2. Key Points for Behavioral Health Providers who
want to participate in CT EHR Incentive Program
• For year 1 of Medicaid program, eligible professionals can
attest once a certified EHR is purchased.
• Although CMHA’s are not eligible for the program, rendering
providers can reassign the incentive dollars back to the
agency.
• In order to participate, a provider must have an individual
CT Medical Assistance Program provider ID.
• What you can do now-
– Have the discussion with your providers about MU and the
reassignment of incentive dollars
– Pull together all necessary data required for registration and
attestation including the individual provider ID.
• If your provider does not have an individual Medicaid provider ID number,
begin the application process now.
3. Year 1 CT Medicaid EHR Incentive Program for
Eligible Professionals
For year 1, of the Medicaid EHR
Incentive Program only, an Eligible
Professional can earn the first year
incentive payment by attesting to
A/I/U
4. Connecticut Medicaid defines Adopt, Implement or
Upgrade (A/I/U)
For year 1 of the Medicaid EHR Incentive Program only, an
Eligible Professional can earn the first year incentive payment
by attesting to A/I/U
Adopt - Acquire, purchase or install a certified EHR system.
Implement - Install or commence use of certified EHR
technology and have started one of the following:
Upgrade - Expand the available functionality of certified
EHR technology capable of meeting meaningful use
requirements at the practice site, including staffing,
maintenance, and training, or upgrade from existing EHR
technology to certified EHR technology per the Office of the
National Coordinator (ONC) EHR certification criteria.
5. Non hospital based
A hospital-based EP is defined as an
EP who furnishes 90% or more of
their covered professional services
in either the inpatient or emergency
department of a hospital;
6. Which provider types are eligible to participate in the CT
Medicaid EHR Incentive program?
1. Physician (primarily doctors of medicine
and doctors of osteopathy)
2. Nurse Practitioner
3. Certified Nurse-Midwife
4. Dentist
5. Physician Assistant who furnishes services
in a Federally Qualified Health Center
(FQHC) or Rural Health Clinic that is led by
a physician assistant
7. Additional eligibility requirements
• Must be licensed in the state of
Connecticut;
• Must have an individual Medicaid
Provider ID number
• Must not have any current sanctions
that have temporarily or permanently
barred them from participation in the
Medicare or State Medicaid programs.
8. Must meet Patient Volume requirements
To qualify for an incentive payment under the Medicaid EHR
Incentive Payment Program, an EP must meet one of the
following criteria over any continuous 90-day period in the
preceding calendar year:
1. Have a minimum 30% Medicaid patient volume;
2. Have a minimum 20% Medicaid patient volume, and is a
pediatrician;
3. Practice predominantly in a FQHC or Rural Health Center and have
a minimum 30% patient volume attributable to needy individuals.
• Medicaid patients include individuals receiving services under
Medicaid Fee-for-Service (FFS), Medicaid for Low Income Adults
(MLIA) and the HUSKY A programs.
9. Patient Volume: Individual or group by proxy
• EPs that are members of group practices or clinics can either use their
individual claim volume or use the group practice/clinic claim volume to
calculate patient volume. Using the group practice/clinic claim volume will
be subject to the following limitations:
1. The clinic or group practice’s patient volume is appropriate as a patient
volume methodology calculation for the EP.
2. There is an auditable data source to support the clinic’s or group practice’s
patient volume determination.
3. All EPs in the group practice or clinic must use the same methodology for the
payment year.
4. The clinic or group practice uses the entire practice or clinic’s patient volume
and does not limit patient volume in any way.
5. If an EP works inside and outside of the clinic or practice, then the patient
volume calculation includes only those encounters associated with the clinic
or group practice, and not the EPs outside encounters.
10. How to complete the calculation
To calculate patient volume an EP must
Total Medicaid patient encounters
Total patient encounters
Both numerator and denominator must come from the same
consecutive 90-day period in the previous calendar year.
An encounter is defined as services rendered to
– a Medicaid FFS,
– MLIA or HUSKY A
individual on any one day where Medicaid, MLIA or a Medicaid Managed
Care Organization paid for part or all of the service; or paid all or part of
the individuals’ premiums, co-payments, and cost-sharing.
11. What each eligible professional will need for
registration and attestation at CMS
• National Plan and Provider Enumeration
System (NPPES) User ID and Password
• National Provider Identifier (NPI)
• Provider Tax Identification Number
• Payee Tax Identification Number if you are
reassigning your incentive payments
• Payee National Provider Identifier if you
are reassigning your incentive payments
12. If you do not have any of these numbers..
• If you do not have a CT Medicaid provider ID, you
must register asap as a CT Medical Assistance
Program as either a performing or billing provider
http://www.chnct.org/providers.aspx
• If you do not know or to locate your NPI number,
visit:
https://nppes.cms.hhs.gov/NPPES/NPIRegistryHo
me.do
• If you do not have an NPPES login account, you
must get one. https://nppes.cms.hhs.gov/NPPES
13. Reassigning Incentive payments
• If the eligible professional (EP) is a
rendering physician for your
agency/clinic , you will want to ask the
EP to reassign the incentive dollars to
your agency.
• We recommend each agency should
negotiate and execute a written
reassignment of incentive payment
agreement
14. Required supporting documentation
needed for attestation in MAPIR system
• Documentation supporting A/I/U of Certified EHR Technology including invoices,
license agreements, purchase orders, and contracts (Required)
• CMS Certification EHR ID Cart page showing certification ID and certified EHR
product(s) used (Required)
• Documentation supporting patient volume calculations (e.g. Practice
Management System reports) (Optional, but strongly recommended)
• Dashboard screenshots, printouts or reports from the certified EHR technology
supporting the Meaningful Use attestation (Required)
• Dashboard screenshots, printouts or reports from the certified EHR technology
supporting the Clinical Quality Measures (Optional)
• Public health meaningful use measure exclusion letter, if applicable (Optional)
• Please Note: Only PDF format documents, no greater 2 Mega Bytes (MB) in size, can be uploaded into MAPIR.
15. Step by step
• Gather all required numbers and other information (NPI, Individual
Medicaid ID, NPPES login info, etc)
• Execute Reassignment of incentive agreement
• Register at CMS
• Wait up to 48 hours
• Print out supporting documentation needed for upload in MAPIR system
• Attest at CT State Medicaid using MAPIR system
• Wait for incentive payment
16. Links to the sources and authorities on the EHR
Incentive Programs
• Connecticut EHR Incetive Program User Manual for EPs
• CT Medicaid EHR Incentive Program site>Connecticut EHR Incentive Program website link
• CT EHR Incentive Program Resources: Please contact the following for assistance:
– 1-855-313-6638, Monday through Friday from 8:00 am to 5:00 pm EST
– ctmedicaid-ehr@hp.com
• Eligibility Requirements for EPS in Connecticut>
https://www.ctdssmap.com/CTPortal/portals/0/StaticContent/Publications/EHR%20Eligibil
ity%20for%20Professionals.pdf
• Centers for Medicaid and Medicaid Services, EHR Incentive Program>
http://www.cms.gov/ehrincentiveprograms/
• The Meaningful Use specification Sheets on each of the Core and Menu Measures >
http://www.cms.gov/EHRIncentivePrograms/Downloads/EP-MU-TOC.pdf
• EP eligibility Decision Tool> https://www.cms.gov/EHRIncentivePrograms/15_Eligibility.asp
• Department of Health and Human Services (HHS) Frequently Asked
Questions>http://questions.cms.hhs.gov/app/answers/list/p/21,26,1139
17. Other links you may find helpful
• HITECH Answers>
www.HITECHAnswers.net
• TWITTER LINKS:
http://twitter.com/ONC_HealthIT
http://twitter.com/HITECHAnswers
http://twitter.com/CMSGov
http://twitter.com/GovHIT
http://twitter.com/AHRQNews
18. Disclaimer
It is important that each individual take responsibility for understanding of the final rules and
regulations of the Medicaid and Medicare EHR Incentive Programs. Qualifacts Systems Inc and
www.MUforBH.com offers these free webinars as a service and makes every effort to provide
accurate information. We make no claim that our information is complete or contains no
inaccuracies.
Under no circumstances shall anyone associated with Qualifacts Systems Inc. be liable for any
incidental, indirect, consequential or special damages or loss of any kind including those
resulting from the expected incentives themselves.
Qualifacts Systems, Inc and www.MUforBH.com in no way considers itself the ultimate
authority or expert on the final rules and regulations of the Medicare and Medicaid EHR
Incentive Programs and expects that each individual will consult the state specific Medicaid
EHR Incentive Program website for their specific states rules and/or the CMS website for the
EHR Incentive Program Rules.
It is important that each Eligible Professional note that CMS views the EP as ultimately
responsible for the numerator and denominator and their Medicaid Encounter volume as well
as the data used for attestation on the measures of Meaningful Use. CMS has announced there
will be audits. “There are numerous pre-payment edit checks built into the EHR Incentive
Programs’ systems to detect inaccuracies in eligibility, reporting and payment. Post-payment
audits will also be completed during the course of the EHR Incentive Programs.”
19. www.MUforBH.com
A resource for behavioral health professionals seeking advice, guidance, and
information on meeting Meaningful Use requirements.
• FAQs
o Get quick answers to the most common Meaningful Use
questions
• Forum
o Chat and exchange ideas with others in your community
• Play the MU Game
o A step-by-step guide to claiming your Meaningful Use dollars
• Videos and Webinars
o Access past Meaningful Use presentations for additional help
or join our free live webinars
• MU State University
o Meaningful Use Education State by State
