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Transcript of Meaningful Use Registration & Attestation WV HFMA / WVHIMSS Fall Conference The Changing Seasons of...
Meaningful Use Registration & Attestation
WV HFMA / WVHIMSS Fall Conference
The Changing Seasons of Healthcare
September 26-28, 2012
Objectives
1. Understand steps to register – EH & EP
2. Understand steps to attest – EH & EP
3. Understand differences between Medicare and Medicaid for registration & attestation
4. Understand resources available to assist you
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Registration – Eligible Hospital(EH)
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Registration - EH
Obtain registration guide from CMShttp://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/RegistrationandAttestation.html
There is a separate registration guide for EH’s & EP’s
You will need your hospital NPI numberYou can apply for an NPI # through NPPES
You will need your hospital CCN (CMS Certification Number
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Registration - EH
You must have an I&A (Identity & Access Mgmt) user web account to register.You can register for one through the I&A websiteA link is available in the CMS EH Registration
Guide
EHR Certification Number. This is optional for the registration but is required during attestation. http://oncchpl.force.com/ehrcert
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Registration - EH
You can register for Medicare and Medicaid incentive programs at the same time if: You are a sub-section(d) hospital in the 50 U.S.
States or the District of Columbia or CAH; and You have a CMS Certification Number ending in
0001-0879 or 1300-1399; and You have at least 10% Medicaid patient volume
Email address – the address entered during registration is where the registration confirmation will be sent.
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Registration - EH
Print the registration confirmation receipt – retain for your records
EHR Incentive Program Information Center at 888-734-6433
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Registration – Eligible Providers(EP)
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Registration - EP
Obtain registration guide from CMShttp://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/RegistrationandAttestation.html
There is a separate EP registration guide for Medicare & Medicaid
Medicare EPsDoctor of Medicine or OsteopathyDoctor of Dental Surgery or Dental MedicineDoctor of Podiatric MedicineDoctor of OptometryChiropractor9/28/12 Kimberly F. Clarke, FHIMSS, CPHIMS
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Registration - EP
Medicaid EPsPhysiciansNurse PractitionerCertified Nurse MidwifeDentistPAs who practice in a Federally Qualified Health
Center (FQHC) or Rural Health Center (RHC)
PLUS…20% Medicaid volume if Pediatric based30% Medicaid volume – all others
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Registration - EP
A provider can attest for the Medicare OR Medicaid incentive program - not both
Medicaid – NLR & StateDelay of ~48 hours for registration to flow to
state registration system for approval
Email address – the address entered during registration is where the registration confirmation for the provider will be sent.
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Registration - EP
Steps to determine EP Incentive Program Eligibility
1. Identify timeframe to Attest
2. Run claims data for the same time period but from the previous year.
3. Determine if provider is hospital baseda. If => 90% activity hospital based, do not
qualify as EP
b. Based on place of service (POS) code on claims (21-Inpatient, 23-Emergency Dept)
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Registration - EP
4. Calculate percent Medicare volume
5. Calculate percent Medicaid volume
6. Identify incentive program for provider
To register you will needProvider PECOS / NPPES loginProvider NPIGroup practice NPI I&A web account (each provider)
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Registration – Lessons Learned
Save EVERYTHING!Registration ConfirmationsData to determine program eligibility for
providersAll information used to registerProvider consent to register/attest on his/her
behalf
EH registration – easy; straightforward
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Registration – Lessons Learned
EP Registration – not so easy Begin collecting all PECOS logins EARLY Character length of PECOS passwords changed
so may have to log in to I&A system to reset password • Provider must do this – it takes time!
Obtain signed consent from provider to register and attest on provider’s behalf• Audits…
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Registration – Lessons Learned
EP Registration – continuedRegister all EPs as soon as possible. You can
register as Medicare until you have your claims data• Validates provider PECOS login• Once provider incentive program determined, update
registration to the correct program• Prior to attestation, you can change between Medicaid
and Medicare as many times as you need to• After attestation, you can only switch the program ONE
TIME
Easier to identify a specific timeframe to attest so claims data can be run – streamlines process
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Registration – Lessons Learned
EP Registration – continued Implement a process to track data and progress
for each provider
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Attestation – Eligible Hospital(EH)
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Attestation - EH
Obtain attestation user guide from CMShttp://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/RegistrationandAttestation.html
Medicare Attestation If qualify for Medicare & Medicaid, attest for Medicare• Will be deemed meaningful users for Medicaid
Medicare calculates a payment amount; Medicaid calculates a total amount that States may pay eligible hospitals.
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Attestation - EH
Numerator & Denominator for Objectives & Quality Measures• Worksheet on CMS website (link on previous page)
Attestation steps through each objective and quality measure (QM)
Summary of attestation for each objective & QM
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Attestation - EH
Medicaid Attestation – data required Workbook on MMIS website
http://www.wvmmis.com/welcome.screen
Data from cost reports Total # of discharges for the past 4 years (FFY)
• Does not include Observ, ED or Newborn
Total # of discharges for the most recent fiscal year Total # of inpatient bed days for most recent fiscal
year Total # Medicaid inpatient (indemnity) days for
most recent fiscal year
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Attestation - EH
Total # of hospital charges for most recent fiscal year
Total # of Charity care charges for most recent fiscal year
Data from cost reports is used to calculate average annual growth rate and the Medicaid incentive payment calculation
Summary of calculated payments provided
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Attestation – Eligible Provider(EP)
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Attestation - EP
Obtain attestation user guide from CMShttp://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/RegistrationandAttestation.html
The more providers, the more complex the process
Medicaid – straightforward for first year AIU
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Attestation - EP
Medicare – more prep work involvedDetermination of quality measures for provider If multi-specialty practice, consider QMs that
apply to all providers in the specialty practiceProcess to track QMs to attest to per provider
MedicaidFirst yearAIUNeed claims data – same data gathered to
determine if EP eligible for Medicaid incentives
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Attestation - EP
Claims data entered as part of attestationAttest through the WV MMIS (Molina) websiteAfter attestation, takes approximately 48 hrs. to
get status on attestation Must keep checking the website for your list of
providers to check their status If claims data entered differs from the state’s
claims data by more than 10%, attestation is rejected
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Attestation - EP
WV Medicaid uses total of paid claims + reversed claims• Do not include CHIP• Do not include Carelink• Do not include UniCare• Do not include HealthPlan
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Attestation – Lessons Learned
Save EVERYTHING!Screen shots of attestationsAttestation confirmationsProof of objectives requiring a yes/no attestationData extracted from certified EHR (numerator /
denominator) and detail behind the numbersTest plan/scripts to validate MU dataSystem design/build required to meet MUCertified EHR vendor supporting documentation
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Attestation – Lessons Learned
Take advantage of the MMIS and CMS help desks
Have cost report data ready prior to starting attestation for Medicaid (EH)
Medicaid Attestation – EPsCheck MMIS incentive attestation site regularly
to confirm status of attestationUse the MMIS “EDI Help Desk” to clarify reasons
for rejected attestations
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Attestation – Lessons Learned
Medicaid Attestation – Eps (continued)Check MMIS incentive attestation site regularly
to confirm status of attestationUse the MMIS “EDI Help Desk” to clarify reasons
for rejected attestations If first year, determine the 90 day attestation
period for the providers. Streamlines process – alleviates a lot of rework.
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Resources
CMS Registration & Attestation Linkhttp://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/RegistrationandAttestation.html
NPPES Help Desk (800) 465-3203 https://nppes.cms.hhs.gov/NPPES/Welcome.do
PECOS Help Desk (866) 484-8049https://pecos.cms.hhs.gov/
WV Medicaid Molina EDI Help Desk1-888-483-0793 (have your NPI# ready, then press selection “6”) [email protected]
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Resources
CMS FAQshttp://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/FAQ.html
Sign up for notifications when new FAQs or clarifications are posted!
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Kimberly F. Clarke, FHIMSS, CPHIMS
QUESTIONS?