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Wisconsin Medicaid Electronic Health Record Incentive Program Application Requirements
Wisconsin Department of Health Services
December 15, 2015
Elliot Hamer, Communications and Outreach Lead
Janelle Safian, Pre-Payment Verification Specialist
Division of Health Care Access and Accountability
Electronic Health Record (EHR) Incentive Program
Program Year 2015 Application Requirements
1
Wisconsin Medicaid Electronic Health Record Incentive Program Application Requirements
Wisconsin Department of Health Services
Agenda • Current State of Program Year 2015
• Certified EHR Technology (CEHRT) and Documentation Requirements
• Patient Volume and Documentation Requirements
• Documentation Submission Requirements
• Application Process Guide
• Program Resources
• Questions
2
Wisconsin Medicaid Electronic Health Record Incentive Program Application Requirements
Wisconsin Department of Health Services
Current State of Program Year 2015 Program Year 2015 Application Requirements
3
Wisconsin Medicaid Electronic Health Record Incentive Program Application Requirements
Wisconsin Department of Health Services
Current State of Program Year 2015 • Now accepting adopt, implement, and upgrade
applications.
• Will accept meaningful use applications at a later date.
4
Wisconsin Medicaid Electronic Health Record Incentive Program Application Requirements
Wisconsin Department of Health Services
Meaningful Use Delay • Modified Stage 2 and Stage 3 final rule was published
October 16, 2015:
o Program Year 2015 has a 90-day EHR reporting period for all providers.
o Changes to meaningful use measures necessitate attestation system changes.
• Continue to check Wisconsin Medicaid EHR Incentive Program website for announcements.
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Wisconsin Medicaid Electronic Health Record Incentive Program Application Requirements
Wisconsin Department of Health Services
Did You Know? • Program Year 2016 is the last year to initiate
participation in the Medicaid EHR Incentive Program.
• Starting in Program Year 2015, providers must submit CEHRT and patient volume documentation with their applications.
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Wisconsin Medicaid Electronic Health Record Incentive Program Application Requirements
Wisconsin Department of Health Services
CEHRT and Documentation Requirements
Program Year 2015 Application Requirements
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Wisconsin Medicaid Electronic Health Record Incentive Program Application Requirements
Wisconsin Department of Health Services
CEHRT Requirements
• 2014 edition of CEHRT required
• New CEHRT documentation requirements:
o Proof of CEHRT must be submitted with applications.
o Applications without proof of CEHRT will be returned to the provider for resubmission including the required documentation.
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Wisconsin Medicaid Electronic Health Record Incentive Program Application Requirements
Wisconsin Department of Health Services
CEHRT Documentation Requirements
Supporting documentation must identify:
Vendor Name
Eligible Professional or Organization
Name
Product Version
Product Name
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Wisconsin Medicaid Electronic Health Record Incentive Program Application Requirements
Wisconsin Department of Health Services
CEHRT Documentation Examples
Providers may need to submit more than one item below to fulfill documentation requirements:
• Contract
• Lease
• Proof of purchase
• Receipt
• Vendor letter: signed and dated by vendor
• System screenshot: may be submitted in addition to one of the above items
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Wisconsin Medicaid Electronic Health Record Incentive Program Application Requirements
Wisconsin Department of Health Services
Patient Volume and Documentation Requirements
Program Year 2015 Application Requirements
11
Wisconsin Medicaid Electronic Health Record Incentive Program Application Requirements
Wisconsin Department of Health Services
Patient Volume Requirements
• Standard deduction is 7.07 percent.
o Multiply numerator by 0.9293 to apply the standard deduction.
o Required except for Eligible Professionals with needy individual patient volume.
o Applications without standard deduction will be returned.
• New patient volume documentation requirements.
o Individuals must submit a detail report.
o Groups must submit a detail report and a summary report.
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Wisconsin Medicaid Electronic Health Record Incentive Program Application Requirements
Wisconsin Department of Health Services
Patient Volume Documentation Requirements: All Providers
Detail report must:
• Represent all encounters during the patient volume reporting period.
• Identify needy encounters, if applicable.
• Display all Department of Health Services (DHS) required elements for each encounter.
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Wisconsin Medicaid Electronic Health Record Incentive Program Application Requirements
Wisconsin Department of Health Services
Patient Volume Documentation Requirements: All Providers
Detail report required elements for each encounter:
• Rendering provider National Provider Identifier (NPI)
• Date of service
• Unique patient identifier
• Financial payer
• State Medicaid agency (out-of-state Medicaid encounters only)
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Wisconsin Medicaid Electronic Health Record Incentive Program Application Requirements
Wisconsin Department of Health Services
Patient Volume Documentation Requirements: Groups
Summary report required elements:
• Rendering provider name
• Rendering provider NPI
• Number of Medicaid encounters per rendering provider
• Number of needy encounters per rendering provider, if applicable
• Number of total encounters per rendering provider
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Wisconsin Medicaid Electronic Health Record Incentive Program Application Requirements
Wisconsin Department of Health Services
Patient Volume Documentation Examples (Format)
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Wisconsin Medicaid Electronic Health Record Incentive Program Application Requirements
Wisconsin Department of Health Services
Documentation Submission Requirements
Program Year 2015 Application Requirements
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Wisconsin Medicaid Electronic Health Record Incentive Program Application Requirements
Wisconsin Department of Health Services
Documentation Submission CEHRT
Groups with less than 30 applicants: Upload documentation to each application.
Groups with 30 or more applicants: Do one of the following:
• Upload documentation to each application.
• Submit via secure email.
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Note: Email submissions must include the Required CEHRT Documentation spreadsheet, available on the program website at dhs.wisconsin.gov/forms/f01564.xlsx.
Wisconsin Medicaid Electronic Health Record Incentive Program Application Requirements
Wisconsin Department of Health Services
Documentation Submission Patient Volume
Individual: Upload documentation to the application.
Group: Do one of the following:
• Upload documentation to each application.
• Submit via secure email.
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Note: Email submissions must include the Required Patient Volume Documentation spreadsheet, available on the program website at dhs.wisconsin.gov/forms/f01565.xlsx.
Wisconsin Medicaid Electronic Health Record Incentive Program Application Requirements
Wisconsin Department of Health Services
Documentation Submission Application Upload
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Source: Wisconsin Medicaid EHR Incentive Program User Guide for Eligible Professionals
Wisconsin Medicaid Electronic Health Record Incentive Program Application Requirements
Wisconsin Department of Health Services
Application Process Guide Program Year 2015 Application Requirements
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Wisconsin Medicaid Electronic Health Record Incentive Program Application Requirements
Wisconsin Department of Health Services
Application Process Guide
New Application
Process Guide
Application process flow
Step-by-step application instructions
List of information needed for each step CEHRT and
patient volume
requirements
Operational and policy resources
dhs.wisconsin.gov/publications/p01151.pdf
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Wisconsin Medicaid Electronic Health Record Incentive Program Application Requirements
Wisconsin Department of Health Services
Step-by-Step Instructions
23
Wisconsin Medicaid Electronic Health Record Incentive Program Application Requirements
Wisconsin Department of Health Services
Documentation Requirements
24
Wisconsin Medicaid Electronic Health Record Incentive Program Application Requirements
Wisconsin Department of Health Services
Quick Reference Guide
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Register the Eligible Professional for EHR
Incentive Program using the CMS R&A system
-START-
Are you the Eligible Professional?
STOPWait 48 hours for the registration information to transfer from the CMS R&A system to Wisconsin s ForwardHealth Portal. Do not log into the CMS R&A system again until you have confirmation that
the information has been updated in the ForwardHealth Portal.
Complete Eligibility tab of application
Start application using the ForwardHealth
Portal
YesNo
Initiate a connection with the Eligible
Professional using the CMS I&A Management
System
Step 1
Complete R&A / Contact Info tab of
application
Approve connection request
(performed by Eligible Professional)
Complete Patient Volume tab of
application
Complete Attestation tab of application
Complete Review tab
of application
Complete Submit tab
of application-END-
If an Eligible Professional is attesting on their own behalf, start with Step 3.
Steps 1-3 will only be completed in Payment Year 1, unless the Eligible Professional s CMS registration information changes.
Step 2
Step 3
Step 4
Step 5
Step 6
Step 7
Step 10
Step 9
Step 8
Wisconsin Medicaid Electronic Health Record Incentive Program Application Requirements
Wisconsin Department of Health Services
Program Resources Program Year 2015 Application Requirements
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Wisconsin Medicaid Electronic Health Record Incentive Program Application Requirements
Wisconsin Department of Health Services
Program Announcements • Wisconsin DHS EHR website
o dhs.wisconsin.gov/ehrincentive/index.htm
• ForwardHealth Updates
o dhs.wisconsin.gov/ehrincentive/resources.htm
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Wisconsin Medicaid Electronic Health Record Incentive Program Application Requirements
Wisconsin Department of Health Services
Operational Resources • New Application Process Guide
o dhs.wisconsin.gov/publications/p01151.pdf
• Wisconsin Medicaid EHR Incentive Program User Guide for Eligible Professionals
o dhs.wisconsin.gov/publications/p0/p00358c.pdf
• EHR Incentive Program email
• ForwardHealth Portal Help Desk
o 866-908-1363
28