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Program Information for Eligible Professionals

Program Year 1 For Eligible Professionals (EPs): Adopt / Implement / Upgrade

Establishing Medicaid Patient Volume Eligibility:

  • Determine if you as an EP will use Medicaid patient volume taken from your individual patient volume statistics or if your group / practice will combine all patient volume, utilizing the Group Proxy volume. You can either use individual or group statistics. It’s either one way or another. All Individual or All Group.
  • Select a continuous 90-day period from the previously finished calendar year
  • Report all encounters (regardless of payment type). This will be the denominator.
  • Report all Medicaid encounters (a unique patient seen on a particular date). This will be the numerator.
  • Medicaid Patient Volume should be at least 30% for Eligible Professionals (20% – for pediatricians).
  • Supply certification numbers from the Office of National Coordinator (ONC). This is referred to as the CHPL Website.
  • Required documentation: Contract with vendor, Medicaid patient Volume calculator, Supporting Management Report, Signed Attestation Agreement.

Program Year 2-6 For Eligible Professionals (EPs): Meaningful Use

Establishing Medicaid Patient Volume Eligibility:

  • Determine if you as an EP will use Medicaid patient volume taken from your individual patient volume statistics or if your group / practice will combine all patient volume, utilizing the Group Proxy volume. You can either use individual or group statistics. It’s either one way or another. All Individual or All Group.
  • Select a continuous 90-day period from the previously finished calendar year
  • Report all encounters (regardless of payment type). This will be the denominator.
  • Report all Medicaid encounters (a unique patient seen on a particular date). This will be the numerator.
  • Medicaid Patient Volume should be at least 30% for Eligible Professionals (20% – for pediatricians).
  • Supply certification numbers from the Office of National Coordinator (ONC). This is referred to as the CHPL Website.
  • Required documentation: Contract with vendor, Medicaid patient Volume calculator, Supporting Management Report, Signed Attestation Agreement.

Electronic Health Record (EHR Reporting period):

Your Certified Electronic Health Record software should be able to generate reports for a prescribe number of objectives and measures. You will be asked to supply those results in a numerator/denominator format. Some objectives will ask for a Yes/No response.

  • Meaningful Use Year One – Select a 90-day period within the current calendar year to attest for your EHR
  • Meaningful Use Years Two-Five – This must be a full 365-day reporting period. (NOTE: you will be allowed to use a 90-day reporting in 2014 because of the required re-certification of all Electronic Health Record software programs).
  • Complete the required MU CORE measures and attach the required documentation.
  • Select five MU MENU measures.
  • Complete the three MU CQM measures and select an additional six MU CQM measures for a total of nine.

Provider Incentive Payments Registration and Accounts

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