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Meaningful Use Registration & Attestation WV HFMA / WVHIMSS Fall Conference The Changing Seasons of Healthcare September 26-28, 2012

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Meaningful Use Registration & Attestation. WV HFMA / WVHIMSS Fall Conference The Changing Seasons of Healthcare September 26-28, 2012. Objectives. Understand steps to register – EH & EP Understand steps to attest – EH & EP - PowerPoint PPT Presentation

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Page 1: Meaningful Use Registration & Attestation

Meaningful Use Registration & Attestation

WV HFMA / WVHIMSS Fall ConferenceThe Changing Seasons of HealthcareSeptember 26-28, 2012

Page 2: Meaningful Use Registration & Attestation

Objectives

1. Understand steps to register – EH & EP2. Understand steps to attest – EH & EP3. 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

GuideEHR 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 approvalEmail 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 Eligibility1. Identify timeframe to Attest2. Run claims data for the same time period

but from the previous year.3. Determine if provider is hospital based

a. 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 volume5. Calculate percent Medicaid volume6. 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

behalfEH 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 LearnedEP Registration – continued

Register 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

TIMEEasier to identify a specific timeframe to attest so

claims data can be run – streamlines process9/28/12 Kimberly F. Clarke, FHIMSS, CPHIMS

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Registration – Lessons LearnedEP 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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QUESTIONS?