Registration & Attestation For WV Medicaid EHR Incentive

1. Registration & AttestationFor WV Medicaid EHR Incentive • Medicaid Professionals • August 8, 2011

2. Agenda: • Federal EHR Incentive Program and Timeline • WV Medicaid EHR Incentive for Eligible Providers • Eligibility and requirements • Medicaid incentive payment amounts • WV Medicaid EHR Registration/Attestation Process

3. Why CMS Is Doing This—Desired Progression of EHR Use 2010 2011 2013 2015 Source: DHHS, HIT Policy Committee, Meaningful Use Workgroup Presentation, 7/16/09

4. ARRA EHR Incentives • Available to eligible Providers and Hospitals • Providers must select Medicare or Medicaid • Medicare - $44,000 potential total payment per eligible provider • Medicaid - $63,750 potential total payment per eligible provider • First payments being provided this year (2011) • Tied to achieving three progressively more complex “meaningful use” stages to be rolled out over the next several years

5. Medicaid EHR Incentive • Under Medicaid, Eligible Professionals (EPs) are: • physicians (primarily doctors of medicine and doctors of osteopathy), • dentists, • nurse practitioners, • certified nurse midwives, and • physician assistants (practicing in a Federally Qualified Health Center (FQHC) or Rural Health Clinic (RHC) led by a physician assistant). • Must have 30% Medicaid patient volume. For those practicing in an FQHC or RHC, must have 30% “needy individual” volume which includes Medicaid, WV-CHIP, sliding fee, and free care.

6. ARRA Incentive Payments- Medicaid

7. Meaningful Use • Meaningful Use occurs in three stages, with Stage 1 starting in 2011 • New rules will be published in 2013 and 2015 (Stages 2 and 3) – each stage will be more comprehensive • Focus areas for each stage • Stage 1: Data capture and sharing • Medicaid first-year: A/I/U • Stage 2: Advanced clinical processes; exchange* • Stage 3: Improved outcomes* • * Requirements for Stages 2 and 3 will be defined in future CMS rulemaking.

8. Medicaid - First Year: Adopt/Implement/Upgrade (A/I/U) 8 • Adopted – Acquired and Installed • Ex: Evidence of installation prior to incentive • Implemented – Commenced Utilization of • Ex: Staff training, data entry of patient demographic information into EHR • Upgraded – Expanded • Upgraded to certified EHR technology or added new functionality to meet the definition of certified EHR technology Year 1 investment relates to “up until now”; years 2-6 updated each year

9. Medicaid EHR Registration/Attestation The Process

10. Two-Step Process • National Registration • State BMS Portal • You must register before you can submit attestation • https://ehrincentives.cms.gov/hitech/login.action

11. Process – Step 1 • Register at the CMS National Level Repository (NLR) https://ehrincentives.cms.gov/hitech/login.action • Note: You will need to be prepared to enter and select the following information at the NLR: • National Plan and Provider Enumeration System (NPPES) Logon and Password: https://nppes.cms.hhs.gov/NPPES/ • Provider Name • National Provider Identification (NPI) • Business Address and Phone • Input “Incentive Payment To” Tax Identification Number (TIN) • Note: Please call 1-888-483-0793 (Molina Provider Services) to have your information on file changed.

12. Process – Step 1 • Select Medicaid EHR incentive • Select West Virginia as the “State” for Medicaid EHR incentive participation • Record CMS EHR Product Certification Number • Note: The NLR will walk you through on going to http://onc-chpl.force.com/ehrcert to obtain your CMS EHR Product Certification Number if you do not already have one.

13. Process – Step 2 • Wait 2 business days…then access the WV EHR Provider Incentive Payment program secure site by going to: • www.wvmmis.com • Select the WV EHR Incentive Program, and login to the secure site using your web portal user name and password. • NOTE: Providers without a user name and password who work in certain types of clinics will need to first enroll via the web portal registration secure site to receive an ID and location code.

14. WV Process-once NLR registration complete Go to www.wvmmis.com, login, and select the W.V. Medicaid EHR Incentive Program. Providers are required to have a login user name and password. Please call 1-888-483-0793 or use the following link https://www.wvmmis.com/xjRegManage/tradingPartnerRegRight.screen for a login user name and password.

15. WV Registration

16. WV Registration

17. WV Registration

18. Registration Verification Information is verified based on the data entered in the NLR. Inaccuracies must be corrected through that system.

19. Process – Step 2 • Attest that at least 30% of all encounters (20% if a Pediatrician) within a consecutive 90-day period from the previous calendar year were with Medicaid patients. To obtain this documentation, run a report for any consecutive 90-day period for the total Medicaid encounters. An encounter is defined as an unduplicated personal direct contact (or series of contacts occurring within the same day). • Enter: • Total number of patient encounters in a consecutive 90-day period. • Total number of encounters for Medicaid patients in a consecutive 90-day period. • Note: If practicing in an FQHC or RHC, use the number of encounters attributable to services provided to “needy individuals”. Encounters for services rendered to needy individuals on any one day include services paid for by Medicaid or Children’s Health Insurance Program (CHIP), furnished at no cost or paid for at a reduced cost based on a sliding scale determined by the individuals ability to pay during a consecutive 90-day period.

20. Things To Keep In Mind Providers Practicing in an FQHC:A provider is considered an FQHC provider if more than 50% of their encounters over a period of 6 months during the most recently completed calendar year are in an FQHC or RHC. The Medicaid registration system will allow for assignment of payment by a provider to any entity set up as a “pay to” entity in the provider’s profile. Contracts often define the fiscal relationships between providers and the organization, and these contracts will govern payment assignment. The Medicaid registration system will allow for assignment of payment by a provider to any entity set up as a “pay to” entity in the provider’s profile.

21. Attestation Process Notes • You do not need to complete the Attestation process in one sitting. Each screen in the Attestation flow has a Save and Continue button. This will save your changes and allow you to stop at any time without the loss of data that was entered on that page. The attestation process does not allow you to skip forward to screens or jump past a screen without entering data. You may edit answers until you have submitted the attestation. • The BMS Provider Incentive Payment Manual includes a worksheet that can be completed in advance of starting the online process. • Even though eligible professionals are not required to provide MU objectives measures during the first year, the online system will walk you through al of the objectives before the actual attestation is made.

22. Beginning of the attestation screen sequence The topic listing identifies the completed topic by placing a check mark next to the topic. A topic is completed when the required answers are entered and saved. Topics become available as prerequisite topics are completed

23. Moving into the AIU Attestation…

24. Things To Keep In Mind • AIU – Acquire, Implement, Upgrade • acquiring, purchasing or securing access to certified EHR technology; • installing or commencing utilization of certified EHR technology capable of meeting meaningful use requirements; or • expanding the available functionality of certified EHR technology capable of meeting meaningful use 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.

25. Things To Keep In Mind A/I/U – Aquire, Implement, Upgrade For the West Virginia Medicaid EHR Provider Incentive Payment program a provider must demonstrate A/I/U for year 1 by simply selecting within the West Virginia EHR Provider Incentive Program web portal whether they are going to adopt, implement, or upgrade. However, providers should be prepared to provide proof of A/I/U according to the West Virginia Medicaid Provider Manual Common Chapter Section 800.19 Maintenance of Records.

26. Attestation The Submit Attestation button remains disabled if the eligibility checks failed or not all required questions have been answered. If the eligibility checks passed and all required questions are answered, selection of the Submit Attestation button will provide the screen above.

27. Process – Final • Electronically Sign and Submit Attestation to receive an EHR incentive payment. Upon submission of attestation, an Acknowledgement Page will display. Please print the completion screen and keep with EHR records. • Medicaid EHR incentive payment will be issued by W.Va. BMS within 30 business days after successful registration and attestation.

28. Final Thoughts • For the West Virginia Medicaid EHR Provider Incentive Payment program an eligible professional must demonstrate AIU for year 1 by simply selecting within the West Virginia EHR Provider Incentive Program web portal that they are going to adopt, implement, or upgrade. However, they should be prepared to provide proof of AIU according to the West Virginia Medicaid Provider Manual Common Chapter Section 800.19 Maintenance of Records. • All information submitted during the registration and attestation process is subject to verification and audit.

29. Going Back into the System… Review Attestation Status/Payment • Provides a screen that lists the registration IDs linked to you and displays attestation and payment status. • Emails will communicate status changes when they occur. • Help Desk will be able to provide support.

30. Resources W.Va. Regional HIT Extension Center – www.wvrhitec.org • Independent, non-profit organization providing technical assistance, guidance, and information on best practices to support and accelerate providers’ efforts to become meaningful users of certified electronic health record technology; • Made up of a team of experienced health information technology (HIT) and clinical professionals with intimate knowledge of West Virginia’s medical community; and • Has federal funds available to provide priority primary care providers, generally those associated with FQHCs and small private practices, with subsidized training and services (electronic health record selection and implementation, meaningful use, workflow redesign, privacy & security, etc.).

31. More Resources • WV Medicaid EHR Incentive Program website http://www.dhhr.wv.gov/bms/ehr • CMS EHR Incentive http://www.cms.gov/EHRIncentivePrograms/ • ONC Health Information Technology EHR product certification http://onc-chpl.force.com/ehrcert • WV Regional HIT Extension Center (WVRHITEC) http://www.wvrhitec.org

32. Please submit questions by email to dhhrehr@wv.gov or call 1-888 483-0793 and select option 8 when prompted. QUESTIONs?