Illinois Medicaid Promoting Interoperability:

What You Should Be Doing Today

Tuesday, August 14th, 2018Speaker: Nicole Swain Moderator: Zaina Awad

Today’s Audience & Speaker

• Designed for:• Eligible Providers• PI Coordinators

• Familiar with Promoting Interoperability (PI) Program

• Purpose: Broad Overview

CHITREC Team Member

Nicole Swain

What We DoThe Illinois Department of Healthcare and Family Services (HFS) contracted with CHITREC to operate a Promoting Interoperability (formerly Meaningful Use) Help Desk.

Call our expert advisors with any questions you have about attestation, registration, and meeting the measures.

MU Rebranding to PI

Centers for Medicare & Medicaid Services (CMS) renamed EHR Incentive Programs to Promoting Interoperability (PI) Programs

• Formerly branded as Meaningful Use (MU)

• Reason: Continue focus on improving patients’ access to health information and reducing time & cost to providers

CMS in the process of finalizing updates to the programs through rulemaking

Disclaimer• This webinar is based on official guidance provided by the Centers for

Medicare and Medicaid Services (CMS) and the Office of the National Coordinator (ONC), experiences from CHITREC, and other Regional Extension Centers.

• This presentation was prepared as a tool to assist providers enrolled in the EHR Incentive Program administered by CMS. The ultimate responsibility for compliance, submission, and response to any remittance from CMS rests with the provider. It is highly recommended that providers and their designee review rules and regulations frequently.

• The focus of this presentation is recommendations for current actions in regards to the 2018 Promoting Interoperability Program for Eligible Providers. The content applies to the Medicaid EHR Incentive Program through CMS and the ONC.

Agenda: What You Should Be Doing Today• Monitoring EHR Reports• Addressing Common Challenges• Prepare for Audit • Patient Volume Pre-Approval• CMS & HFS Registrations• Summary and Additional Resources

Monitoring EHR Reports

• Objective Measures• 90-Day Reporting Periods• 2018 Modified Stage 2 • 2018 Stage 3

• Requires 2015 CEHRT

• Clinical Quality Measures• 365 days for CQMs• Reporting on six measures

• Deadline to Attest: March 31, 2019

PI

Monitoring EHR Reports:Objective Measures - Modified Stage 2, 20181. Conduct security risk assessment, including encryption.2. Implement five clinical decision support interventions, drug/drug, and

drug/allergy interaction checks.3. Use computerized physician order entry (CPOE) for > 60% medication, > 30%

lab, and > 30% radiology orders.4. e-Prescribe > 50% of prescriptions and have drug formulary enable for the

entire reporting period.5. Provide summary of care electronically for > 10% of transitions of care and

referrals.6. Use EHR to provide education to > 10% of patients.7. Perform medication reconciliation for 50% of transitions of care.8. Within four days of a visit, provide online access to health information for >

50% of patients seen. Ensure that > 5% of those patients view, download, or transmit that information to a third party.

9. Send a secure message to > 5% of patients seen.10. Engage with public health and select two out of three registries.

Monitoring EHR Reports:Objective Measures - Stage 3, 20181. Conduct security risk assessment, including encryption.2. e-Prescribe > 60% of prescriptions and have drug formulary enabled for the entire reporting

period. 3. Implement five clinical decision support interventions, drug/drug/ and drug/allergy interaction

checks.4. Use computerized physician order entry (CPOE) for > 60% medication, > 60% lab, and > 60% of

radiology orders.5. a) Provide electronic access to > 80% of patients seen.

b) Use Electronic Health Record (EHR) to provide education electronically to > 35% of patients seen.

6.* a) Ensure that > 5% of patients view, download, or transmit their health information to a third party (or access their health information through an application program interface [API]).

b) Send a secure message to > 5% of patients seen.c) Ensure that > 5% of patients have non-clinical data in the EHR.

7.* a) Send electronic summary of care for > 50% of outbound transitions of careb) Ensure that > 40% of incoming TOC have summary from another EHR c) Ensure that > 80% of incoming TOC have reconciled medications, allergies and problems.

8. Engage in public health or clinical registry (select two from five choices).

* Objectives 6 and 7: Must meet two objectives but report all three

Monitoring EHR Reports: Running Weekly Reports• Run weekly reports to check performance

thresholds

Monitoring EHR Reports: Clinical Quality Measures• Select Measure• Run Report

Common Challenging Measures*

• Objective 1: Security Risk Assessment• Objective 5: Health Information Exchange (HIE)• Objective 8: Patient Access/VDT • Objective 9: Secure Messaging• Objective 10: Public Health Reporting

*Based on Objective Measures - Modified Stage 2, 2018

Common Challenging Measures: Objective 1 - Security Risk Analysis

• What is security risk analysis?• Documentation of security plan to address risks to

confidentiality/availability/security of data• Subset of full HIPAA compliance

• EPs must perform a new security risk analysis OR review an existing one

• Health Information Exchange (HIE) requires willing partners with means to accept referral via EHR

• Exclusion if <100 outbound transitions in 90 days• Vendor costs may apply

Common Challenging Measures: Objective 5 - Health Information Exchange

• Objective 8 - Patient access: view, download, transmit (VDT)

• Requires coordinated effort to enroll patients

• Objective 9 - Secure messaging• EPs control, no coordinated effort required

Common Challenging Measures: Objectives 8 & 9 -Access & Secure Messaging

Common Challenging Measures: Objective 10: Public Health Reporting• EPs must partner with the necessary registries for

Public Health Reporting• Select two or more registries from three choices

• Measure 1: Immunization Registry Reporting • Measure 2: Syndromic Surveillance Reporting• Measure 3: Specialized Registry Reporting

• ILPMP: https://murs.illinois.gov• CDC Healthcare Surveys:

https://www.cdc.gov/nchs/dhcs/meaningful_use.htm

• Maintain Documentation• Limited information required at time of submission but…• Subject to audit up to six year post-payment

• Source Data • Objectives and CQM reports from EHR• Billing reports for patient volume • Risk analysis• Public health registry confirmation• Screen shots of clinical decision support, drug

formulary use

Prepare for Audit

Patient Volume Pre-Approval• Illinois Medicaid providers must meet patient

volume requirements annually• Have a minimum 30% Medicaid patient volume• If EP is a pediatrician, minimum 20% Medicaid patient

volume• Practice predominantly in a Federally Qualified Health

Center (FQHC) or Rural Health Clinic (RHC) and have a minimum 30% patient volume attributable to needyindividuals

• Medicaid• Charity care• Sliding fee scale

Patient Volume Pre-Approval• Medicaid patient volume pre-approval can be sent to

Mecky Lang at hfs.ehrincentive@illinois.gov• Submit 90 days of billing data with:

• Total encounters• Medicaid encounters• Medicaid Managed Care encounters

• Please be patient for a response before moving forward with attestation

• Attestations for providers who have not pre-approved are highly likely to be rejected

CMS Registration

• Federal registration• https://ehrincentives.cms.gov• If necessary:

• Update contact information for communication about program

• Add new providers who participated in AIU/MU elsewhere

• Register with your practice• Direct funds to your TIN

HFS Registration• HFS

• Log into IMPACT to ensure administrative privileges for all EPs

• Access eMIPP application and reach the attestation page by searching CMS ID

Summary• “Promoting Interoperability”• Monitoring and Running EHR Reports

• Common Challenges

• Preparing for Audits• Patient Volume Pre-Approval• Updating CMS & HFS Registrations

Available Resources: Archived Webinars• Access our webinar archive:

http://www.chitrec.org/webinars/archive/

• Recommended viewing: • Increasing Engagement Using Your Patient Portal• A Guide to Pre-Approving Medicaid Patient Volume• Promoting Interoperability – The Illinois Prescription Monitoring

Program• Getting Ready for Successful MU Attestation: Steps You Need to Take

with IMPACT and eMIPP• Getting Ready for Successful MU Attestation: Steps You Need to Take

with CMS• What You Need to Know about the MU Security Risk Analysis• I’ve Been Audited — What Do I Do? Medicaid Meaningful Use Audit

Support

Save the Date: Upcoming Webinars

Upcoming webinars*:

• September 18: “Meeting the most challenging PI measures”

• October 9: “Are you prepared for an audit? A step by step guide”

• November 13: “Getting familiar with Promoting Interoperability Stage 3”

• December 11: “Clearing the hurdles to successful PI attestation”

*Webinar registration information to come

Questions? Give us a call.

“I have depended on the Help Desk for several years now for Meaningful Use. They are professional, knowledgeable, and always

helpful and patient with my questions or concerns.” – Help Desk Customer

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