To participate in the Medicaid Promoting Interoperability (PI) program, an EP would need to have submitted and been paid for a registration in program year 2016 or earlier. Program Year 2016 was the last year a provider could start their participation in the program.
Medicaid PI Program participants are encouraged to continue to participate in this program to earn all available incentive payments. Up to six incentive payments are available with participation through program year 2021.
The Medicaid PI Program is not the same as the MACRA/MIPS program. These are two separate programs and EPs will need to participate and attest to BOTH programs to meet the individual requirements of each program. Successful program participation in the Medicaid Promoting Interoperability program will not only result in a Medicaid MU incentive payment, but will also increase the likelihood of attaining a favorable, if not maximum, MIPS Promoting Interoperability performance category score and avoidance of a negative Medicare payment adjustment. Although the same data can be used to attest to meeting each programs’ requirements, separate program attestations are required. Currently there is no cross over of information from one program to the other.
To receive an incentive payment, EPs must show that they are “meaningfully using” certified EHR technology. EPs do this by meeting Centers for Medicare and Medicaid Services (CMS)-established MU objectives, which are specific, measurable ways in which an EHR can or must be used. This page is a brief introduction to MU. For more detailed information, and to see how MU applies specifically to the Michigan Promoting Interoperability Program, download the EP Guide below:
EP Guide to the Medicaid Promoting Interoperability Program
Certified EHR Technology (CEHRT)
Before EPs can meet MU requirements, they must acquire or have access to a CEHRT. EHR certification is conducted by an Office of the National Coordinator for Health Information Technology (ONC) Authorized Testing and Certification Body.
All certified EHR products appear on the Certified Health IT Products List (CHPL). Products can be certified as stand-alone EHRs, capable of meeting MU on their own, or as separate modules pieced together to achieve MU functionality. The CHPL will assign each EHR, or group of modules, a CMS EHR Certification ID. This ID is required for registration.
Find your Certified EHR product below:
Certified EHR Technology requirements:
2020 – 2021 Program Years:
- All EPs will be attesting to Stage 3 which requires the use of a 2015 CEHRT.
For program years 2020 – 2021, providers will have the ability to use a second certified EHR technology for their Clinical Quality Measures (CQMs). The CEHRT for the CQMs will be populated from the information entered at the federal level. If using a second different CEHRT for CQMs, providers will be able to edit the pre-populated CEHRT number during the registration process. The use of a second (different) certified EHR technology is optional.
2020 & 2021 – Stage 3 Meaningful Use (MU)
Please review the Stage 3 Spec sheets for 2020 & 2021 and the table below to understand how to meet the program requirements.
PROTECT ELECTRONIC PROTECTED HEALTH INFORMATION (ePHI)
Protect electronic protected health information (ePHI) created or maintained by the certified electronic health record technology (CEHRT) through the implementation of appropriate technical, administrative, and physical safeguards.
Generate and transmit permissible prescriptions electronically.
CLINICAL DECISION SUPPORT
Implement clinical decision support (CDS) interventions focused on improving performance on high-priority health conditions.
COMPUTERIZED PROVIDER ORDER ENTRY
Use computerized provider order entry (CPOE) for medication, laboratory, and diagnostic imaging orders directly entered by any licensed healthcare professional, credentialed medical assistant,or a medical staff member credentialed to and performing the equivalent duties of a credentialed medical assistant, who can enter orders into the medical record per state, local, and professional guidelines.
PATIENT ELECTRONIC ACCESS TO HEALTH INFORMATION
The eligible professional (EP) provides patients (or patient-authorized representative) with timely electronic access to their health information and patient-specific education.
COORDINATION OF CARE THROUGH PATIENT ENGAGEMENT
Use CEHRT to engage with patients or their authorized representatives about the patient’s care.
HEALTH INFORMATION EXCHANGE
The EP provides a summary of care record when transitioning or referring their patient to another setting of care, receives or retrieves a summary of care record upon the receipt of a transition or referral or upon the first patient encounter with a new patient, and incorporates summary of care information from other providers into their EHR using the functions of CERHT.
PUBLIC HEALTH AND CLINICAL DATA REGISTRY REPORTING
The EP is in active engagement with a public health agency (PHA) or clinical data registry (CDR)to submit electronic public health data in a meaningful way using CEHRT, except where prohibited, and in accordance with applicable law practice.
For program years 2020 & 2021, providers will have the ability to use a second (different) certified EHR technology for their Clinical Quality Measures (CQMs). The use of a second certified EHR technology is optional.
EPs will continue to have an additional reporting period specific to Clinical Quality Measures.
Providers must report at least 6 measures, one of which must be an Outcome or High-Priority Measure. If no Outcome or High-Priority measure is relevant to the provider’s scope of practice, report on any six measures that are relevant.
- Person and Caregiver-Centered Experience and Outcomes
- Patient safety
- Communication and Care Coordination
- Community/Population Health
- Efficiency and Cost Reduction
- Effective Clinical Care
2020 & 2021 Reporting Periods
The MU reporting period is a continuous period during which the EP needs to meet all of the various MU objectives. The CQM reporting period is a continuous period during which the EP is capturing data for the various CQM measures available. Neither of these reporting periods should be confused with the Medicaid eligibility reporting period.
All EPs will be attesting to a minimum of 90 days and up to a full calendar year of MU and CQM data for program year 2020.
All EPs will be attesting to a minimum of 90 days of MU and CQM data for program year 2021.
Program years do not have to be consecutive; an EP may skip a year, although one must keep in mind that the program expires at the end of 2021. EPs must conduct 50% or more of their combined patient encounters at locations equipped with CEHRT.
For Further Assistance
Please click on the Contact button – at the top of every page – for further support on the Michigan Medicaid Promoting Interoperability Program. Or check out the EP Guide to the Medicaid Promoting Interoperability Program for more complete information.