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NY Medicaid EHR Incentive Program

Eligible Professionals
Modified Stage 3

Webinar is also available in Portable Document Format (PDF)

Host: Cassandra Bixler

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Audio PIN
Q&A at the end

Agenda

Program Eligibility Overview
Stage 3 Overview
CQM Overview
Program Reminders
Questions & Answers

Program Eligibility Overview

Medicaid Patient Volume (MPV)

For each payment year, eligible professionals (EPs) must meet one of the following conditions:

30% Medicaid patient volume

20% MPV for pediatricians

Two–thirds of the incentive payment

Needy patient volume

Federally Qualified Health Center (FQHC)
Rural Health Clinic (RHC)

MPV Reporting Period

The Medicaid patient volume must be a continuous 90–day period from either:

Previous calendar year

Preceding 12 months from the date of attestation

MPV Reporting Period Scenario

Payment Year: 2017 Meaningful Use

Date of Attestation: February 1, 2018

Attestation Method: Previous Calendar Year

January 1, 2016 – December 31, 2016

MPV Reporting Period Scenario

Payment Year: 2017 Meaningful Use

Date of Attestation: February 1, 2018

Attestation Method: Preceding 12 months from the date of attestation

February 1, 2017 – February 1, 2018

Medicaid / Needy Encounter

Type of Service	Medicaid Encounter	Needy Encounter
Medicaid Fee–for–Service	✓	✓
Medicaid Managed Care	✓	✓
Child Health Plus		✓
Uncompensated Care		✓
Sliding Scale		✓

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Stage 3 Overview

Meaningful Use Policies

During the EHR reporting period:

80% of unique patients must have data stored in EP´s CEHRT.

50% of the EP´s total outpatient encounters must be at locations equipped with CEHRT.

An EP must report on MU data from all locations equipped with CEHRT.

Stage 3 EHR Reporting Period

2017	2018
Continuous 90 days during the calendar year	Continuous 90 days during the calendar year

MU data must be from the calendar year that the EP attests to (e.g 2016 MU must be within calendar year 2016).

Stage 3

8 objectives (variation of threshold & activity)
Required to meet the measures or qualify for the exclusions

#	Objectives	Measures
1.	Protect Patient Health Information	Security risk analysis
2.	Electronic Prescribing	More than 60% prescriptions
3.	Clinical Decision Support (CDS)	5 CDS interventions Drug–drug and drug–allergy checks
4.	Computerized Provider Order Entry (CPOE)	More than 60% medication orders More than 60% laboratory orders More than 60% radiology orders
5.	Patient Electronic Access	Timely access for more than 80% of patients Patient–specific educational resources for more than 35% of patients
6.	Coordination of Care through Patient Engagement	Must meet at least 2 measures:
		More than 10% of patients view, download, transmit or access via API their health info
		Secure messaging with more than 5% of patients
		Patient generated health data or nonclinical setting data incorporated into CEHRT for more than 5% of patients
7.	Health Information Exchange	Must meet at least 2 measures:
		Use CEHRT to create summary of care record and electronically transmit for more than 50% transitions/referrals
		Incorporate electronic summary of care into patient´s EHR for more than 40% of transitions/referrals received
		Clinical information reconciliation for more than 80% of transitions/referrals received
8.	Public Health Reporting	Must meet at least 2 measures: Immunization Syndromic Surveillance Electronic Case Public Health Registry Clinical Data Registry

MU Public Health Support

Phone: 1–877–646–5410 Option 3
Email: MUPublicHealthHELP@health.ny.gov

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Clinical Quality Measures

CQM Reporting for EPs – 2016

At least 9 clinical quality measures (CQMs) that cover at least 3 National Quality Strategy domains
CQM reporting period may be different from the EHR reporting period

National Quality Strategy Policy Domains

Patient and Family Engagement
Patient Safety
Care Coordination
Population and Public Health
Efficient Use of Healthcare Resources
Clinical Processes and Effectiveness

Recommended Adult CQMs

eM ID & NQF	CQM Title	Domain
CMS165v1 NQF 0018	Controlling High Blood Pressure	Clinical Process/ Effectiveness
CMS156v1 NQF 0022	Use of High-Risk Medications in the Elderly	Patient Safety
CMS138v1 NQF 0028	Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention	Population/ Public Health
CMS166v1 NQF 0052	Use of Imaging Studies for Low Back Pain	Efficient Use of Healthcare Resources
CMS2v1 NQF 0418	Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan	Population/ Public Health
CMS68v1 NQF 0419	Documentation of Current Medications in the Medical Record	Patient Safety
CMS69v1 NQF 0421	Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up	Population/ Public Health
CMS50v1	Closing the referral loop: receipt of specialist report	Care Coordination
CMS90v1	Functional status assessment for complex chronic conditions	Patient and Family Engagement

Recommended Pediatric CQMs

eM ID & NQF	CQM Title	Domain
CMS146v1 NQF 0002	Appropriate Testing for Children with Pharyngitis	Efficient Use of Healthcare Resources
CMS155v1 NQF 0024	Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents	Population/ Public Health
CMS153v1 NQF 0033	Chlamydia Screening for Women	Population/ Public Health
CMS126v1 NQF 0036	Use of Appropriate Medications for Asthma	Clinical Process/ Effectiveness
CMS117v1 NQF 0038	Childhood Immunization Status	Population/ Public Health
CMS154v1 NQF 0069	Appropriate Treatment for Children with Upper Respiratory Infection (URI)	Efficient Use of Healthcare Resources
CMS136v1 NQF0108	ADHD: Follow-Up Care for Children Prescribed Attention Deficit/Hyperactivity Disorder (ADHD) Medication	Clinical Process/ Effectiveness
CMS2v1 NQF 0418	Preventive Care and Screening: Screening for Clinical Depression and Follow–Up Plan	Population/ Public Health
CMS75v1	Children who have dental decay or cavities	Clinical Process/ Effectiveness

CQM Reporting for EPs – 2017

IPPS Final Rule:

Modified 2017 CQM reporting period for EPs from a full year to a 90–day period
Reduced the number of CQMs that EPs must report on for 2017 from 9 CQMs to 6
Reduced CQM pool from 64 to 53 – to align with MIPs
Can report on any NQS Domain, relevant to the EPs scope of practice

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Program Reminders

EP Checklist

Please make sure this information is up to date:

CMS Registration – phone & email contacts
Medicaid fee–for–service enrollment
Payee affiliation

Certified EHR Technology (CEHRT)

Current minimum requirement: 2014 Edition
Visit https://chpl.healthit.gov/ to obtain CEHRT Id

Program Integrity

Providers must retain all supporting documentation for attestations for no less than six years after each payment year.

Examples:

Date–stamped reports generated from the EHR system
Screenshots of the EHR system´s interface
Dated correspondence with the public health registries

For post payment audit guidance, contact hitech@omig.ny.gov.

Resources for EPs

Modified Stage 2 Webinar

Stage 3 Webinar

Public Health Reporting Webinar

MU Attestation Workbook Tutorials & Resources

Regional Extension Centers

New York City	NYC Regional Electronic Adoption Center for Health (NYC REACH) Website: www.nycreach.org Email: pcip@health.nyc.gov Phone: 347–396–4888
Outside of New York City	New York eHealth Collaborative (NYeC) Website: www.nyehealth.org Email: hapsinfo@nyehealth.org Phone: 646–619–6400

IPPS Final Rule Summary

Reduced 2018 MU reporting period from a full year to a minimum 90–day period
Allows providers to use 2014 CEHRT for 2018
Reduced 2017 CQM reporting period from a full year to be a minimum 90–day period
Reduced 2017 CQMs from 9 CQMs to 6
Aligned with MIPS – CQMs from 64 to 53
Can report on any NQS Domain, relevant to the EPs scope of practice

IPPS Final Rule