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Meaningful Use

What is Meaningful Use?

It is a measure of determining whether or not Eligible Providers and Eligible Hospitals are using CEHRT (Certified Electronic Health Record Technology) by the standards which qualify them for participation and gain from the EHR Incentive Program run by the ONC (Office of the National Coordinator for HIT) and the CMS (Centers for Medicare and Medicaid Services). Successful participation awards financial incentives to offset the cost of implementing a CEHRT system, the funds for which is paid for from the ARRA – HITECH Act

-In other words, providers need to show they are using certified EHR technology in ways that can be measured significantly in quality and quantity.

How has the CMS arranged the reporting of Meaningful Use?

  • Stage 1 (2011 and 2012) sets the standard for electronic data capture and exchange of information.
  • Stage 2 (2013) and Stage 3 (2015) will continue to expand the standards and continue to grow from Stage 1, making menu items into core items, and will add more CQMs

How do I meet Meaningful Use Requirements?

To qualify for incentive payments, meaningful use requirements must be met in the following ways:

  • Medicare EHR Incentive Program – EPs must successfully demonstrate meaningful use of certified EHR technology every year they participate.
  • Medicaid EHR Incentive Program – EPs may qualify for incentive payments if the adopt, implement, upgrade or demonstrate meaningful use in their first year of participation and subsequent years of participation.

What does this mean?

  • Adopted: Acquired and installed certified EHR technology and can show evidence of installation.
  • Implemented: Began using certified EHR technology, providing staff training or data entry of patient demographics into the EHR.
  • Upgraded: Expanded existing technology to meet certification requirements, upgrading or adding new functionality to meet the guidelines of certification.

What are the requirements for Stage 1 of Meaningful Use 2011 and 2012?

  • For EPs there are a total of 25 meaningful use objectives. To qualify for an incentive payment, 20 of these 25 must be met.
    • There are 15 required core objectives.
    • The remaining 5 objectives may be chosen from the list of 10 menu set objectives. These are mandatory!

What are the requirements for Stage 2 of Meaningful Use 2014 and 2015?

  • For EPs there are a total of 23 meaningful use objectives. To qualify for an incentive payment, 20 of these 23 must be met.
    • There are 17 required core objectives.
    • The remaining 3 objectives may be chosen from the list of 6 menu set objectives. These are also mandatory!

What are Clinical Quality Measures?

To demonstrate meaningful use successfully, EPs are required to also report clinical quality measures specific to their practice of medicine or specialty.

  • In Stage 1, EPs must report on 6 total clinical quality measures: 3 required core measures (having 3 substitutes if necessary) and 3 additional measures (selected from a list of 38 clinical quality measures)
  • In Stage 2, EPs must report on 9 CQMs from a list of 64 and they must cover at least 3 of the 6 National Quality Strategy domains

Why 3 core, 3 alternative and 3 additional measures?

  • EPs must report on 6 total measures. The breakdown is as follows:
    • EPs must report on 3 required core CQMs.
    • If the denominator of 1 or more of the required core measures is 0, they will be required to report results on (up to) 3 alternate core measures.
    • Three additional measures must also be selected from the list of 38 CQMs (excluding the core and alternate core).

The Reporting Period

  • The reporting period for the EHR Incentive program using a certified EHR is any continuous 90 day period during the first payment year.
  • The second attestation will be for a period of one year, unless that second attestation period falls within 2014
  • All 2014 attestations will be for a period of one calendar quarter (3 months)

Can an EP receive both the Medicare and the Medicaid EHR Incentive Payment?

  • No, EPS must choose to receive the payment from either Medicare or Medicaid.

What do I need to do to receive my Medicare EHR Incentive Payment?

  • First, you must successfully register for the Medicare EHR Incentive Program
    • To register, you will need your NPI# and have a National Plan and Provider Enumeration System (NPPES) user account with ID and password information available.
    • All EPs must have an enrollment in the PECOS system
    • You might also need a Taxpayer ID number (TIN) or Employer ID number (EIN)
  • Meet Meaningful Use criteria using certified EHR technology
  • Successfully attest, using CMS’ Web-based system, that you have met meaningful use criteria using a certified EHR.

How will I attest?

In the Medicare and Medicaid EHR Incentive Program Registration and Attestation System, providers will fill in numerators and denominators, demonstrating meaningful use of your certified EHR.

  • Providers will also indicate if they qualify for exclusions to specific objectives.
  • Using reports generated from MicroMD EMR, you will be able to obtain reports that will provide you with the numbers you will need to attest.

What are the deadlines for registering and attesting for the 2011 payment year?

  • For Medicare, October 3, 2011 was the last day to begin your 90 day reporting period, December 31, 2011 ends the reporting period for EPs.
  • HFS has received approval from federal CMS to extend the deadlines for registering and attesting for the Medicaid EHR/PIP to 90 days after the end of the calendar year
  • By 2015 penalties will begin on Medicare

Here’s a sneak peek…

https://www.cms.gov/EHRIncentivePrograms/Downloads/AttestationSneakPeek.pdf
Immediately after you attest, you will see a summary of your attestation and whether or not it was successful.
What do I need to do to receive my Medicaid Incentive Payment?

  • Providers will follow a similar process using their state’s Attestation System.
  • You will be taken to the Providers’ Medicaid website for your state
  • Log on to Web interChange
  • Answer a few questions
  • Download the two forms to be completed and faxed

What are the deadlines for registering and attesting for the 2011 payment year?

  • For Medicare, October 3, 2011 was the last day to begin your 90 day reporting period, December 31, 2011
    ends the reporting period for EPs.
  • HFS has received approval from federal CMS to extend the deadlines for registering and attesting for the
    Medicaid EHR/PIP to 90 days after the end of the calendar year

    • Changed from February 29, 2012 to March 31, 2012
  • By 2015 penalties will begin on Medicare

https://www.cms.gov/EHRIncentivePrograms/Downloads/FAQsRemediatedandRevised.pdf
http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Stage_2.html
(Participation Timeline)

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