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Kentucky Medicaid EHR Incentive Program

Status of the Kentucky Medicaid EHR Incentive Program

Attention Providers: The Kentucky Medicaid EHR Incentive Program is not accepting program year 2017 MU attestations at this time.

Please visit EHR Incentive Program to complete your registration for the Kentucky Medicaid EHR Incentive Program. Information about the program is provided below.

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What's New

EHs and CAHs: How to View Your MU Data

(November 8, 2017) CMS is streamlining the Medicare attestation process by migrating the MU attestation system from the Medicare and Medicaid EHR Incentive Program Registration and Attestation System to the QualityNet Secure Portal (QNet). As part of this transition, MU data is now in view-only mode on the EHR Incentive Program Registration and Attestation System. EHs and CAHs will be able to access this MU data on QNet beginning January 2, 2018.

Starting in January, Medicare eligible hospitals and CAHs must attest to CMS for MU through QNet. The change applies to 2017 meaningful use data, as well as future reporting periods. QNet is the same system Medicare eligible hospitals and CAHs currently use for CQM reporting. Medicaid eligible hospitals should contact their state Medicaid agencies for specific information on how to attest. The Registration and Attestation System will still be available to these hospitals. Dually eligible hospitals and CAHs will register and attest for Medicare on the QNet portal and update and submit registration information in the Registration and Attestation System.

Don’t forget to review the 2017 Modified Stage 2 and Stage 3 EHR Incentive Program requirements to ensure you are ready to attest in 2018.

Attention Providers

Please read the Program Reminders

The Kentucky Medicaid Electronic Health Record (EHR) Incentive Program encourages eligible professionals , eligible hospitals, and critical access hospitals to review program requirements each program year as they demonstrate meaningful use (MU) of certified EHR technology (CEHRT). Since the Modified Stage 2 Rule was released, CMS has published new rules, MACRA and IPPS to name a couple, that impact the EHR Incentive Program. Unfortunately, the release of the multiple rules has created some confusion regarding the requirements of attesting to the Kentucky Medicaid EHR Incentive Program. Please keep in mind the following: 

  • Reports—It is very important to discuss the need for MU reports with your EHR vendor. Note , you will need more than the ACI reports needed for MIPS participation.
  • Attesting—All providers attesting to the state Medicaid program will manually enter attestation information. EHR vendors cannot electronically submit your attestation. 
  • CEHRT—In order to attest to Stage 3 measures you must have a fully implemented 2015 edition or a combination of 2014 and 2015 editions CEHRT.

MIPS does not replace the Medicaid EHR Incentive Program. If a provider plans to participate in the Medicaid EHR Incentive Program and they are also a Medicare Part B clinician who is eligible for MIPS, they will also need to participate in the MIPS program to avoid a negative MIPS payment adjustment. Even though the Medicare MU program has sunset, the Medicaid EHR Incentive Program is available for provider participation through 2021.

Partners Commit to Helping Kentucky Clinicians Successfully Participate in the Quality Payment Program

The Kentucky Health Information Exchange (KHIE), Kentucky Department for Medicaid Services (DMS), Kentucky Department for Public Health (KDPH), Kentucky Rural Healthcare Information Organization (KRHIO), Qsource -- a member of atom Alliance, the Quality Innovation Network-Quality Improvement Organization (QIN-QIO) -- and the University of Kentucky’s Regional Extension Center (KY REC) have made the bold commitment to helping 90 percent of eligible clinicians in the state successfully participate in the Quality Payment Program for performance year 2017. The Quality Payment Program is new federal legislation altering the way clinicians are reimbursed for their Medicare Part B encounters. Since 2017 is the transition year into the MIPS program, clinicians have multiple reporting options, known as “Pick Your Pace,” to be successful and avoid a negative payment adjustment.

Read the full announcement

CMS Issues IPPS Final Rule

On August 2, 2017, the Centers for Medicare and Medicaid Services (CMS) issued the IPPS final rule, which has implications for the Medicare and Medicaid Electronic Health Record Incentive Programs.

Changes to Clinical Quality Measures (CQMs)

For Program Year 2017, EHs and CAHs reporting CQMs electronically, the reporting period will be one self selected quarter of CQM data in CY 2017. If an EH or CAH is only participating in the EHR Incentive Program or is participating in both the EHR Incentive Program and the Hospital IQR Program, the EH or CAH will report on at least four (self-selected) of the available CQMs.

For Program Year 2018, EHs and CAHs reporting CQMs electronically, the reporting period will be one self-selected quarter of CQM data in CY 2018. For the Medicare EHR Incentive Program, the submission period for reporting CQMs electronically will be the two months following the close of the calendar year, ending February 28, 2019. EHs and CAHs participating only in the EHR Incentive Program or participating in both the EHR Incentive Program and the Hospital IQR Program, the EH or CAH will report on at least four (self-selected) of the available CQMs. EHs and CAHs that report CQMs by attestation under the Medicare EHR Incentive Program, as a result of electronic reporting not being feasible, and EHs and CAHs that report CQMs by attestation under their state’s Medicaid EHR Incentive Program are required to report on all 16 available CQMs for the full CY 2018 (consisting of four quarterly data reporting periods).
 
Additionally, CMS finalized for EPs in the Medicaid EHR Incentive Program for Program Year 2017, the CQM reporting period to be a minimum of a continuous 90-day period during CY 2017. Also for Program Year 2017, CMS aligned the specific CQMs available to EPs participating in the Medicaid EHR Incentive Program with those available to clinicians reporting eCQMs via their EHR for the Merit-based Incentive Payment System (MIPS).

Changes to the Medicare and Medicaid EHR Incentive Programs
 
For 2018, CMS finalized the modification to the MU reporting period for participants attesting to CMS or their state Medicaid agency from the full year to a minimum of any continuous 90-day period during the calendar year.
 
CMS finalized the addition of a new exception from the Medicare payment adjustments for EPs, EHs, and CAHs, that demonstrate through an application process, that compliance with the requirement for being a meaningful EHR user is not possible because their CEHRT has been decertified under ONC’s Health IT Certification Program. CMS also finalized an exception to the 2017 and 2018 Medicare payment adjustments for ambulatory surgical center (ASC)-based EPs and defining ASC-based EPs as those who furnish 75 percent or more of their covered professional services in an ASC, using Place of Service (POS) code 24 to identify services furnished in an ASC.
 
CMS also finalized policies to allow healthcare providers to use either 2014 Edition CEHRT, 2015 Edition CEHRT, or a combination of 2014 Edition and 2015 Edition CEHRT, for Program Year 2018.  This policy is based on our ongoing monitoring of the deployment and implementation status of EHR technology certified to the 2015 Edition and feedback by stakeholders who requested more time for the transition process.
 
For more information:
Fact Sheet
Press Release
Federal Register

Kentucky REC hosts Healthcare Transformation Survival Seminars

(July 10, 2017) The Kentucky REC is hosting four seminars providing an in-depth look at the Medicare Access and CHIP Reauthorization Act (MACRA) legislation and the Quality Payment Program. Significant changes to physician payments now are tied to quality and value. This event will prepare healthcare providers for the changes under MACRA and Value-Based Payment. We will explore: QPP eligibility, QPP reporting metrics, improvement activities, ACI and meaningful use, HIPAA requirements and quality improvement. Lunch will be provided. This activity has been approved for AMA PRA Category 1 Credit.

Dates/Locations
Aug. 18, 2017 - London, KY
London Community Center
Room AB
529 S Main St
London, KY 40741
9:30 a.m. - 3 p.m. Eastern time

Sept. 14, 2017 - Georgetown, KY
Georgetown College
Banquet Hall
100 Crawford Drive
Georgetown, KY 40324
9:30 a.m. - 3 p.m. Eastern time

Sept. 28, 2017 - Paducah, KY
Baptist Health Paducah
Heart Center Auditorium
2501 Kentucky Avenue
Paducah, KY 42003
9:30 a.m. - 3 p.m. Central time

Oct. 5, 2017 - Ashland, KY
Ashland Community College
The Rocky Adkins Pavilion
902 Technology Drive
Grayson, KY 41143
9:30 a.m. - 3 p.m. Eastern time

Register Now

Registration Fee
Clinicians/practice representatives/non-profit organizations: $25
Vendors and non-practice representatives: $75

Quality Payment Program (QPP) Resources

(June 15, 2017) CMS recently has revamped the look of the Quality Payment Program website and also posted new resources to help clinicians successfully participate in the first year of the Quality Payment Program. CMS encourages clinicians to visit the website to review the following new resources:

To get the latest information, visit the Quality Payment Program website.

KHIE Declaration of Readiness: Program Year 2018

(June 15, 2017) The Kentucky Health Information Exchange (KHIE) is the Public Health Authority for meaningful use (MU) reporting in Kentucky.  Kentucky Eligible Professionals (EPs) and Eligible Hospitals/Critical Access Hospitals (EH/CAHs) who wish to submit to any of the following registries must do so through KHIE. 
For Meaningful Use, KHIE provides support for the following public health reporting measures:

Kentucky Immunization Registry
Any EP or EH/CAH that administers any type of immunization (influenza, pneumococcal, HPV, chickenpox, shingles, etc.) during the EHR reporting period, can submit to or query the immunization registry.

CDC BioSense Syndromic Surveillance
In Kentucky, all EPs or EH/CAHs collect syndromic surveillance data.

Kentucky Cancer Registry
Any EP that diagnoses and/or treats cancer patients is eligible to submit to the Kentucky Cancer Registry.

KHIE Advance Directive Registry
In Kentucky, any EP or EH/CAH is eligible to submit advance directive documents to the KHIE Advance Directive Registry.

Kentucky National Electronic Disease Surveillance System
Kentucky recently adopted legislation, 902 KAR 2:020, requiring laboratory results to be reported electronically to KHIE.

Kentucky Health Information Exchange
Any EP or EH/CAH is eligible to utilize KHIE as a public health measure.
KHIE supports public health reporting data submission from ONC 2014 certified electronic health record technology (CEHRT) and ONC 2015 CEHRT. To register your intent to submit to any of these registries, contact the KHIE outreach coordinator for your region.

MIPS Lookup Tool

(May 12, 2017) Unsure of your participation status in the Merit-based Incentive Payment System (MIPS)? Clinicians now uses an interactive tool on the CMS Quality Payment Program website to determine if they should participate in the MIPS track of the Quality Payment Program in 2017. To determine your status, enter your national provider identifier in the entry field on the tool which can be found on the Quality Payment Program website. Information then will be provided on whether or not you should participate in MIPS this year and where to find resources.

You will participate in MIPS in 2017 if you bill Medicare Part B more than $30,000 a year AND see more than 100 Medicare patients a year. You must be a physician, physician assistant, nurse practitioner, clinical nurse specialist or certified nurse practitioner. If you are new to Medicare in 2017, you do not participate in MIPS. You also may be exempt if you qualify for one of the special rules for certain types of clinicians or are participating in an Advanced Alternative Payment Model. To learn more, review the MIPS Participation Fact Sheet.

To get the latest information, visit the Quality Payment Program website. The Quality Payment Program Service Center may be reached at 1-866-288-8292 (TTY 1-877-715- 6222), available Monday through Friday, 8 a.m. - 8 p.m. Eastern time or via email.

Announcement

CMS has updated the CMS EHR Incentive Programs website and resources based on changes to the program. CMS encourages EPs, eligible hospitals and CAHs to visit the updated website to find official CMS resources and program information, including:

Since the Stage 2 Final Rule was released there have been numerous changes to the meaningful use (MU) objectives and measures. CMS has made available comparison tools for EPs and EHs. The tool highlights how the MU objectives have evolved from Stage 2 to Modified Stage 2 to Stage 3. In addition to describing the MU requirement changes, a timeline is presented that includes key dates and deadlines associated with the MU stages and associated program years.

CMS Finalizes Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Rule

The Centers for Medicare and Medicaid Services finalized updated payment rates and policy changes in the Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System for calendar year 2017. This rule includes changes to the EHR Incentive Program, as well. Changes include a 90-day meaningful use reporting period in program years 2016 and 2017, removal of clinical decision support and computerized provider order entry objectives and measures and reduction of a subset of the remaining objectives and measure for EHs, new participants in program year 2017 must attest to modified stage 2 objectives and measures, significant hardship exception for new participants transitioning to MIPS in 2017 and modifications to measure calculations for actions outside of the EHR reporting period.

For more information, read the:
Press Release
Fact Sheet
The OPPS/ASC Final Rule with comment period and the IFC are available on the Federal Register.

CMS Finalizes MACRA

(Oct. 14, 2016) The Department of Health and Human Services finalized its policy implementing the Merit-Based Incentive Payment System (MIPS) and the Advanced Alternate Payment Model incentive payment provisions in the Medicare Access and CHIP Reauthorization Act of 2015. A Quality Payment Program website has been created to help explain the new program and help clinicians identify the measures most meaningful to their practice or specialty.

What does MIPS mean for the Medicaid EHR Incentive Program? MIPS applies to physicians and clinicians providing services under Medicare Part B. MIPS does not replace the Medicaid EHR Incentive Program, which will continue through program year 2021. Clinicians eligible for the Medicaid EHR Incentive Program will continue to attest to their respective State Medicaid Agencies to receive their incentive payments. If those clinicians are also Medicare Part B clinicians, they may also participate in MIPS.

MACRA/MIPS will sunset the Medicare meaningful use payment adjustment, and there will no longer be a separate Medicare EHR Incentive Program at the end of CY 2018. Medicaid EPs that fail to meet the eligibility criteria for the Medicaid EHR Incentive Program, or who fail to properly attest to meaningful use, will no longer be subject to any Medicare payment adjustments after the CY 2018 payment year. No changes were proposed to the objectives and measures previously established in rulemaking for the Medicaid EHR Incentive Program (for EPs). MIPS does not apply to hospitals or facilities – it only applies to clinicians.

Please read the

Help Stop Information Blocking

(Aug. 11, 2016) -The Department of Health and Human Services is working to identify and stop instances of information blocking. Information blocking (or data blocking) occurs when individuals or entities (healthcare providers or IT vendors as example) knowingly and unreasonably interfere with the exchange or use of electronic health information. Read more information regarding helping to stop information blocking. Help stop information blocking by reporting information blocking.

Kentucky Health Information Exchange Declaration of Readiness: Program Year 2017

(July 5, 2016) The Kentucky Health Information Exchange (KHIE) is the Public Health Authority for meaningful use (MU) reporting in Kentucky. Eligible Professionals (EPs) and Eligible Hospitals/Critical Access Hospitals (EH/CAHs) who wish to submit electronic immunization, syndromic surveillance, laboratory results, and cancer cases (specialized registry reporting) in Kentucky must do so through KHIE. Additionally and with regards to the immunization registry, KHIE has the ability to respond to bidirectional queries and receive NDC codes.

For EHR Incentive Program Year 2017, KHIE provides support for the following public health reporting measures:

Measure 1 - Immunization Registry Reporting
Any EP or EH/CAH that administers any type of immunization (influenza, pneumococcal, HPV, chickenpox, shingles, etc.) during the EHR reporting period, can submit to the immunization registry.

Measure 2 - Syndromic Surveillance Reporting
In Kentucky, all EPs or EH/CAHs collect Syndromic Surveillance data; therefore, this option is available to all providers.

Measure 3 - Specialized Registry Reporting
Any EP that diagnoses and/or treats cancer patients is eligible to submit to the Kentucky Cancer Registry through KHIE for specialized registry reporting.

Measure 4 - Electronic Reportable Laboratory (ELR) Results Reporting
Kentucky recently adopted legislation, 902 KAR 2:020, requiring laboratory results to be reported electronically to KHIE.

KHIE supports public health reporting data submission from ONC 2014 certified electronic health record technology (CEHRT). KHIE will make a separate announcement when we are ready to begin onboarding of public health reporting from providers that are using ONC 2015 CEHRT.

View older EHR announcements.

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Kentucky Medicaid EHR Incentive Program Information

The American Recovery and Reinvestment Act of 2009 (Section 4201) established the Medicaid EHR Incentive Program for payment to certain classes of Medicaid professionals and hospitals who adopt and become meaningful users of electronic health records.

The Centers for Medicare and Medicaid Services (CMS) and Office of the National Coordinator have released rules to guide the program, integrating it into the broader health information technology infrastructure needed to reform the health care system and improve health care quality, efficiency and patient safety.

Information on the Medicare and Medicaid EHR Incentive Programs can be found on the CMS website. Administration of the Medicaid EHR Incentive Program is a combined effort of both the states and CMS. We recommend you visit the CMS website for a baseline understanding of the program and use this website to find information on Kentucky-specific questions.

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Why an EHR Incentive Program?

The nation's health care system is undergoing a transformation in an effort to improve quality, safety and efficiency of care, from the upgrade to ICD-10 to information exchanges of EHR technology.

To help facilitate this vision, the Health Information Technology for Economic and Clinical Health Act, or the HITECH Act established programs under Medicare and Medicaid to provide incentive payments for the meaningful use of certified EHR technology. David Blumenthal, MD, MPP, explains this in more detail in his article The Meaningful Use Regulation for Electronic Health Records published in The New England Journal of Medicine.

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Kentucky Medicaid EHR Incentive Program Specifics

There are slight differences between the Medicare and Medicaid EHR Incentive Programs. Refer to the Medicaid Provisions of the EHR Incentive Program.

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Who are Eligible Professionals?

The final rule published to the Federal Register on July 28, 2010, defines eligible professionals as physicians, dentists, certified nurse-midwives, nurse practitioners and physician assistants who are practicing in federally qualified health centers or rural health clinics led by a physician assistant.

To be eligible for a Medicaid EHR incentive payment, a professional must meet certain Medicaid patient volume requirements. For more information, visit the Medicaid Eligible Professionals section of the CMS website.

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Who are Eligible Hospitals?

Eligible hospitals that may participate are acute care hospitals, critical access hospitals and children's hospitals whose CCN number falls into one of the following ranges: 0001-0879, 1300-1399 and 3300-3399.

To be eligible for a Medicaid EHR incentive payment, acute care hospitals and critical access hospitals must have at least 10 percent Medicaid (Title XIX) patient volume. Children's hospitals have no Medicaid patient volume requirements. For more information visit the Hospital section of the CMS website.

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Last Updated 11/20/2017