Eligible Professional Types

The following types of healthcare practitioners are eligible to apply for the NY Medicaid EHR Incentive Program:

• Physicians (M.D. or D.O.)
• Nurse Practitioners
• Certified Nurse Midwives
• Dentists
• Physician Assistants who practice in a Federally Qualified Health Center (FQHC) that is led by a Physician Assistant or Rural Health Clinic that is led by a Physician Assistant

Medicaid Patient Volume (MPV) Requirements

Eligible Professionals (EP) who enroll in the Medicaid EHR Incentive Program must demonstrate each year that at least 30% of their patient volume is attributed to Medicaid during a 90–day reporting period they choose (see section below for more details). EPs must also attest to the Medicaid patient volume requirement by attesting to either the standard or alternative patient volume methods in the attestation portal.

Additionally, EPs in groups have an option to combine the totals of all EPs in the group and attest using aggregate totals. There is assistance available for those who have difficulty assembling their Medicaid Patient Volume. Medicaid encounter types which can be counted towards both methods:

• ✓ Medicaid Fee–For–Service
• ✓ Medicaid Managed Care
• ✓ Family Health Plus

For more information on Medicaid Patient Volume visit:
Medicaid Patient Volume Overview

Medicaid Patient Volume (MPV) Reporting Period

The patient volume reporting period may be any consecutive 90–day period within the calendar year (CY) prior to the payment year attesting to or preceding 12–month period from the date of the attestation*. The patient volume recorded within this 90–day period must be "representative" of the provider´s overall practice.

*Expanded Reporting Period Disclaimer: Please be aware that it may take an additional 90 days to validate your attestation if you select a 90–day reporting period up to the date of attestation.

For more information on Medicaid Patient Volume visit:
Medicaid Patient Volume Overview

Pre–Payment Requirements

Eligible professionals (EP) participating in the NY Medicaid EHR Incentive Program must maintain all program requirements in each participation year. The requirements include the following:

• ✓ Must be enrolled as a NY Medicaid fee–for–service provider
• ✓ Payee must be enrolled as payable NY Medicaid Provider
• ✓ Maintain ETIN association either personally or with a group/hospital

For a full list of pre–payment requirements, visit:
Participation Checklist

For more information on common pre–payment review scenarios, visit:
Pre–Payment Review Scenarios

EHR Reporting Period

Any continuous 90–day period within 2014.

Certified EHR Technology (CEHRT) Requirements

The CMS 2014 Flexibility Rule set the required CEHRT for Eligible Professionals (EPs) and Eligible Hospitals (EHs) to utilize 2011 and/or 2014 Edition CEHRT, if an Eligible Provider could not fully implement 2014 Edition CEHRT due to delays in availability and uses. The requirements are as follows:

Only 2011 Edition CEHRT: The EP or EH must satisfy the objectives and associated measures of the Stage 1 criteria that were applicable for 2013.

Combination of 2011 and 2014 Edition CEHRT: The EP or EH may choose to satisfy one of the following sets of objectives and associated measures:

• The Stage 1 criteria that were applicable for 2013.
• The Stage 1 criteria that were applicable for 2014.

If the EP or EH was scheduled to begin Stage 2 in 2014, the Stage 2 criteria that were applicable for 2014.

Only 2014 Edition CEHRT: The EP or EH must satisfy the objectives and associated measures of the Stage that is applicable for 2014.

Please see the ONC 2011 Edition Final Rule, 2014 Edition Final Rule and 2014 Edition Release 2 Final Rule for additional details on the CEHRT requirements.

EPs must attest to all 17 Core Objectives and 3 of the 6 Menu Objectives.

Core Measures

1. CPOE for Medication, Laboratory, and Radiology Orders
2. e–Prescribing (eRx)
3. Record Demographics
4. Record Vital Signs
5. Record Smoking Status
6. Clinical Decision Support Rule (CDS)
7. Patient Electronic Access
8. Clinical Summaries
9. Protect Electronic Health Information
10. Clinical Lab–Test Results
11. Patient Lists
12. Preventative Care
13. Patient–Specific Education Resources
14. Medication Reconciliation
15. Summary of Care
16. Immunization Registries Data Submission
17. Use Secure Electronic Messaging

Menu Measures

1. Syndromic Surveillance Data Submission
2. Electronic Notes
3. Imaging Results
4. Family Health History
5. Report of Cancer Cases
6. Report Specific Cases

For more information on 2014 Stage 2 Meaningful Use reporting, visit:
Stage 2 Eligible Professional (EP) Meaningful Use Core and Menu Measures

Eligible Professionals, eligible hospitals and CAHs seeking to demonstrate Meaningful Use are required to submit aggregate CQM numerator, denominator, and exclusion data.

For more information on 2014 CQM Reporting, visit:
Clinical Quality Measures Basics

For Post Payment Audit Guidance, visit:
Post Payment Audit Guidance MU Guidance–Stage 2–2014