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AHCCCS Medicaid EHR Incentive Program
Program Year 2016 Attestations
March 2017
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• Introductions
• Arizona Health-e Connection
• Key Terms to Know
• Program Overview
• Attestation Deadlines
• Getting Started
• Patient Volume
• Reminders & Other Tips
• Questions & Answers
Agenda
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• Provide information on how to attest for Program Year 2016
(PY2016) of the AHCCCS Medicaid EHR Incentive Program
• Offer an opportunity for webinar participant’s to ask questions
regarding attesting for PY2016
All lines have been muted
Please use the “Chat” feature to submit questions
Goals for
Today’s Webinar
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Who is AzHeC?
Arizona Health-e
Connection
Arizona HIE
Pi Institute
E & O Program
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Key Terms to Know
• Attestation – The final step in the submission process. The
provider attests that information is complete and accurate.
• Calendar Year = Program Year
– January 1 – December 31, 2016
– PY2016
– Must meet the requirements for PY2016 by December 31, 2016
• Eligible Provider (EP)
– Physician (MD or DO)
– Nurse Practitioner
– Certified Nurse – Midwife
– Dentist
– PA practicing in a FQHC or RHC that is led by PA
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Key Terms to Know Cont.
• ePIP - Electronic Provider Incentive Payment System
• Medicaid Patient Encounters include services rendered on
any one day to a Medicaid Title XIX enrolled individual,
regardless of payment method.
o Multiple claims for the same patient on the same day are counted
as one visit for each rendering provider.
• Medicaid Patient Volume Percentage is defined as the total
Medicaid Patient Encounters in any continuous 90-day period
in the preceding year, divided by the total of all patient
encounters in the same 90-day period.
– Note: It is exactly 90 days, not 3 months
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Resource
AHCCCS Website – www.azahcccs.gov
– Plan/Providers
– EHR Incentive Program
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Resource Con’t
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Medicaid EHR Incentive
Program Overview
• The AHCCCS Medicaid Electronic Health Record (EHR)
Incentive Program provides incentive payments to eligible
professionals as they demonstrate adoption, implementation,
upgrading, or meaningful use of certified EHR technology
• Eligible professionals are eligible for incentive payments (up to
$63,750) for 6 years, and participation years do not have to be
consecutive
• The last year that an eligible professional can begin
participation is 2016 (PY2016)
• The program runs through 2021
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Medicaid EHR Incentive
Program Overview Con’t
• If you qualify for both the Medicare and Medicaid EHR
Incentive Programs, you must choose which program you
want to participate in.
• Medicaid eligible professionals who also treat Medicare
patients will have a payment adjustment to Medicare
reimbursements starting in 2015 if they do not successfully
demonstrate meaningful use.
o If you are only eligible for the Medicaid EHR Incentive Program,
you will not be subject to Medicare payment adjustments.
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Medicaid EHR Incentive
Program Overview Con’t
• Eligible professionals can receive an incentive payment for
adopting, implementing, or upgrading (AIU) certified EHR
technology or demonstrate meaningful use (MU) in their first
year of participation.
• In subsequent years, eligible professionals can receive
incentive payments for successfully demonstrating MU.
Year 1 $21,250
Year 2 $8,500
Year 3 $8,500
Year 4 $8,500
Year 5 $8,500
Year 6 $8,500
$63,750
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Attestation Deadlines
Extended to June 30th!
Although the deadline is June 30th, providers are strongly encouraged to begin the attestation
process as soon as possible in order to allow sufficient time for any questions, system issues,
or other unforeseen events that may impact meeting the deadline.
Program Year Attesting For:
ePIP Availability Attestation
Deadline for Eligible Providers
Program Year 2016
Currently Available June 30, 2017
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Getting Started
First Year in Program
– Need to first register with CMS
– After registering with CMS, your registration details will be
forwarded to the electronic provider incentive payment system
(ePIP)
• Allow 24-48 hours for information to be sent from CMS to State ePIP
– Complete registration in ePIP
– See “AIU Quick Reference” under Resources on the AHCCCS
EHR Incentive Program page
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Getting Started Con’t
Returning Year in Program
– Years do not have to be consecutive
– If nothing has changed, do not need to register with CMS
• Any changes…. Update CMS first
– Log in to ePIP and begin process for PY2016
– Forget your login?
• Login is your AHCCCS ID
– Forget your password?
• Select reset password (Note: will need to know answer to security
questions and email used to register)
• Update CMS registration with email address and/or other changes
• Email AHCCCS ([email protected]) to reset password
– Cannot attest for multiple program years
• If a previous year is pending ePIP will not allow you to attest for PY2016
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Patient Volume
• Patient Volume information needs to be submitted each year
• Eligible Providers must demonstrate a minimum patient volume threshold of 30% Medicaid
o Minimum 20% for Pediatricians
o Medicaid EPs practicing in predominately in a FQHC or RHC – must have minimum 30% Medicaid Patient Volume or Needy Patient Volume
• Continuous 90-day period, from preceding calendar year
o For Program Year 2016, would use 90-day period from 2015
o Specifically 90 consecutive days (not 3 months)
• Individual Provider vs Aggregate Patient Volume
o All Eligible Providers in a practice must agree to use the same methodology
• Can change methodology year to year
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Medicaid Patient
Volume Calculation
Medicaid Patient Volume %
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Aggregate
Patient Volume
• If the aggregate patient volume methodology is to be used, all
eligible professionals in the group must attest using the same
aggregate patient volume
• If “Aggregate” is selected as the Patient Volume Methodology in
ePIP, system will gray out and you will not be able to enter the
patient volume
• Complete “EHR Practice Request Form” (located under Eligible
Providers on website)
• Submit form to AHCCCS
• Do this at least 30 days before the attestation deadline
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Reminders &
Other Tips
• Audit
– When a provider attests to meeting the requirements for a
program year, they are indicating the information provided is
accurate and truthful.
– The AHCCCS EHR Post-Payment Program (acting under the
Office of the Inspector General) conducts random audits to verify
the accuracy of the information provided.
– In the event a provider is audited, providers are required to retain
all relevant supporting documentation (in either paper or electronic
format) used in the completion of the Attestation
– Documentation to support the attestation should be retained for six
years post-attestation.
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Reminders &
Other Tips Con’t
• Newsletter
– AzHeC distributes a monthly newsletter for AHCCCS EHR
Incentive Program Participants.
– Newsletter contains education/information on such items as the
EHR Incentive Program, ePrescribing, connecting to the HIE, etc
– If you are not already receiving and want to be added to the email
distribution list, please send an email to [email protected].
• Health Information Exchange (HIE) Subsidy Program
– Funding from AHCCCS
– Available to EHR Incentive Program Participants
– Subsidizes implementation fees for connecting to the Arizona HIE
and achieving bidirectional health information exchange
– Contact [email protected] for additional information
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&
Please submit questions using “Chat” feature
Questions
Answers
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Additional Questions?
Arizona Health-e Connection (AzHeC)
602-688-7211
Email: [email protected]
AHCCCS EHR Help Desk Contact AHCCCS EHR Help Desk for questions concerning
registration, attestation and payment. 602-417-4333
Email: [email protected]
AHCCCS Website https://www.azahcccs.gov/PlansProviders/CurrentProviders/EHR/
