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The Kentucky Cabinet for Health Services, Department for Medicaid Services (DMS) implements the Kentucky Medicaid EHR Incentive Program. The program is designed to give Medicaid eligible professionals (EPs) up to $21,250 to adopt, implement or upgrade a certified electronic health record (EHR) system and an additional $42,500 over the following five years for the meaningful use of a certified EHR system according to the requirements developed by the Centers for Medicare and Medicaid Services (CMS) (http://www.cms.gov/EHRIncentiveprograms/) and DMS (http://chfs.ky.gov/dms/ehr.htm).
EPs are Medicaid enrolled non-hospital-based physicians, dentists, pediatricians, nurse practitioners, certified nurse midwives and optometrists. Physician assistants practicing in a rural health clinic or federally qualified health center directed by a physician are eligible. Eligibility also is determined by Medicaid patient volume over a 90-day period. All eligible practitioners must serve an average 30 percent patient volume except pediatricians who must serve 20 percent Medicaid patient volume.
Providers are required to begin by registering at the national level registry with the Medicare and Medicaid registration and attestation system. The official CMS website for the Medicare and Medicaid EHR Incentive Programs can be found at http://www.cms.gov/EHRIncentivePrograms/.
The CMS EHR Certification ID number can be obtained from the website at https://chpl.healthit.gov/#/search. Please follow the steps below: Start by searching the list of certified products by product name, vendor name, or CHPL product number. Select +Cert ID View progress of product. Select Get Certificiation ID button. In 2017 and 2018, providers can choose to use technology certified to the 2014 Edition, 2015 Edition or a combination of the two.
All EHs must have an enrollment record in PECOS to participate in the EHR Incentive Programs except those participating only in the Kentucky Medicaid EHR Incentive Program. To get enrolled in PECOS or to see if you have an enrollment record, please visit the PECOS website at https://pecos.cms.hhs.gov/pecos/login.do.
Kentucky began making incentive payments to EPs and EHs who met the requirements of the Kentucky Medicaid EHR Incentive Program in January 2011.
Yes. The meaningful use Manual as well as the Patient Engagement, Public Health and HIE objective guidance can be found under the title Manuals and Publications on the right side of the page at http://chfs.ky.gov/dms/ehr.htm.
The maximum incentive payment an EP can receive from Kentucky Medicaid is $63,750 over a period of six years or $42,500 for pediatricians with a 20-29 percent Medicaid patient volume. EPs will receive $21,250 the first year and $8,500 for each of the remaining five years. If utilizing the 20-29 percent threshold for pediatricians, $14,167 will be paid the first year with $5,667 being paid for each of the remaining five years.
The payment for a EH is contingent on the hospital’s annual attestations and registrations, the aggregate hospital incentive payment amount over a period of three annual payments. In the first year, if all conditions for payment are met, 50 percent of the aggregate amount will be paid to the EH. In the second year, if all conditions for payment are met, 40 percent of the aggregate amount will be paid to the EH. In the third year, if all conditions for payment are met, 10 percent of the aggregate amount will be paid to the EH.
EPs must have at least 30 percent patient volume attributable to Medicaid. Pediatricians must have a Medicaid patient volume of 20 percent to be eligible. Also, EPs practicing predominantly in a RHC or FQHC can qualify for incentive payments with a 30 percent needy individuals patient volume threshold.
A needy individual is defined as an individual who receives medical assistance from Medicaid or the Children's Health Insurance Program; is furnished uncompensated care by the provider; or is furnished services at either no cost or reduced cost based on a sliding scale determined by the individual's ability to pay.
EPs may use a clinic or group practice’s patient volume as a proxy for their own under four conditions: The clinic or group practice’s patient volume is appropriate as a patient volume methodology calculation for the EP (for example, if an EP only sees Medicare, commercial, or self-pay patients, this is not an appropriate calculation); The EP must be with the clinic or group practice at least 50 percent of the 90 day reporting period; There is an auditable data source to support the clinic’s patient volume determination and; As long as the practice and EPs decide to use one methodology in each year (in other words, clinics could not have some of the EPs using their individual patient volume for patients seen at the clinic, while others use the clinic-level data). The clinic or practice must use the entire practice’s patient volume and not limit it in any way. EPs may attest to patient volume under the individual calculation or the group/clinic proxy in any participation year. Furthermore, if the EP works in both the clinic and outside the clinic (or with and outside a group practice), then the clinic/practice level determination includes only those encounters associated with the clinic/practice.
There is nothing preventing this. Any organization registering on behalf of EPs would need to have an identity and account (I&A) management user ID and password.
If a provider is eligible to participate in the Medicare EHR Incentive Program, they must demonstrate meaningful use in either the Medicare EHR Incentive Program or in the Medicaid EHR Incentive Program, to avoid a payment adjustment. Medicaid providers who are only eligible to participate in the Medicaid EHR Incentive Program are not subject to these payment adjustments.
No, EPs may receive an incentive payment from either Medicaid or Medicare, but not both.
The last program year an eligible provider could initiate participation was 2016. Initiate participation is defined as submitting a completed attestation.
The EHR final rule does not provide for incentive payments beyond the limits established by the legislation, regardless of the cost of the EHR system chosen by EPs or EHs. The purpose of the incentive payments is to encourage the adoption and meaningful use of certified EHR technology, not to act as a direct reimbursement.
Starting in 2015, the EHR reporting period for EPs, EHs and CAHs began being based on the calendar year. Also, the 90-day meaningful use period must be started and completed within the program year with no overlapping.
Nursing homes are not eligible. The following types of institutional providers are eligible for EHR incentive payments under Medicaid, acute care hospitals (which include CAHs and cancer hospitals) and children's hospitals. EPs also can choose to assign their incentive payments to their employer provided they meet the applicable criteria.
As per the Final Rule, which regulates the Medicaid EHR Incentive program, identifies the program as an individual professional program. Although a provider can designate a practice to receive the incentive funds on their behalf, it is up to the provider to make this decision. The practice or medical group cannot claim the money or make the decision for the provider, even if the EHR system belongs to the practice.
An EP is considered hospital-based if 90 percent or more of their services are performed in a hospital inpatient or emergency room setting (POS 21/23). Physicians who primarily work in inpatient and emergency room settings are excluded from the Kentucky Medicaid EHR Incentive Program.
The requirement that the incentives be passed to providers without deduction or rebate refers to requiring that the State not use the incentive payment to pay for its own program administration or to fund other State priorities. However, where there are public debts under a collection mandate, CMS considers the incentive as paid to the provider, even when part or all of the incentive may offset public debts. States should apply the same process that they use for other payments to providers in order to recoup public debts. Please note that the State of Kentucky does not subject EHR incentive payments to State debt.
The Office of the National Coordinator for Health Information Technology (ONC) is the principal federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information. The ONC is organizationally located within the Office of the Secretary for the U.S. Department of Health and Human Services (HHS). The position of National Coordinator was created in 2004, through an Executive Order and legislatively mandated in the Health Information Technology for Economic and Clinical Health Act (HITECH Act) of 2009.
An organization must submit an application to the National Coordinator to demonstrate its competency and ability to test and certify EHR technology (complete EHRs and/or EHR Modules). Once authorized, ONC-ATCBs are required to comply with the principles and conditions applicable to the testing and certification of EHR technology as specified in the temporary certification program final rule.
The list of ONC Authorized Testing and Certification Bodies is available on the ONC website at https://www.healthit.gov/policy-researchers-implementers/authorized-testing-andcertifications-bodies.
The American Recovery and Reinvestment Act of 2009 specifies three main components of meaningful use: The use of a certified EHR in a meaningful manner. The electronic exchange of health information to improve quality of health care. The use of certified EHR technology to submit clinical quality and other measures. Simply put, meaningful use means providers need to show they're using certified EHR technology in ways that can be measured significantly in quality and in quantity.
All providers are required to attest to a single set of objectives and measures for Modified Stage 2 and Stage 3. This replaces the core and menu objectives structure of previous stages. For EPs attesting to Modified Stage 2, there are 10 objectives, including one consolidated public health reporting objective, while EPs attesting to Stage 3, there are 8 objectives also including one consolidated public health reporting objective. For EHs, there are 8 objectives, including one consolidated public health reporting objective. Please visit the CMS website for more information on meaningful use and Clinical Quality Measures at https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/index.html
The Public Health Authority for Kentucky is the Kentucky Health Information Exchange (KHIE). KHIE enables safe, secure electronic exchange of patient health information among participating providers and organizations throughout the state. Connection to KHIE is required in order to meet the public health objectives for participation in the Medicaid EHR Incentive Program. They can be contacted at http://khie.ky.gov/pages/index.aspx.
Eligible hospitals (EHs) and critical access hospitals (CAHs) are eligible to participate in the Kentucky Medicaid EHR Incentive Program a maximum of three years. While eligible professionals (EPs) are eligible to participate a maximum of six years. Once a provider has completed all eligible years of participation, you are no longer required to submit an attestation to the Kentucky Medicaid EHR Incentive Program. However, providers are encouraged to participate in other programs available. The Quality Payment Program (QPP) helps providers focus on care quality and making patients heathier. QPP also ends the sustainable growth rate formula and gives the provider new tools, models and resources to help give their patients the best possible care. Providers may select to participate in the Advanced Alternative Payment models (APMs) or the Merit-based Incentive Payment System (MIPS). If you participate in an Advanced APM, through Medicare Part B you may earn an incentive payment for participating in an innovative payment model. If you participate in MIPS, you will earn a performance-based payment adjustment. To check your participation status and for more information, providers can visit https://qpp.cms.gov/.

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