From time to time, various agencies issue reports, announcements, and other information of value to our members and other physicians who are vigilant of changes to health care policy, laws and/or happenings that could affect the business of practicing medicine. Therefore, it is our goal to alert physicians to these changes by providing a resource page of helpful links to information that could affect their bottom line. Please take a moment to scan the categories and links below.
Important Information Regarding the Final Rule for Stage 2 of the Medicare and Medicaid EHR Incentive Programs.
CMS has developed a Stage 2 Overview Tipsheet, a resource that provides a summary of the Stage 2 final rule and highlights key changes to the EHR Incentive Programs, including:
The tipsheet is available on the CMS website and should be reviewed in its entirety to effectively prepare for Stage 2 requirements.
- Stage 2 Timing – The earliest eligible hospitals and CAHs will demonstrate meaningful use of Stage 2 criteria will be fiscal year 2014, or calendar year 2014 for EPs. Providers who were early demonstrators of meaningful use in 2011 will meet three consecutive years of meaningful use under the Stage 1 criteria before advancing to the Stage 2 criteria in 2014.
- Stage 2 Core and Menu Objectives – Stage 2 retains the Stage 1 core and menu structure for meaningful use objectives. Although some Stage 1 objectives were either combined or eliminated, most of the Stage 1 objectives are now core objectives under the Stage 2 criteria.
To demonstrate meaningful use under Stage 2 criteria:
- EPs must meet 20 measures (17 core and 3 of 6 menu).
- Eligible hospitals must meet 19 (16 core and 3 of 6 menu).
- Reporting Periods in 2014 – All providers, regardless of their stage of meaningful use, are only required to demonstrate meaningful use for a three-month EHR reporting period. CMS is permitting this one-time, three-month reporting period in 2014 only so that all providers who must upgrade to 2014 certified EHR technology will have adequate time to implement their new Certified EHR systems.
- Clinical Quality Measures in 2014 – Beginning in 2014, all providers, regardless of their stage of meaningful use, will report on CQMs in the same way.
- All Medicare EPs and eligible hospitals beyond their first year of demonstrating meaningful use must electronically report their CQM data to CMS.
- All Medicaid providers that are eligible only for the Medicaid EHR Incentive Program will electronically report their CQM data to their state.
- Additionally, all providers will complete this number of CQMs in 2014:
- EPs must report on 9 out of 64 CQMs
- Eligible hospitals and CAHs must report on 16 out of 29 CQMs.
CMS Has Updated the EHR Information Center with New Self-Service Options
The Electronic Health Record (EHR) Information Center Interactive Voice Response (IVR) system has been enhanced to provide users with an increased number of options and services to make accessing and reviewing data easier than ever before.
Effective February 16, 2012, providers will be able to obtain registration status, acquire attestation status, review payment information and check progress towards meeting the $24,000 threshold amount. Included in this option is reinforced privacy protection that requires the provider to enter their individual National Provider Identifier (NPI), the last five digits of their Tax Identification Number (TIN) and their EHR registration ID.
Users may access these new options by following the steps outlined below:
- Begin by dialing (888) 734 6433
- Press 3 for Self Service
- Enter the authentication elements
EHR Information Center Hours of Operation:
7:30 a.m. – 6:30 p.m. (Central Time) Monday through Friday, except federal holidays.
(Please note that General Information and Self-Service options may be reached via IVR 24 hours a day, except during periods of planned system maintenance or upgrades).
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Florida HIE Direct Secure Messaging: Free Webinars Available
Please join Health Information Exchange program staff for webinars designed to provide information to eligible professionals on the benefits of Direct Secure Messaging and how to register for this free service. Registering for the webinar in advance is not required. Please visit the Health Information Exchange Program website (www.florida-hie.net) for log-in information.back to top
CMS Will Conduct EHR Incentive Program AuditsAny provider attesting to Meaningful Use for the purpose of receiving an EHR incentive payment may be subject to an audit. CMS and its contractors will perform audits on Medicare and dually-eligible (Medicare and Medicaid) providers, while States and their contractors will perform audits on Medicaid providers. Appeals processes will be managed according to the same scheme. To make sure you're prepared, please read over the information below and follow CMS’s record-keeping recommendations.
Record Keeping Tips
- Each provider who attests to Meaningful Use to receive an EHR incentive payment should retain ALL relevant supporting documentation used in the completion of the Attestation Module responses.
- Save the supporting electronic and/or paper documentation that support your attestation.
- Save the documentation you used to support your Clinical Quality Measures (CQMs).
- Documentation to support the attestation should be retained for six years post-attestation.
- Documentation to support payment calculations, such as cost report data, should continue to follow the current documentation retention processes.
- If you are selected for an audit, this documentation will be used by CMS or the State of Florida to validate that you accurately attested and submitted CQMs, as well as verify that the incentive payment amount you received was accurate.
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- There are many pre-payment “edit checks” built into the EHR Incentive Program systems to detect inaccuracies in eligibility, reporting and payment.
- Post-payment audits will also be completed during the course of the EHR Incentive Programs.
- If the audit determines that a provider was ineligible for an EHR incentive payment, the provider must return the monies received.
- CMS will be implementing an appeals process for eligible professionals that participate in the Medicare EHR Incentive Program. Check the CMS website for more information, which should be released soon.
- States will implement appeals processes for the Medicaid EHR Incentive Program. For more information about these appeals, please contact the Florida Agency for Health Care Administration.
Florida Medicaid Program
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- September 5, 2011: Registration is now open. The Florida Agency for Health Care Administration begun accepting EHR Incentive Program Applications on September 5, 2011. To complete registration, you will first need to register on the national level (through the CMS Website) and then register in Florida using AHCA’s online Medical Assistance Provider Incentive Repository (MAPIR). To read more about the State’s registration process, click here.
While this initiative does not relate to EHRs or Meaningful Use directly, this is an important change that all physicians and other clinicians need to be aware of as, it will affect your ability to process claims for payment starting in January 1, 2012. Version 5010 (and NCPDP Version D.0) refers to the new version of the X12 standards for HIPAA transactions.
The Secretary of the Dept. for Health & Human Services adopted version 5010 to replace the current version of the X12 standard, 4010, because it lacked some functionalities necessary to meet current health care industry needs. Version 5010 is the new standard that covered entities such as health plans, health care clearinghouses, and certain health care providers must use when conducting electronic transactions, including: claims (professional, institutional and dental), claims status requests and responses, payment to providers, eligibility requests and responses, referral requests and responses, enrollment and disenrollment in a health plan, Coordination of Benefits and premium payments.
As of January 1, 2012, version 4010 will no longer be accepted or sent by the Florida Medicaid Program, nor by CMS. All covered entities (including physicians) providing care to Medicare and/or Medicaid patients must prepare for compliance by this deadline or face delays in processing and receiving Medicaid payments.
HIPAA Version 5010 makes substantial changes in the content of the data that providers submit with their claims, as well as the data available to them in response to their electronic inquiries for eligibility or claims status. The links below inform providers of these changes and how they need to plan for their implementation.
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PaperFree in the Spotlight
- April of 2010 – “The University of South Florida (USF) will help doctors across West Central Florida move towards electronic health records, with the support of a $5.9 million grant in federal stimulus funds, university and political leaders announced last week.” To read more, click here.
- To watch a news report explaining the genesis of PaperFree Florida, in addition to Representative Kathy Castor’s comments on the award, click here.
- USF Health is on the cutting edge of health information technology, leading the charge for paperless medical care. To read a Tampa Tribune article entitled “USF Pushing Doctors to Dump Prescription Pads and Go Digital,” click here.