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Registration and Attestationfor the Medicare & Medicaid EHRIncentive Programs forEligible ProfessionalsNational Provider CallSeptember 9, 20111
Agenda Path to Payment Register Attest Payments Highlights of the Registration and AttestationProcesses Third Party Proxy Trouble shooting Helpful Resources Q&A Session2
Medicare-only EligibleProfessionalsDoctors of OptometryDoctors of PodiatricMedicineChiropractorMedicaid-only EligibleProfessionalsNurse PractitionersCertified Nurse-MidwivesPhysician Assistants (PAs)when working at an FQHC or RHCthat is so led by a PADoctors of MedicineDoctors of OsteopathyDoctors of Dental Medicine orSurgeryCould be eligible for eitherMedicare & Medicaid3
Medicare Eligible Professionals Must be a physician (defined as MD, DO,DDM/DDS, optometrist, podiatrist, chiropractor) Must have Part B Medicare allowed charges Must not be hospital-based Must be enrolled in Provider Enrollment, Chainand Ownership System (PECOS) and in an‘approved status’ , living4
Medicaid Eligible Professionals Physicians (primarily doctors of medicine anddoctors of osteopathy) Nurse practitioner Certified nurse-midwife Dentist Physician assistant who furnishes services in afederally Qualified Health Center or Rural HealthClinic that is led by a physician assistant5
Register for the EHR IncentivePrograms Visit the CMS EHR Incentive Programs website Click on the Registration tab Complete your ms/6
Medicaid EP Registration If your State has not yet launched its Medicaid EHRIncentive Program, you will not be able to register. States launch their EHR Incentive Programs the 1st Mondayof the month. Check your State’s Medicaid EHR Incentive Program websitefor details regarding your State’s timeline if they have notyet launched their program. This information is also on the CMS website at:http://www.cms.gov/EHRIncentivePrograms/40 MedicaidStateInfo.asp#TopOfPage7
EHR Incentive ProgramsWebsite8
Registration Link andRegistration User GuidesRegistrationUser Guides9
EHR Incentive ProgramRegistration Module - LoginEnter theNPPES webUser ID andPasswordUser ID andPassword arecase sensitive10
Tabs will guide users through each phase11
Register12
Medicare QuestionnaireSELECT Program type Provider type EHRCertificationNumber(optional atregistration)For the certified health IT product list visit;http://healthit.hhs.gov/CHPL13
Medicaid QuestionnaireSELECT Program type MedicaidState/Territory Provider type EHRCertificationNumber(optional atregistration)14
Personal InformationMedicareInformationis pulledfrom PECOS123456789Select where your payment will go in the Payee TIN Type.The EP may select their individual billing EIN to receive their EHRincentive payment.The EP will select their group if all of their Medicare benefits areassigned to the group in PECOS.15
Medicaid Payment Assignment Medicaid EPs can elect to have theirpayment go to another qualified entity byselecting Payee TIN Type of EIN. This information will be sent to theState. There are rules around reassignmentsgoverning this program.16
The address will be posted on theprogram website once you receivepayment (Medicare only)17
Read theRegistrationDisclaimerand chooseAGREE orDISAGREE18
Medicare Successful SubmissionThiscompletesyourregistrationPrint thereceipt foryour records19
Medicaid Successful SubmissionThiscompletesyourregistrationPrint thereceipt foryour recordsThe StateMedicaidagency willcollect andverifyadditionaleligibilityinformation.After 24 hours,continue toyour State’sEHR IncentiveProgramwebsite20
Switching between ProgramsEligible Professionals may switch programs onceafter having received an incentive payment, butthe switch must occur before 201521
Notable Differences between theMedicare and Medicaid EHR Incentive ProgramsMedicareMedicaidFederal Government will implement(will be an option nationally)Voluntary for States to implement(may not be an option in every State)Payment reductions begin in 2015 for providers that do notdemonstrate Meaningful UseNo Medicaid payment reductionsMust demonstrate MU in Year 1A/I/U option for Year 1Maximum incentive is 44,000 for EPs(10% bonus for EPs in HPSAs)Maximum incentive is 63,750 for EPsMeaningful Use definition is common for MedicareStates can make minor modifications to Stage 1 Meaningful Usewith CMS prior approval (none have to date)Last year a provider may initiate program is 2014 for fullamount; Last year to register is 2016; Payment adjustmentsbegin in 2015. Last payment year is 2016Last year a provider may register for and initiate program is2016; Last payment year is 2021Only physicians, subsection (d) hospitals and CAHs5 types of EPs, acute care hospitals(including CAHs) and children’s hospitalsAIU Adopt, Implement and UpgradeCAH Critical Access HospitalHPSA Health Professional Shortage Area22
Reassigning PaymentsMedicare EPs can elect to have their payment go to anotherentity by selecting Payee TIN Type of EIN. (Choosing thisoption will activate a list of entities list that the EPreassigned Medicare benefits to in PECOS)23
Medicare Attestation24
Medicare Attestation InstructionsThere arefiveattestationactionsChooseATTEST tobegin theattestationprocessJane Doe52-123456123456789Attest25
In order to complete your attestation you must complete ALL of the topicsSelect START ATTESTATION to begin26
Attestation InformationTo obtain yourEHRCertificationNumber visit,Office of theNationalCoordinator forHealth IT (ONC)websiteEHR reporting periodEnter the EHR Certification Number and the EHRreporting period for this attestationhttp://healthit.hhs.gov/chpl27
Meaningful Use Core MeasuresSomemeasuresrequirewhether datathat youindicate wasextracted fromALL patientrecords orfrom patientrecordsmaintainedusing certifiedEHRtechnologyThere are 15 meaningful use core measures28
Meaningful Use Core MeasuresEligibleProfessionals canbe excluded frommeeting anobjective if theymeet therequirements ofthe exclusion29
Meaningful Use Core MeasuresThese objectives must be reported and there are noexclusions to reporting these measures30
Meaningful Use Core MeasuresEnternumeratoranddenominatorfor themeasureNumeratoranddenominatormust bepositivewholenumbers31
Meaningful Use Menu MeasuresReport a total of five menu measuresNote: you may log out at any point during this attestation32
Public Health MeasuresSelect up to two from the Public HealthMeasures33
Additional MeasuresSubmitadditionalmenumeasureobjectivesuntil atotal offive menumeasureshavebeenselectedOnly the five chosen measures will present on the next fivescreens34
Public Health Menu Measure35
Public Health Menu Measure36
Menu MeasureExclusions example37
Menu MeasurePatient Records example38
Menu MeasureNumerator and Denominator example39
Core Clinical Quality MeasuresEach EligibleProfessionalmust reporton three coreClinicalQualitymeasures(or alternatecore) andthreeadditionalqualitymeasuresDenominator is entered before numerator for the clinical quality measuresYou will be reporting on a minimum of 6 Clinical Quality Measures(CQMs) or a maximum of 9 CQMs40
Core Clinical Quality Measures41
Core Clinical Quality MeasuresEnterdenominator,numerator andexclusion* (ifapplicable) forthe three CQMs*Exclusionrefers to thepatientpopulation42
Alternate Clinical QualityMeasuresThe screenwill promptyou with thenumber ofalternate coreCQMs youmust selectThat numberis based onthe numberof zeros youreported inthedenominatorsof core CQMs43
Additional Quality MeasuresSelectthreeadditionalCQMsfrom thelist offorty-fourmeasures44
Additional Quality MeasuresEnter denominator,numerator for the CQMsand exclusion(if applicable) for allthree measures45
Topics for this AttestationOnce kswill indicatethecompletedtopicsChoose PROCEED WITH ATTESTATION to review the summary of measuresor MODIFY ATTESTATION to start the process from the Attestation Information screen46
Summary of MeasuresSelect the measure links to review the details of your attestationThis is your last chance to view/edit the information you have enteredbefore you attest47
Summary of MeasuresMeaningful Use Core Measure List TableEdit your entries before attesting48
Modify each Measure Individually49
Summary of Measures, continuedChooseNEXT PAGE toreview andedit theremainingmeasuresWhencomplete,chooseCONTINUE TOATTEST50
Submission Process:Attestation StatementsCheck the box next to each statement to attestChoose AGREE to complete your attestation51
Attestation DisclaimerRead the disclaimer and choose AGREE to continue yourattestation52
Submission ReceiptPrint this page for your recordsYour attestation is locked and cannot be edited53
Rejected AttestationYou did notmeet oneor more EASURESto reviewyourentries54
Summary of Measures(rejected attestation)55
Rejected AttestationReassess/modify your practice so that you can meet themeasure(s) Resubmit your attestation information again Re-submit new informationReview your documentation If an error is found correct and re-submitYou may submit an attestation for a different reportingperiod during the first payment year to successfullydemonstrate meaningful use The 90-day reporting period can be a day later (example 03/01/11 through05/31/11 versus 03/02/11 through 06/01/11). That will mean that the eligibleprofessional will have to recalculate numerator and denominator information56
Third Party ProxyIdentification & Authentication System(I&A)Users Workingon Behalf of anEligibleProfessional(s)Click CREAT ALOGIN to obtainan I&A web useraccount57
I&A Application Security CheckFor help with the I&A System, contactExternal User Services (EUS) Help Desk 1-866-484-8049 - TTY 1-866-523-4759EUSSupport@cgi.com58
I&A Create User ID and Password59
I&A User Profile60
I&A Employer InformationProvide youremployer’s EIN,legal business nameandmailing address61
I&A My Access Requests62
I&A Select Request TypeSelect request type: ‘you are requesting to act on behalf of an individual provider’A proxy user may only register and attest for 300 eligible professionals63
I&A Application Type and NPISelect Application Type:EHR Incentive ProgramEnter the EP’s NPI tosearch for the EP64
I&A My Access RequestsThe EP must log into the I&A system and approve your requestNotify the EP that you have requested accessAt this time there is not an automated email notification of the I&A system65
EP Path to Payment Make sure you are eligible for the Medicare or Medicaid EHRIncentive Program Get registered on the CMS website Adopt, implement or upgrade (Medicaid) or Meaningfully use(Medicare or Medicaid) certified Electronic Health Record(EHR) technology Obtain your EHR certification number from the Office of theNational Coordinator for Health Information Technology (ONC)Certified HIT Product List (CHPL) website Complete attestation for CMS (Medicare) or State (Medicaid)66
Helpful Resources CMS EHR Incentive Program websitewww.cms.gov/EHRIncentivePrograms Frequently Asked Questions (FAQs)Final RuleMeaningful Use Attestation CalculatorRegistration & Attestation User GuidesListserv HHS Office of National Coordinator Health IT certified EHR technology listhttp://healthit.hhs.gov/CHPL67
TroubleshootingEHR Information Center Help Desk(888) 734-6433 / TTY: (888) 734-6563Hours of operation: Monday-Friday 8:30 a.m. – 4:30 p.m. in all time zones(except on Federal holidays)NPPES Help Desk for assistance.Visit; https://nppes.cms.hhs.gov/NPPES/Welcome.do(800) 465-3203 - TTY (800) 692-2326PECOS Help Desk for assistance. Visit; https://pecos.cms.hhs.gov/(866)484-8049 / TTY (866)523-4759Identification & Authentication System (I&A) Help Desk for assistance, PECOS External UserServices (EUS) Help Desk Phone: 1-866-484-8049 – TTY 1-866-523-4759E-mail: EUSSupport@cgi.com68
User Guides and Other Resources69
Questions &Answers70
Make sure you are eligible for the Medicare or Medicaid EHR Incentive Program Get registered on the CMS website Adopt, implement or upgrade (Medicaid) or Meaningfully use (Medicare or Medicaid) certified Electronic Health Record (EHR) technology Obtain your EHR certification number from the Office of the
