Important Announcement on Post-Payment Audits

The Department of Health Care Policy and Financing has hired the firm Myers and Stauffer, LLC to perform all post-payment audits for the Colorado Medicaid EHR Incentive Program. This includes all Eligible Professionals and Medicaid-only Eligible Hospitals.

Myers and Stauffer, LLC will contact you directly if you have been chosen for a post-payment audit and will be the only entity working with you to complete the audit process.

Reminder: You should keep all related documents to your attestation for a minimum of six years.

FOR MORE INFORMATION Contact Tracy McDonald, Medicaid EHR Incentive Program Coordinator, by email at MedicaidEHR@corhio.org or by phone at 720.285.3232.

EHR AND MEANINGFULUSE BOOT CAMP

June 27, 2013
11:30am-5:00pm Mountain Time
Double Tree Hotel, Westminster, CO

Attend the free EHR & Meaningful Use Boot Camp and learn how to incorporate Meaningful Use objectives into your practice to increase efficiency, improve patient outcomes and make the most of the expense and time you put into your EHR adoption. Presented by CORHIO, with David Ginsberg as the featured speaker. Click here for further information or to register.

Join the CMS and ONC Meeting on Coding and Billing

Meeting about EHRs, Coding, and Billing:

May 3 from 9 a.m. to 2 p.m. ET

Please join CMS and ONC for a meeting to discuss EHRs, the increase in code levels billed for some Medicare services, and appropriate coding in an increasingly electronic environment. 

Speakers will discuss the effect of EHRs on quality clinical care, provider efficiency, and coding, as well as coding challenges and opportunities facing hospitals and clinicians. Click here to read more.

EHR Audits Q&A

With the news that CMS has started conducting pre-payment audits to monitor meaningful use payments, some providers have been worried about what it means if they get a letter in the mail. Rob Anthony, Deputy Director of the HIT Initiatives Group, Office of E-Health Standards and Services at CMS, sat down with EHRIntelligence to discuss how CMS is handling its audits of potential meaningful users, and to give some tips to providers about what to have on hand if an auditor comes knocking on the door.

Click here to read more about:

• What’s the purpose of meaningful use audits, and how do they help CMS and providers?
• The OIG made some strong recommendations last year about how CMS should improve their oversight of EHR Incentive Payments. How are you addressing these concerns?
• What are somethings to look for, and how can providers satisfy the audit requirements? 
• What advise do you have for providers who might be nervous about the audit process?  

Register Now for HRSA Webinar - Using EHRs for HIE and Interoperability for Safety Net Providers

Health Resources and Services Administration
Friday, April 26, 2013, 2 PM ET

This webinar will focus on how safety net providers can electronically exchange health information and achieve interoperability using electronic health records (EHRs). Exchanging electronic health information with other providers is a requirement under Stage 2 of Meaningful Use and has been shown to reduce costs and duplication of services, increase patient engagement, enhance patient safety, and improve healthcare quality. Follow this link to find out what presenters for this webinar will focus on.

Participants can register here.
Questions for presenters are welcome ahead of the event and may be emailed to healthit@hrsa.gov

EHR Incentive Programs

The EHR Incentive Programs Stage 1 Rule stated that, in order for a Medicaid encounter to count towards the patient volume of an eligible provider, Medicaid had to either pay for all or part of the service, or pay all or part of the premium, deductible or coinsurance for that encounter. 

The Stage 2 Rule now states that the Medicaid encounter can be counted towards patient volume if the patient is enrolled in the state’s Medicaid program (either through the state’s fee-for-service programs or the state’s Medicaid managed care programs) at the time of service without the requirement of Medicaid payment liability.

 

How will this change affect patient volume calculations for Medicaid eligible providers?
Importantly, this change affecting the Medicaid patient volume calculation is applicable to all eligible providers, regardless of the stage of the Medicaid EHR Incentive Program they are participating in. Billable services provided by an eligible provider to a patient enrolled in Medicaid would count toward meeting the minimum Medicaid patient volume thresholds. Examples of Medicaid encounters under this expanded definition that could be newly eligible might include: behavioral health services, HIV/AIDS treatment, or other services that might not be billed to Medicaid/managed care for privacy reasons, but where the provider has a mechanism to verify eligibility. Also, services to a Medicaid-enrolled patient that might not have been reimbursed by Medicaid (or a Medicaid managed care organization) may now be included in the Medicaid patient volume calculation (e.g., oral health services, immunization, vaccination and women’s health services, telemedicine/telehealth, etc.).

Providers who are not currently enrolled with their state Medicaid agency who might be newly eligible for the incentive payments due to these changes should note that they are not necessarily required to fully enroll with Medicaid in order to receive the payment.
In some instances, it may now be appropriate to include services denied by Medicaid in calculating patient volume. It will be appropriate to review denial reasons. If Medicaid denied the service for timely filing or because another payer’s payment exceeded the potential Medicaid payment, it would be appropriate to include that encounter in the calculation. If Medicaid denied payment for the service because the beneficiary has exceeded service limits established by the Medicaid program, it would be appropriate to include that encounter in the calculation. If Medicaid denied the service because the patient was ineligible for Medicaid at the time of service, it would not be appropriate to include that encounter in the calculation.

Further guidance regarding this change will be distributed to the states as appropriate.