Medicaid Promoting Interoperability (PI) Program

(formerly known as the Medicaid EHR Incentive Program)

2019 Program Year Applications

 

  • For any providers that bill Medicare Part B and are required to submit data to MIPS (now known as the Medicare Promoting Interoperability (PI) Program) you can continue to participate with the Medicaid PI Program until you have received the maximum six payments or until the final program year of 2021.
  • Submission of meaningful use data to the Medicaid PI Program does not fulfill the MIPS (Medicare PI Program) reporting requirements.
  • Providers that are returning MU attesters for program year 2019 must submit Stage 3 data.
  • All CEHRT products must be 2015 edition to qualify for the 2019 program year. Be sure to check with your vendor on details of your CEHRT upgrade.
  • Submit the completed worksheet to: EhrHelpdesk.DHHS@maine.gov. You may submit the 2019 Medicaid Eligibility worksheet any time from now through the deadline date of March 31, 2020.
  • Once we receive the 2019 Medicaid Eligibility worksheet we will enter each provider into our system and mark them eligible for the 2019 program year.
  • Because the CQM reporting period is the full 2019 calendar year we will not open for submission of MU data until January 2, 2020.
  • For any providers that submits the 2019 Medicaid Eligibility worksheet prior to January of 2020 we will send out the 20189 MU wizard email to those providers on January 2, 2020.
  • All others will receive the 2019 wizard email after the 2019 Medicaid Eligibility worksheet has been submitted and accepted.

2019 Reporting Periods and Deadline Dates

 

EHR Reporting Period and requirements for Program Year 2019

  • The reporting period for the MU objectives is a 90-day period within CY 2019.
  • The reporting period for CQM data is 365 days of data from CY 2019.
  • Providers are required to submit a minimum of 6 CQMs. We encourage the submission of all CQM data you have available in your reports.

Deadline dates for the 2019 program year:

  • The deadline date for the submission of the 2019 Medicaid Eligibility worksheet is March 31, 2020. No new worksheet submissions will be accepted after March 31, 2020.
  • There is a potential that a provider may not be able to receive a payment for the 2019 program year if all requirements are not met by the deadline dates.
  • If there are any issues or errors on the worksheet or the MU data there may not be enough time for a re-submission.
  • The deadline date for the submission of MU wizard data is April 30, 2020. No new MU submissions will be accepted after April 30, 2020.

 

2019 Program Year - Stage 3 is Required for All Applicants

 

Maine will begin accepting the submission of the 2019 program year Medicaid eligibility worksheet on June 1, 2019.

We will open for submission of MU data for the 2019 program year on January 2, 2020.

 

2019 Program Year Requirements

 

2019 Reporting Period

  • Objectives will be a 90-day reporting period within the calendar year 2019
  • CQMs will be a 365-day reporting period within the calendar year 2019

 

Tip Sheets and other helpful documents

 

Clarification of the Secure Electronic Messaging Objective

 

There has been some confusion on the requirement for the Secure Electronic Messaging objective. We have summarized some of the requirements and given examples to help clarify the objective requirements. Click the documents below for details.

 

Stage 3 has objectives that allow action to occur before, during or after the reporting period of 90 days but within the calendar year of 2019.

  • Objective 5 - Patient Electronic Access - (measure 2 only)
  • Objective 6 - Coordination of Care through Patient Engagement - (measures 1 & 2)
  • Objective 7 - Health Information Exchange (measure 1 only)

 

CEHRT Technology

 

Public Health Reporting Requirements

 

Please see the Public Health Registration page for more information on the Public Health reporting requirements. There will be a link posted to download the 2019 Public Health Wizard and the guide to using the Public Health Wizard to register or update an existing registration available on the page.

 

Important Note:

If you did not update the Public Health Wizard for the 2018 program year, you must remove any previous version of the Public Health Wizard application (lobster icon) on your computer and re-install it by going to the site linked above.

We changed the server the wizard was stored on and you need to download it from the new server.

 

Public Health Contacts:

Sign up for the CMS Interoperability Program Listserve

Go to the CMS Email Updates subscription page to sign up for program updates.

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 into your inbox.

CMS News Alerts

Contact: CMS Media Relations

(202) 690-6145

Two proposed rules have been released that have an impact on the Medicaid EHR Incentive Program

  • Program name change to "Medicaid Promoting Interoperability Program" - (Medicaid PI Program).
  • Beginning with the EHR reporting period in CY 2019, all providers and hospitals will be required to use the 2015 Edition of CEHRT.
  • Submission of Stage 3 is required starting with program year 2019.
  • Objective reporting period for program years 2019 and 2020 will be a 90-day reporting period.
  • CQM reporting period for program years 2019 and 2020 will be a 365-day reporting period.

 

2021 Program Year - final year of the Medicaid IP Program

  • Reporting period will be a 90-day period for both objectives and CQMs.
  • The 90-day period can be selected from January 2021 - September 30, 2021.
  • Deadline for submission for the 2021 program year is September 30, 2021.
  • Per CMS regulations all provider payments for the 2021 program year must be completed before December 31, 2021.

Quality Payment Program Resources Available

 

We are presenting this information on the Medicare Quality Payment Program (QPP) for your information only. The Maine Medicaid Interoperability Program is not a part of the QPP.

 

The Quality Payment Program is part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and includes two tracks - Advanced Alternative Payment Models (APMs) and the Merit-based Incentive Payment System (MIPS) - Now called the Medicare Interoperabilty Program

 

The Medicare Interoperability Programwill replace three Medicare reporting programs:

  • EHR Incentive Program (Meaningful Use) (Medicare MU program only, the Medicaid MU program will continue through 2021)
  • Physician Quality Reporting System
  • Value-Based Payment Modifier

The Quality Payment Program listserv will provide news and updates on:

  • New resources and website updates
  • Upcoming milestones and deadlines
  • CMS trainings and webinars

More Information:

  • The Quality Payment Program Service Center can also be reached at 1-866-288-8292 (TTY 1-877-715- 6222), available Monday through Friday, 8:00 AM-8:00 PM ET or via e-mail at QPP@cms.hhs.gov
  • Quality Payment Program website - resources are available to help clinicians successfully participate in the Quality Payment Program.
  • CMS encourages clinicians to visit the website to review the following new resources:
  • Quality Payment Program Resource Library - This website is a good place for in-depth information on the QPP reporting requirements.
  • Go to this site to check your participation status requirements: QPP Participation Status website- QPP Participation Status includes APM participation as well as MIPS participation.
  • Individual or Group Participation website - If you are Merit-based Incentive Payment System (MIPS)-eligible, you can choose to participate as an individual, a group, or both.

 

Hospital 2019 Medicare Requirements

Hospitals that will file with Medicare for the 2019 program year will submit 4 objectives and the number of CQMs per CMS.

We are providing information here for the objectives.

Clarification of the 2019 Public Health and Clinical Data Exchange for hospitals

Hospitals can meet the Public Health objectives by meeting any of the three options for active engagement. This remains the same as previous program years. The hospital is not required to be in full production or submitting bi-directional data to meet the requirements.

Definitions:

  • Active Engagement with public health agency (PHA) - Means that the eligible hospital or CAH is in the process of moving towards sending "production data" to a PHA or is sending production data to a PHA.
    • Active Engagement Option 1: Completed Registration to Submit Data - The eligible hospital or CAH registered to submit data with the PHA to which the information is being submitted; registration was completed within 60 days after the start of the EHR reporting period; and the eligible hospital or CAH is awaiting an invitation from the PHA or CDR to begin testing and validation. This option allows eligible hospitals or CAHs to meet the measure when the PHA has limited resources to initiate the testing and validation process. Eligible hospitals or CAHs that have registered in previous years do not need to submit an additional registration to meet this requirement for each EHR reporting period. If the hospital or CAH has not yet been onboarded by Maine CDC the original registration remains active and meets requirements.
    • Active Engagement Option 2: Testing and Validation - The eligible hospital or CAH is in the process of testing and validation of the electronic submission of data. Eligible hospitals or CAHs must respond to requests from the PHA within 30 days; failure to respond twice within an EHR reporting period would result in that eligible hospital or CAH not meeting the measure.
    • Active Engagement Option 3: Production - The eligible hospital or CAH has completed testing and validation of the electronic submission and is electronically submitting production data to the PHA.
      • Production Data: Refers to data generated through clinical processes involving patient care, and it is used to distinguish between data and “test data” which may be submitted for the purposes of enrolling in and testing electronic data transfers.

 

Please see the Public Health Registration page for more information on the Public Health registrations available in Maine for the 2019 program year.

 

Public Health Registrations Available in Maine

 

Note: Eligible hospitals and CAHs are required to report on any two measures of the eligible hospital or CAHs choice.

 

Registry Name Applicable for Hospital objective number

Providers

Stage 3

Exclusion
Immunization Registry Providers and Hospitals Objective 4, measure 1 Objective 8, measure 1 Does not administer immunizations
Syndromic Surveillance Providers and Hospitals Objective 4, measure 2 Objective 8, measure 2 Does not collect Syndromic data
Electronic Lab Reporting (ELR) Hospitals Only  Objective 4, measure 6    
Electronic Case Reporting Providers and Hospitals Objective 4, measure 3 Objective 8, measure 3 Not available in Maine, eligible for the exclusion
Public Health Registry Reporting (Cancer and Specialty Registries will move here for Stage 3) Providers and Hospitals Objective 4, measure 4 Objective 8, measure 4 Does not diagnose or treat any condition or collect relevent data
Clinical Data Registry (CDR) Providers and Hospitals  Objective 4, measure 5 Objective 8, measure 5 Not available in Maine, eligible for the exclusion

 

Resources

Maine's Approved State Medicaid Health Plan and Implementation Plan

2015 Maine SMHP.PDF

Questions?

E-mail: EhrHelpdesk.DHHS@maine.gov