Updates and Announcements

 


   Request a consultation session with the EHRIP Team to review PY2017 changes and requirements.

    Receive notification of program updates to your inbox: send your request to ahs.dvhaEHRIP@vermont.gov

    Find a list of our past EHRIP email communications at our Archived Announcements


LATEST POSSIBLE START DATE FOR PY2017 REPORTING PERIOD IS 10/3/17 (Posted 9/28/17)
The latest possible 90-day reporting period for Program Year 2017 is October 3 – December 31st. If you would like a short refresher on the changes and issues for your organization’s providers who will be meeting Meaningful Use, we have a 30-minute presentation we would be happy to schedule with you (contact us at ahs.dvhaEHRIP@vermont.gov). The outline of the review is as follows:

  • Changes Resulting from the August 2017 IPPS Rule from CMS
    • EHR Reporting Periods for MU Objectives and CQMs are 90 Days for All Providers
    • Changes to Clinical Quality Measures for EPs
    • CEHRT Flexibility and Extension of MU Stage 2 for PY2018
  • Changes to Meaningful Use Objectives in 2017 as Compared to 2016
    • Objective 1, Protect ePHI: SRA conducted or reviewed by 12/31/17
    • Objective 8, Measure 2, Patient Electronic Access: Threshold Change
    • Objective 9, Secure Messaging: Threshold Change
    • Objective 10, Option 1, IZ Reporting: Ongoing Documentation Requirements
    • Objective 10, Option 3A, Specialized Registry Reporting: No More Alternate Exclusion
    • ONC EHR System Surveillance and Review Activities: “Objective 0”
  • CMS Specification Sheets for PY2017 Objectives
  • Other CMS Guidance and Resources for PY2017
  • VT Medicaid EHRIP Audit Tip Sheet - Updated
  • Are your providers required to participate in the Medicare Quality Payment Programs (MACRA/MIPS)?
  • Questions and Contact Information

DO YOU NEED TO REPORT TO MIPS? (Posted 9/28/17)
Receiving a Medicaid EHR Incentive Program payment does not exempt you from other Quality Payment Program reporting requirements. If a clinician participates in the Medicaid EHRIP, BUT ALSO participates in Medicare Part B, he or she must assess their participation status requirements for the Quality Payment Program. This can be done by simply by entering the provider’s NPI at the QPP website: https://qpp.cms.gov.  Questions about the Advanced Alternative Payment Models (APMs) track or the Merit-based Incentive Payment System (MIPS) track can be directed to QPP@cms.hhs.gov and the QPP Helpdesk number: 1-866-288-8292.

NEW RULE FROM CMS INCLUDES CHANGES FOR PY2017 EHRIP REQUIREMENTS (Updated 8/25/17)
(FY) 2018 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Acute Care Hospital (LTCH) Prospective Payment System Final Rule Issued

The new IPPS rule finalized by CMS on August 2nd, 2017 has implications for the Medicare and Medicaid Electronic Health Record Incentive Programs. The rule will be effective as of October 1st, 2017, and includes a number of changes to requirements for participants in the Medicaid EHRIP in 2017 and beyond:

  • The reporting periods for Eligible Professionals have been ALIGNED so that all EPs may utilize a 90-day reporting period for both Clinical Quality Measures and Meaningful Use Objectives.
  • CEHRT flexibility has been adopted for 2018: Providers will have the option to continue to attest to the Modified-MU2 objectives and measures using 2014 Edition CEHRT, 2015 Edition CEHRT, or a combination of 2014 and 2015 Edition CEHRT.
  • Exceptions for Medicare payment adjustments for Eligible Hospitals and Eligible Professionals have been added for those whose CEHRT has been decertified by ONC.  
  • The total number of CQMs EPs must attest to in 2017 for the EHRIP has been reduced from 9 to 6, and there are no longer any domain requirements.
  • To align CQMs between Quality Payment Programs for EPs, the total number of CQMs to select from has been reduced from 64 to 53.
  • Below are the 11 CQMs that are no longer active for the 2017 EHRIP.
  • A complete inventory of 2017 CQMs is available here.

CQMs No Longer Active for EPs in 2017 for EHRIP

WHEN TO ATTEST FOR PROGRAM YEAR 2017 (Updated 8/25/17)
Because the changes outlined in the 8/2/17 IPPS rule impact our current MAPIR system, providers will not be able to start a Program Year 2017 application until MAPIR has been updated with the new requirements. We anticipate the updates to be complete by January 2018. Providers attesting to Stage 3 Meaningful Use requirements, which is an option for those who have upgraded their CEHRT, will await MAPIR enhancements that will be available in March 2018. Stay tuned for announcements about the availability of MAPIR for PY2017 applications.

NEW CHANGES AS WELL AS "OLD" CHANGES (Updated 8/25/17)
The changes announced in the IPPS Final Rule add to the changes that are already established for Program Year 2017 measures and objectives, as compared to previous Program Years' requirements.

Changes to Specific Objectives in Modified-MU2 in PY2017:

  • Objective 0, ONC Questions: A CMS final rule effective 1/1/2017 requires the EP to attest to cooperating with ONC’s EHR system surveillance and review activities.  Objective 0 in the MAPIR Meaningful Use Objective array has been added to capture this requirement. For a screenshot of the attestation questions, click here.
  • Objective 1, Protect ePHI: It is acceptable for the security risk analysis (or review of the SRA) to be conducted outside the EHR reporting period; however, the analysis must be unique for each EHR reporting period, the scope must include the full EHR reporting period, and must be conducted within the calendar year of the EHR reporting period (January 1st – December 31st).
  • Objective 8, Measure 2, Patient Electronic Access: For an EHR reporting period in 2017, more than 5 percent of unique patients seen by the EP during the EHR reporting period (or his or her authorized representatives) view, download or transmit to a third party their health information during the EHR reporting period.
  • Objective 9, Secure Messaging: For an EHR reporting period in 2017, for more than 5 percent of unique patients seen by the EP during the EHR reporting period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the EHR reporting period.
  • Objective 10, Public Health Reporting: For an EHR reporting period in 2017, all EPs must attest to at least two measures, or document exclusions if they cannot meet one or more measures. The Alternate Exclusion for Specialty Registry reporting is not longer available (“the EP did not plan to report on special registry data, therefore the EP is able to claim an exclusion”).

PUBLIC HEALTH DOCUMENTATION AID UPDATED FOR PY2017 MODIFIED-MU2  (Posted 6/29/17)
The Public Health Documentation Aid contains screenshots of the three Public Health Meaningful Use Measures as they appear within the MAPIR attestation environment, keyed with spaces to provide additional information for the measures met or the exclusions qualified for. The Documentation Aid, when emailed or uploaded at the time of attestation along with the supporting documentation, will facilitate the application review process, and will also help provide the information that would be requested in the event of an audit:
Program Year 2017 EPs Attesting to Modified MU Stage 2

UPDATED VERMONT MEDICAID EHRIP AUDIT TIPSHEET  (Posted 6/29/17)
The VT EHRIP Audit Team has updated their helpful Eligible Professional Audit Tip Sheet based on their activities and experience with reviewing provider records. Remember, the best time to prepare for an audit is during the attestation process. Download and consult this guidance as you prepare and submit your EHRIP attestation.

REMINDER: LAPSED MEDICAID ENROLLMENT CANCELS ANY ACTIVE MAPIR APPLICATION  (Posted 6/29/17)
If an Eligible Professional’s Vermont Medicaid enrollment lapses at any time after an application is started and BEFORE A PAYMENT IS RECEIVED, the application will be automatically cancelled in the MAPIR system. All saved data for the application will be eliminated. The attestation must then be restarted from the beginning in MAPIR if the EP is able to be fully re-enrolled in Vermont Medicaid. If a MAPIR application of one of your providers is cancelled, please contact us right away: ahs.dvhaEHRIP@vermont.gov

THE BLUEPRINT VERMONT CLINICAL REGISTRY IS A SPECIALIZED REGISTRY  (Posted 6/29/17)
E
ligible Professionals at practices participating in the Vermont Blueprint for Health may use their engagement with Blueprint’s Vermont Clinical Registry to meet the Specialized Registry reporting option for the Public Health Objective. A significant number of Blueprint practices send their data through VITL’s Health Information Exchange where it then flows to the Vermont Clinical Registry. If you have any questions about whether you qualify for registering, onboarding or reporting data to this registry for meeting the measure, please do not hesitate to contact the EHRIP Team: ahs.dvhaEHRIP@vermont.gov

MEANINGFUL USE STAGE 3  (Posted 6/29/17)
S
tage 3 of Meaningful Use is an option for the first time in 2017 for those providers who have upgraded their Certified EHR Systems to the 2015 Edition, or are using a combination of 2014 and 2015 CEHRT.  Providers attesting with the Vermont Medicaid EHR Incentive Program in Program Year 2017 who will be meeting Stage 3 criteria will wait to start their attestations. We will alert our program participants when MAPIR upgrades are complete and Stage 3 screens are configured with the correct options. More information about Stage 3 criteria can be found at the CMS Website:  MU3 Guidance for Medicaid EHRIP.

MEETING MU IN 2017 TO AVOID CALENDAR YEAR 2018 PAYMENT ADJUSTMENTS  (Posted 6/29/17)
M
any thanks to our colleagues in the Pennsylvania Medical Assistance Electronic Health Record Incentive Program for this Q&A explaining the timeframe for attesting to Meaningful Use in order to avoid Payment Adjustments:

Q—Your communication indicates that Program Year 2017 will have payment adjustments applied in payment year 2018.  We thought that payment adjustments were on a two-year delay from Program Year to payment year, so Program Year 2017 would impact 2019 payment adjustments.  Please clarify if payment adjustments are on a one- or two-year delay?
A—This issue is very confusing indeed and we hope not to confuse you further but here goes.  CMS established an alternative for providers attesting to MU for the first time in 2016 and beyond and our message only applies to those providers.  You are correct that, traditionally, meeting MU in 2016 would allow providers to avoid payment adjustments in 2018 (the two year delay).
This time, however, those attesting to MU for the first time in 2016 will avoid payment adjustments in 2017.  Further, if you are attesting to MU for program year 2017, for the VERY first time, you will avoid payment adjustments in 2018.  So, all providers attesting to MU for the second time and beyond, in program year 2016, would still avoid the payment adjustment on a two year delay or 2018.
Also consider this, Adopt, Implement or Upgrade (AIU) does not count toward MU…so if a provider attested to AIU in program year 2016, then program year 2017 would be the provider’s first year to attest to MU and that would allow the provider to avoid 2018 payment adjustments.  Keep in mind that AIU is no longer available.

CHANGES TO MEANINGFUL USE MEASURES IN PY2017 (Posted 6/8/17)
Stage 3 of Meaningful Use is an option for the first time in 2017, for those providers who have upgraded their Certified EHR Systems to the 2015 Edition, or are using a combination of 2014 and 20115 CEHRT. More information about Stage 3 criteria can be found at the CMS Website:  MU3 Guidance for Medicaid EHRIP
Most providers will still be attesting to the Modified-MU2 criteria in Program Year 2017. However, please keep in mind that certain measures and requirements have evolved for PY2017:

Changes to Specific Objectives in Modified-MU2 in PY2017:

  • Objective 0, ONC Questions: A CMS final rule effective 1/1/2017 requires the EP to attest to cooperating with ONC’s EHR system surveillance and review activities.  Objective 0 in the MAPIR Meaningful Use Objective array has been added to capture this requirement. For a screenshot of the attestation questions, click here.
  • Objective 1, Protect ePHI: It is acceptable for the security risk analysis (or review of the SRA) to be conducted outside the EHR reporting period; however, the analysis must be unique for each EHR reporting period, the scope must include the full EHR reporting period, and must be conducted within the calendar year of the EHR reporting period (January 1st – December 31st).
  • Objective 8, Measure 2, Patient Electronic Access: For an EHR reporting period in 2017, more than 5 percent of unique patients seen by the EP during the EHR reporting period (or his or her authorized representatives) view, download or transmit to a third party their health information during the EHR reporting period.
  • Objective 9, Secure Messaging: For an EHR reporting period in 2017, for more than 5 percent of unique patients seen by the EP during the EHR reporting period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the EHR reporting period.
  • Objective 10, Public Health Reporting: For an EHR reporting period in 2017, all EPs must attest to at least two measures, or document exclusions if they cannot meet one or more measures. The Alternate Exclusion for Specialty Registry reporting is not longer available (“the EP did not plan to report on special registry data, therefore the EP is able to claim an exclusion”).

PUBLIC HEALTH OBJECTIVE FOR MODIFIED-MU2 IN PY2017 (Posted 6/8/17)

  • As indicated above, all EPs must attest to at least two measures, or document exclusions if they cannot meet one or more measures.
  • Providers in Active Engagement to report immunization data to the Vermont Department of Health can request documentation for the measure from  AHS.VDHPHMeaningfulUse@vermont.gov.
  • Syndromic Surveillance data is not accepted electronically by Vermont or New Hampshire, and providers will exclude to that measure.
  • Reporting to a Specialized Registry cannot be automatically excluded in 2017. Providers reporting data to the Vermont Blueprint for Health Clinical Data Registry, and New Hampshire providers engaged with the NH Cancer Registry can meet the measure by documenting their Active Engagement status.
  • EPs must ensure they are following the guidance of CMS FAQ 13657 to determine if there is a specialized registry available for them, or if they should instead claim an exclusion.
  • CMS has developed a Centralized Repository for Public Health Agency and Clinical Data Registry Reporting, which is one tool providers can utilize to confirm available reporting options.

Please review the detailed guidance, screenshots and Documentation Aids available at our webpage: Public Health Reporting in PY2017 for Modified-MU2.

CMS RESOURCES FOR PY2017 REQUIREMENTS (Posted 6/8/17)

PROVIDERS CONCLUDING THE VERMONT MEDICAID EHRIP: WHAT’S NEXT? (Posted 6/8/17)
Congratulations to the 62 providers scheduled to complete all six years of their eligibity with the Medicaid EHR Incentive Program as of their Program Year 2016 payment! Providers finishing their incentive payments for meeting Meaningful Use in the EHRIP, please keep in mind that other quality programs still exist. For 2017 and beyond, if providers also see Medicare patients, the Merit-based Incentive Payment System will replace Medicare reporting for the Medicare EHR program, Physician Quality Reporting System and the Value-Based Payment Modifier. The Quality Payment Program is part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and includes two tracks — Advanced Alternative Payment Models (APMs) and the Merit-based Incentive Payment System (MIPS).   If you have questions or need assistance with determining eligibility or requirements, visit the Quality Payment Program to find out if providers should participate in MIPS at https://qpp.cms.gov

VERMONT MEDICAID EHRIP REPORTS (Posted 6/8/17)
At the EHRIP Reports webpage, you will find reports that track the perfomance progress of the Vermont Medicaid EHR Incentive Program.
Payments to Eligible Providers: Lists all Eligible Hospitals and Eligible Professionals that received a Vermont Medicaid EHR Incentive Program payment for each Program Year. Each month’s update is a cumulative, full replacement for all previously posted files.
The 2016 Annual Report: A CMS-prescribed format for Federally-defined annual reporting requirements for EHR Incentive Program payments. It contains aggregate Meaningful Use (MU) and Clinical Quality Measure (CQM) data for all Medicaid EHR incentive payments made by the State of Vermont to Eligible Professionals from the program's inception through March 31, 2017.
Cumulative Payment Report: Illustrates the cumulative dollar amount of payments made to date for all Eligible Hospitals and Eligible Professionals.


An archive of previously issued VT Medicaid EHRIP Announcements is available here.


For questions, contact the Vermont EHRIP Team at  ahs.dvhaEHRIP@vermont.gov

Back to the Vermont Medicaid EHRIP Home Page

(Page last updated 09/28/2017)