule defines that a provider’s inability to fully implement a 2014 Edition CEHRT must be based on:

  • Software development delays
  • Missing or delayed software updates
  • Being able to implement 2014 CEHRT for part of the reporting period (not the full reporting period)
  • Unable to train staff, test the updates system, or put new workflows in place due to delay with installation of 2014 CEHRT
  • Cannot meet Stage 2 Summary of Care measures due to the recipient of their Summary of Care transmittal being impacted by 2014 CEHRT issues. The sending provider may experience significant difficulty meeting the 10% threshold for electronic transmissions, despite the referring provider’s ability to send the electronic document, if the intermediary or the recipient of the transition or referral is experiencing delays in the ability to fully implement 2014 Edition CEHRT.

The Rule specifically states that the following are NOT acceptable reasons for NOT being able to fully implement:

  • Financial issues
  • Inability to meet one or more measures
  • Staff turnover and change
  • Provider waited too long to engage a vendor
  • Refusal to purchase the requisite software
  • Providers who fully implemented 2014 Edition CEHRT and can report in 2014

 

2014 MU Participation Options


Under the rule, providers are able to use 2011 Edition CEHRT, and have the option to attest to the 2013 Stage 1 meaningful use objectives and the 2013 definition CQMs.

If a provider is utilizing 2011Edition CEHRT:
Providers scheduled to meet Stage 1 or Stage 2 (the EP would be submitting a third year of Stage 1) may submit MU using their 2011 Certified EHR product and can choose the 2013 definition of Stage 1 meaningful use:

Combination of 2011 & 2014 CEHRT
Providers scheduled to meet Stage 1 may submit MU using their 2011/2014 combined Certified EHR product and can choose either the 2013 or 2014 definition of Stage 1 meaningful use:

Providers scheduled to meet Stage 2:

Providers scheduled to meet Stage 2 in 2014 may choose to submit a third year of Stage 1 MU utilizing 2011 CEHRT if they did not receive the 2014 CEHRT in time to actively meet all Stage 2 requirements; they may choose to meet the 2013 or the 2014 definition MU criteria; or they can submit Stage 2 utilizing their 2011 CEHRT if it has the capability to meet Stage 2 criteria

  • 2013 Stage 1 objectives and 2013 CQMs (third year of Stage 1 submission);or
  • 2014 Stage 1 objectives and 2014 CQMs (third year of Stage 1 submission);or
  • 2014 Stage 2 objectivesand 2014 CQMs

2014 Edition CEHRT
Providers scheduled to meet Stage 1 in 2014 that have 2014 CEHRT in place and meet the 2014 criteria may submit:

  • 2014 Stage 1 objectives and 2014 CQMs

Providers scheduled to meet Stage 2: will choose to submit either 2014 Stage 1 or Stage 2 objectives utilizing the 2014 edition CEHRT

  • 2014 Stage 1 objectives and 2014 CQMs;or
  • 2014 Stage 2 objectives and 2014 CQMs

CEHRT Flexibility Resources
To help the public understand the final rule’s changes to 2014 participation, CMS has developed the following resources:

  • CEHRT Interactive Decision Tool – providers answer a few questions about their current stage of meaningful use and Edition of EHR certification, and the tool displays the corresponding 2014 options.
  • 2014 CEHRT Flexibility Chart – chart provides a visual overview of CEHRT participation options for 2014.
  • 2014 CEHRT Rule Quick Guide – guide provides corresponding resources based on the option a provider chooses to participate in the EHR Incentive Programs in 2014.

Extending Stage 2
The rule also finalizes CMS and ONC’s recommended timeline to extend Stage 2 through 2016. The earliest a provider can participate in Stage 3 of meaningful use is now 2017.

For More Information
Visit the CMS Newsroom to read the press release about the final rule. For more EHR Incentive Programs resources, visit the CMS EHR website.

Below is a diagram of the choices that are available:

2014 EHR Incentive Program options
AIU-2014

Stage 1 2014

A minimum of two years of

Stage 1 MU submission is required

before moving to Stage 2

Stage 2 2014

A minimum of two years of

Stage 2 MU submission is required

before moving to Stage 3

Medicaid Eligibility requirement Any 90 days from the previous calendar year (2013) or a 90 day period prior to the submission of application for 2014 Any 90 days from the previous calendar year (2013) or a 90 day period prior to the submission of application for 2014 Any 90 days from the previous calendar year (2013) or a 90 day period prior to the submission of application for 2014
MU Reporting period No Mu reporting required 90 day reporting period 90 day reporting period
EHR Certification Edition Year Must be a 2014 edition certified
version of software
2011 Certified Edition Software 2014 Certified Edition Software 2011 Certified Edition Software 2014 Certified Edition Software
MU definition criteria to report No Mu reporting required

2013 Definition Stage 1

objectives and 2013 CQMs

2014 Definition Stage 1

objectives and 2014 CQMs

2013 Definition Stage 1 objectives and 2013 CQMs

(this would be a third year of Stage 1 and is only allowed for 2014)
2014 Definition Stage 2 objectives and 2014 CQMs

Changes for the 2014 definition year Stage 1 measures include:

Click here for a pdf of the 2014 definition changes: 2014 Stage 1 Changes Tipsheet

  • The Stage 2 rule for meaningful use included changes to Stage 1 (2014 definition) requirements that took effect on January 1, 2014.
    • The number of Core measures for Stage 1 are now 13
    • The number of Menu measures for Stage 1 are now 9
    • Exclusions chosen for menu measures will not count toward the number of required menu measures. If you must exclude from a menu measure you will need to meet other measures to total the required number. If you cannot meet the required number of menu measures you can select all menu measures and pass by meeting those measures you meet and excluding from those measure you are eligible to exclude from.
    • Patient Electronic Access - New EP Objective: Provide patients the ability to view online, download and transmit their health information
      within 4 business days of the information being available to the eligible professional.
      Change: Addition of new core objective to provide patients with ability to view online,
      download, and transmit health information for all providers
      Timing/Compliance: Added for 2014 and beyond
      What It Means: To better align Stage 1 objectives with the new 2014 capabilities of
      Certified EHR Technology, several Stage 1 objectives for providing electronic copies of
      and electronic access to health information have been replaced with objectives to provide
      patients the ability to view, download, or transmit their health information or hospital
      admission information online
    • Record and Chart Changes in Vital Signs
      Change: Increase in age limit for recording blood pressure in patients to age 3; removal
      of age limit requirement for height and weight
      Timing/Compliance: Required in 2014 and beyond
      What It Means: In 2014, all providers must report using the new age limits below
    • Record and Chart Changes in Vital Signs
      Change: Exclusion for eligible professionals: if they see no patients 3 years or older; if
      all three vital signs are not relevant to their scope of practice; if height and weight are not
      relevant to their scope of practice; or if blood pressure is not relevant to their scope of
      practice
      Timing/Compliance: Replaces prior exclusion criteria starting in 2014
      What It Means: Previously, eligible professionals could only exclude this objective if all
      three vital signs were not relevant to their scope of practice or if they saw no patients 3 years
      or older. Beginning in 2014, eligible professionals can be excluded from recording blood
      pressure if blood pressure is not relevant to their scope of practice, or from recording height
      and weight if both height and weight are not relevant to their scope of practice
    • Clinical Quality Measure (CQM) Reporting
      Change:
      Reporting CQMs is still required, but the core measure that asked if you would be submitting CQMs has been removed

Stage 1 Resources


Visit the Medicare and Medicaid EHR Incentive Programs website for the latest news and updates on the EHR Incentive Programs. To receive CMS communications directly sign up for the CMS listserve at the top of this webpage.

Below are some useful resources listed here for your convenience:

Stage 1 - Public Health Measure - Immunization registry test submission

  • The Maine CDC program is able to accept test submissions for Stage I MU. Please look at the information regarding (menu measure #8- 2014 definition, menu measure #9 - 2013 definition) test submission to schedule your test as soon as possible. Maine CDC expects up to a 30-60 day turnaround time to get your test completed.
  • The documents below are provided for your convience. These are necessary to set up the test submission with the State of Maine ImmPact System.
  • Public Health Registry_TipSheet (.pdf*)

***********************If you require documentation for your records of the time frame - (September 2012 through May 2013) - when the Maine Immunization program was not able to accept test submissions for Stage 1 and you took the exclusion based on that please contact Danielle Hall at danielle.hall@maine.gov*************************************************

 

**********************News Updates | August 22, 2014*************************

How to meet Stage 2 - core measure #15 (#3 of 3)

    Now Available: Provider User Guide for NIST EHR Randomizer Tool

    Are you a provider in Stage 2 of meaningful use who needs help meeting measure #3 of the Transitions of Care (core #15) objective? If so, CMS and ONC encourage you to use a new provider user guide that outlines instructions on how to use the NIST EHR Randomizer, including:

      • Required information
      • Steps to register
      • Guidance on how to perform the test

    The guide walks providers through every step of the Randomizer—from registration to completion of the test.

    About the NIST EHR Randomizer
    The Randomizer tool enables providers to exchange data with a Test EHR in order to meet measure #3 of the Stage 2 Transitions of Care (core #15) objective.

    Once registered, the tool pairs a provider’s EHR technology with a different test EHR from the list of authorized systems. The provider must then send a Consolidated Clinical Document Architecture summary of care record to the Test EHR.

    Providers will receive an email with notification of success or failure that can be used as proof of meeting the measure.

    Transitions of Care Core # 15 Objective in Stage 2
    The Stage 2 Transitions of Care (core #15) objective for eligible professionals and eligible hospitals includes three measures. #3 is outlined below:

      • Conduct one or more successful electronic exchanges of a summary of care document, as part of which is counted in “measure 2” with a recipient who has EHR technology that was developed by a different EHR technology developer than the sender’s, or
      • Conduct one or more successful tests with the CMS designated test EHR during the EHR reporting period.

    More Information
    For more information about the Stage 2 Transitions of Care objective and other Stage 2 requirements, visit the CMS Stage 2 of Meaningful Use webpage.

 

 

Stage 2 Resources

The Stage 2 EHR Incentive Program Guide: Stage 2_Guide for_Eligible Providers (.pdf*)

Stage 2 - Public Health Measures

  • Please note: The public health registries requires the registration be completed within 60 days of the start of the EHR reporting period for a provider or hospital; if you have not completed your registration within 60 days of the start of the EHR reporting period please let us know
  • Maine CDC is currently not able to accept onboarding for the ongoing submissions for all public health measures.
  • To meet the measures you must register for the Maine Public Health registries that apply to your practice within 60 days of the start of the EHR reporting period
  • This tip sheet will provider information regarding the Stage 2 PH requirements: Public Health Registry_TipSheet (.pdf*)
  • This instruction sheet will give your detailed information on registering: Stage 2 Public Health Instruction Sheet(.pdf*)
  • Click this link to go complete your Public Health registration
  • This affects Stage 2 only for core measure #16- ongoing submission to Immunization registry, menu measure #1-ongoing submission to Syndromic surveillence registry, menu measure #5-ongoing submission to Cancer registry
  • The registration meets this measure as indicated in the text included in the specification sheets from CMS as follows: "Registration of intent to initiate ongoing submission was made by the deadline (within 60 days of the start of the EHR reporting period) and the EP or hospital is awaiting invitation to begin testing and validation".
  • After you register for the registries you will receive an email acknowledgement. Retain that for your documentation that you met the measure by registering your intent to submit ongoing submissions when the State of Maine is able to accept those submissions.
  • If your practice will not complete the onboarding process for any of the registries do not sign up for them. You will choose the exclusion for those measures as they do not apply to your type of practice. The registration process is the first step to establishing on going submissions for the various public health registries.

Resources

Hardship Exception Tip sheets

Click here for the tip sheet for providers More information is available on the CMS website

The date to apply for a hardship exception for the CY 2015 has passed. If you are a MD, DO or Dentist that bills Medicare part B and you did not submit MU in 2013 you must submit your first year of MU and the attestation statment prior to October 1, 2014 or you will receive a 1% reduction in payment for all Medicare claims submitted in CY 2015.

ATTENTION: PECOS/NPPES/I&A System Updates

  • All providers must update their information in the PECOS/NPPES site - CMS has centralized all accounts to the I&A System for greater ease
  • If you have another person that works on your behalf in PECOS/NPPES or the EHR Incentive program you will need to set up an I&A identity for them
  • CMS has determined that each provider must have a unique email address for the I&A account and should not be linked (by email) to an organization.
  • Please be sure that the email you list in your EHR Incentive program registration is an email address that you or the person responsible for your application for the incentive program will be able to receive and respond to. For the EHR incentive program the email listed in the registration is the only way we have of contacting you. This email contact needs to be updated as needed.
  • We have put together a schematic guide that will help you to set up an I&A account for your PECOS/NPPES/EHR incentive program credentials - Please download this file for reference: I&A process (.pdf)
  • Please visit the I&A website for more information-https://nppes.cms.hhs.gov/IAWeb/warning.do?fwdurl=/
  • If the tools available on the I&A site do not provider what you need please contact the EUS: External User Services (EUS) Help Desk: 1-866-484-8049 or EUSSupport@cgi.com

Educational Resources:

Additional HIT web pages

Maine's Approved State Medicaid Health Plan and Implementation Plan

Questions?

E-mail the EHR Help Desk your questions!

1%