HRSA Message Regarding the Medicare and Medicaid Electronic Health Records (EHR) Incentive Program

HRSA Administrator Mary Wakefield, together with the heads of the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC), recently co-signed a letter to encourage eligible professionals and hospitals in the safety net community to take advantage of the incentive payments under the Medicare and Medicaid Electronic Health Records (EHR) Incentive Program. 

The letter provides information on:

• Eligibility and participation for the Medicare and Medicaid EHR Incentive Program
• Resource entities for health information technology support and information such as ONC’s Regional Extension Centers (REC) and HRSA’s Health Center Controlled Networks (HCCN)
• Participation with State Medicaid Agencies
• Website links to HRSA, ONC, and CMS technical assistance resources available for safety net communities to participate in the EHR Incentive Program. 

As a first step towards becoming meaningful users of EHRs, HRSA grantees, especially Federally Qualified Health Centers (FQHCs), are encouraged to take advantage of the Adopt, Implement, and Upgrade option for the Medicaid Electronic Health Record (EHR) Incentive Program.  

Please click here to read the full letter to HRSA grantees.

For more information regarding this message, please contact healthit@hrsa.gov.

HHS Press Release: HHS Secretary Kathleen Sebelius Announces Delay of ICD-10 until October 1, 2014

In a new press release from HHS, Secretary Kathleen Sebelius announced a proposed rule that would delay the compliance date for ICD-10 from October 1, 2013 to October 1, 2014

The ICD-10 compliance date change is part of a proposed rule that would adopt a standard for a unique health plan identifier (HPID), adopt a data element that would serve as an “other entity” identifier (OEID), and add a National Provider Identifier (NPI) requirement. The proposed rule was developed by the Office of E-Health Standards and Services (OESS) as part of its ongoing role, delegated by HHS, to establish standards for electronic health care transactions under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). OESS is part of the Centers for Medicare & Medicaid Services (CMS). 

The full release can be found on the CMS Website, and more information about this proposed rule can be found on the proposed rule ICD-10 fact sheet. A segment of the HHS press release is located below.  

The Department of Health and Human Services (HHS) today announced a proposed rule that would establish a unique health plan identifier (HPID). The change would save the health care industry up to $4.6 billion over ten years by enabling greater automation of electronic health care transactions, in turn helping physicians spend less time interacting with health plans — and more time with patients.

The proposed rule was developed by the Office of E-Health Standards and Services (OESS),  as part of its ongoing role, delegated by HHS, to adopt standards for electronic health care transactions under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). OESS is part of the Centers for Medicare & Medicaid Services (CMS).  The proposed rule would implement several administrative simplification provisions of the Affordable Care Act.

The proposed rule also would delay by one year, until Oct. 1, 2014, the date by which covered entities must comply with International Classification of Diseases, 10th Edition diagnosis and procedure codes (ICD-10). Covered entities are defined in HIPAA as (1) health plans, (2) health care clearinghouses, and (3) health care providers who electronically transmit any health information in connection with a transaction for which HHS has adopted a standard .

Some provider groups have expressed serious concerns about their ability to meet the October 1, 2013 compliance date. CMS and HHS believe the change in the compliance date for ICD-10, as proposed in this rule, would give providers and other covered entities more time to prepare and fully test their systems to ensure a smooth and coordinated transition among all industry segments. 

CMS has Posted the Proposed CQMs under the Stage 2 NPRM on the CMS Website

CMS has posted the full set of proposed Clinical Quality Measures (CQMs) for 2014 as part of the Medicare and Medicaid Programs Electronic Health Record (EHR) Incentive Programs Stage 2 Notice of Proposed Rule Making (NPRM). The public can review the CQMs and submit feedback online.

Proposed CQMs
The proposed CQMs are outlined in two tables that describe each measure and provide additional information for eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) beyond the descriptions listed on the National Quality Forum (NQF) website.

Some of these measures are still in development; therefore, the descriptions provided in these tables may change before the final rule is published. When possible, links have been provided for measures that have corresponding information on the NQF website. If a measure does not have an NQF number, it means that measure has not yet been endorsed.

Public Comment
Public comments regarding these measures should be submitted using the same method required for all comments related to the proposed rule. You can submit public comments online through the federal regulations website. 

The deadline for public comments relating to the proposed CQMs and other aspects of the Stage 2 NPRM is May 7, 2012.

CMS Webinar: EHR Incentive Program Basics for Eligible Professionals

Wednesday, May 2^nd 11:30 MDT

CMS Regions VI, VII and VIII are pleased to announce a new webinar presenting basic information on how your practice may be able to access EHR incentive payments.

This session will provide you with the information you need to determine if you are eligible to earn an incentive payment and if so, the steps you need to take to become a meaningful user of EHR technology.

This webinar is unique in its two-part design to ensure you get the information you need for success.

Part One of the webinar is a pre-recorded presentation that you can view at your convenience prior to May 2^nd.

Part Two is a live webinar that will briefly highlight the pre-recorded material and demonstrate helpful incentive program tools available to you online.  The majority of the live webinar will be dedicated to a question and answer session.

What You Need To Do

·         Prior to May 2, click on the link below to learn the basics of the EHR incentive program: http://www.cms.gov/EHRIncentivePrograms/Downloads/EP_Basics_for_July2011.zip.

·         Make a list of your EHR incentive program questions to ask at the Q&A session on the live webinar.  If you prefer, you may submit questions in advance to – ROkcmMFM@cms.hhs.gov please use “May 2 EHR Call” in the subject line of your email.  Questions should be submitted no later than COB Monday, 4/30/12.

·         Join the live webinar on May 2^nd.

Target Audience

The presentation will be geared specifically to EPs in the following states:  AR, CO, IA, KS, LA, MO, MT, NE, ND, NM, OK, SD, TX, UT & WY

Registration is not required.  The session will accommodate 250 webinar and teleconference participants on a first come, first served basis. If several people are calling from one location please use one line if possible.   Presentation materials will be available for viewing upon your entrance into the webinar.  

CMS Announces Extension of Eligibility Appeals Deadline to April 30

CMS is extending the deadline for eligible professionals (EPs) to submit eligibility appeals under the Medicare Electronic Health Record (EHR) Incentive Programs' 2011 payment year. The new deadline is April 30, 2012, giving EPs an extra month to file their appeals. 

An eligibility appeal allows a provider to show that all the requirements for the Medicare EHR Incentive Program were met and that he or she should have received a payment but could not because of circumstances outside of the provider's control.

CMS affords providers with a two-level appeal process: an informal review and a request for reconsideration. Within the two-level appeal process, there are three types of appeals that can be filed in the Medicare EHR Incentive Program: (1) eligibility, (2) meaningful use, and (3) incentive payment appeals. 

Detailed guidance on the appeals process and additional information on all of the appeal types are available on the OCSQ website.

Note: For general questions and for information on how to file an appeal, providers may contact Provider Resources, Inc., CMS' designated appeal support contractor, via phone between 9 a.m. and 5 p.m. EST, Monday through Friday or via email. 

1.            Toll-free number: 855-796-1515
2.            Email: OCSQAppeals@provider-resources.com

Latest Success Data on Provider Participation in the EHR Incentive Programs

CMS has released February 2012 data that highlights program-to-date (since January 2011) participation and payment totals under  the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. The February report documents continued growth in  registrations and payments, including:

• Over 211,500 eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) have registered for the Medicare and/or Medicaid EHR Incentive Programs since January 2011
• Over 20,000 registered for the Medicare and/or Medicaid EHR Incentive Programs in the month of February
• Over 62,000 EPs, eligible hospitals, and CAHs have been paid for successfully participating in the Medicare and/or Medicaid EHR Incentive Programs
• Over $3.8 billion has been paid in Medicare and Medicaid EHR Incentive Program payments to EPs, eligible hospitals, and CAHs across the country
• Over $738 million was paid in the month of February

Visit the Data and Reports page on the EHR website to review more of more data on continued acceleration in  registration and payment data.

Helpful Resources
CMS has created several resources to help participants navigate the Medicare and Medicaid EHR Incentive Programs. A few key resources include:

• An Introduction to the Medicare EHR Incentive Program for Eligible Professionals- This interactive guide helps EPs navigate every aspect of the Medicare program and provides helpful resources and tips along the way. A Medicaid guide will be available later this spring.
• Updated User Guides- CMS has updated the registration and attestation user guides, which walk EPs and eligible hospitals through CMS' registration and attestation system. There are five guides in total and all of them can be downloaded from the Educational Materials page of the EHR website.
• Provider Testimonial Videos- These videos, which can be found on the CMS YouTube channel, highlight providers' experiences participating in the EHR Incentive Programs.

If you are considering registering for the programs, but have not done so yet, take a look at the CMS EHR website and use our eligibility tool to find out if you can participate. 

Remember: 2012 is the last year in which EPs can receive a full incentive payment in the Medicare EHR Incentive Program. Beginning in 2013, EPs will receive a smaller overall total payment. Remember to register early.

Have You Completed Your 5010 Implementation?

There are steps to ensure that your upgrade is a smooth one: establish a line of credit and check partner readiness

Recently, the Centers for Medicare & Medicaid Services (CMS) announced it will not initiate enforcement action against any HIPAA covered entity for an additional three (3) months, through June 30, 2012,for the updated HIPAA transaction standards (ASC X12 Version 5010, NCPDP Versions D.0 and 3.0).

Although much progress has been made in the successful receipt and processing of claims in the Version 5010 format, CMS is aware that there are still challenges and issues impeding an industry wide upgrade.

During these additional 90 days in which CMS will not initiate enforcement penalties, you should collaborate more closely with trading partners on appropriate strategies to resolve any remaining problems. Two steps providers can take to ensure a smooth upgrade are:

1. Establishing a line of credit: To avoid potential cash flow disruptions, providers should consider establishing or increasing a line of credit. By doing so, they can prepare for possible delays and denials in payer claims reimbursements if noncompliant Version 5010 transactions are submitted. 
2. Check partner readiness: Because a provider's Version 5010 upgrade can be dependent upon his or her vendor, it is important for providers to be aware of their vendor's transition status. If your vendor is behind schedule for Version 5010 adoption, get confirmation of their timeline to be compliant, and encourage them to take action so that your system will be prepared to handle your claims.  

Other steps to prepare for the Version 5010 upgrade can be found on the Version 5010: Ensuring a Smooth Transition Fact Sheet, which provides an overview of several actions providers can take to maintain continuity of operations for their practices as they prepare to complete Version 5010 testing.

Keep Up to Date on Version 5010 and ICD-10.
Please visit the ICD-10 website for the latest news and resources to help you prepare, and to download and share the implementation widget today!