Can a private practice include encounters under Healthy Kids in their patient volume calculations to qualify for the Medicaid EHR Adoption Incentive Program?
We have received our first payment from the Medicaid incentive program, but aren't sure which providers are included on this payment and which are still outstanding. Is there a way to find out this information?
When can providers working in County Health Departments apply for A/I/U incentives under the Medicaid EHR Adoption Incentive Program?
Is it legal in Florida to collect patients' race and ethnicity, as is required in the "Core" objectives for Meaningful Use?
Can a Specialist who also provides Primary Care qualify as a Priority Primary Care Provider?
Do clinicians practicing within Health Department clinics providing family planning, STD screening, and other public health services qualify as Priority Primary Care Providers?
Is there a difference between an EMR, an EHR, and/or EHRs?
How do I sign up for the Medicaid EHR Incentive Program?
Does my practice need to sign up with an REC in order to qualify for the CMS EHR Adoption Incentive program?
Who in my practice is authorized to sign the Provider Participation Agreement?
Are Pharmacists eligible to receive EHR Adoption Incentive Payments from CMS?
What is the Regional Extension Center Program?
How do I participate in this program?
How can I locate Health Professional Shortage Areas (HPSA)?
What are the Health Information Technology (HIT) Regional Extension Centers?
Who is the Center for the Advancement of Health IT (AHIT)?
Who is a "Priority Primary Care Provider?"
Will providers that are not considered priority primary care be able to utilize AHIT services?
Who is eligible to receive CMS incentives for EHR adoption?
What Regional Extension Centers will serve Florida?
What services will the AHIT REC provide?
How will AHIT assist providers in achieving Meaningful Use?
What Medicare and Medicaid incentives are available for purchase of electronic healthcare systems?
What is a "Cooperative Funding Agreement?"
What "Milestones" have been established under the cooperative agreeement?
Are Regional Center services to providers and group practices free?
What dollars will our practice receive from the REC program to help with hardware and software acquisition costs?
Congress created the Health Information Technology Extension Program for the establishment of non-profit Health Information Technology Regional Extension Centers (RECs). Congressional funding will:
- Help to underwrite a large portion of the cost of all REC services to priority primary care providers and
- Keep them affordable for all participating practices.
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If you are a medical provider, please click here to begin the application process.
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How can I locate Health Professional Shortage Areas (HPSA)?
Health Resources and Services Administration (HRSA) has a webpage that allows you to search by State and County to locate HPSAs. Click here for the HPSA locator.
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What are the Health Information (HIT) Regional Extension Centers?
The HIT Regional Extension Centers (RECs) were established as part of the Health Information Technology for Economic and Clinical Health (HITECH) Act, (Title IV in Division B of the American Recovery and Reinvestment Act) authorizing financial incentives to Medicare and Medicaid providers who achieve Meaningful Use of certified electronic health record (EHR) technology. They are funded through Cooperative Agreements with the Office of the National Coordinator, Department of Health and Human Services. The purpose of the RECs is to provide education, outreach, and technical assistance to priority primary care providers to assist them in selecting, successfully implementing, and achieving Meaningful Use of certified EHR products.
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The Center for the Advancement of Health IT (AHIT) is a Florida Regional Extension Center program being administered by the Community Health Centers Alliance (CHCA). The AHIT Regional Extension Center supports 41 counties spanning North Florida and the Southwest Coast. AHIT is headquartered at the St. Petersburg, Florida corporate offices of CHCA.
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The ONC defined "Priority Primary Care Provider" in its original notice of funding available (FOA) for the Regional Center program. According to that FOA:
"Pursuant to requirements of the HITECH Act, priority shall be given to providers that are primary-care providers (physicians and/or other health care professionals with prescriptive privileges, such as physician assistants and nurse practitioners) in any of the following settings:
- individual and small group practices (ten or fewer professionals with prescriptive privileges) primarily focused on primary care;
- public and Critical Access Hospitals;
- Community Health Centers and Rural Health Clinics; and
- other settings that predominantly serve uninsured, underinsured, and medically underserved populations."
For more information on PPCP eligibility, please click here to find your local community partner, who can help you assess priority status and complete the required paperwork.
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AHIT is committed to meeting the needs of all providers in the State of Florida who wish to achieve Meaningful Use with their EHRs. While government subsidies are being prioritized for the priority primary care providers, AHIT will have opportunities for other providers to access the information and resources of the center.
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Beginning in 2011, Medicaid and Medicare providers who meet the following criteria will be eligible for the incentives:
- Use of a certified EHR to achieve Meaningful Use;
- Electronic prescribing and exchange of health information to improve the quality of care; and
- Reporting on quality measures.
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Florida has four Regional Centers approved for Cooperative Funding Agreements by the Office of the National Coordinator (ONC):
- University of Central Florida, Orlando, serving Central Florida and the Orlando area
- CHC Alliance, St. Petersburg, serving 41 counties spanning North Florida and the southwest coast
- Health Choice Network, Miami, serving the southernmost east coast
- University of South Florida, Tampa, serving Tampa Bay
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An overview of the services includes but is not limited to:
- General Assistance
- Outreach / Communications / Education (including Meaningful Use)
- Vendor Selection & Group Purchasing Support
- Implementation & Project Management Support
- Practice & Workflow Redesign for HIT
- Education / Support for Functional Interoperability and Health Information Exchange
- Privacy and Security Best Practices
- Local Workforce Support
Click here to review our current menu of services.
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General and technical assistance will be provided to all participating practices. A customized roadmap will be developed for each participant based on the results of a readiness assessment that will be completed at the early stages of participation. Participants will receive tailored assistance for achieving Meaningful Use based on their assessment.
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The American Recovery and Reinvestment Act (ARRA) stimulus package includes financial incentives for healthcare providers that achieve Meaningful Use with an EHR. A maximum of $44,000 per provider is available for Medicare incentives and a maximum of $63,750 per provider for Medicaid.
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Unlike a grant program, a Cooperative Agreement provides payment for specific deliverables achieved; these payments are provided after the fact. The total approved federal share is the maximum that each awardee could receive if 100% of all objectives and milestones are reached. For example, in the case of CHCA:
- Approved for Federal Match of $11.3 M over four years
- Core funds initially only $750K in each of years 1 & 2 for outreach, education, and project administration
- Remaining funds for Direct Technical Assistance received in form of quarterly “Milestone” payments
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Each awardee must demonstrate the achievement of the following milestones to qualify for payments from the ONC:
- Signed contract for Direct Technical Assistance with qualified provider
- Provider is “live” on Certified EHR with ePrescribing & Quality Reporting
- Provider achieves “Meaningful Use”
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While federal funding will help to make services affordable for all practices, including individual providers or small groups under ten providers, fees are associated with specific technical assistance. In fact, the federal guidelines explicitly require that all regional centers establish a model that is sustainable:
- “The application shall include a sustainability plan clearly setting out the recipient’s strategy to achieve sustainability by the end of the year two....”
- “It is expected that Regional Centers will generate resources to support cost sharing in ways that demonstrate provider and community commitment to the center and its goals of supporting adoption and meaningful use of health IT.”
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The REC program does not provide funds for equipment acquisition costs. The Medicare and Medicaid EHR adoption incentive programs were designed to assist practices in offsetting these costs. RECs will help providers select the best certified technology fit for their practices and provide technical assistance in the implementation process. They will also provide education and assistance in ensuring the achievement of meaningful use so that practices may apply for the incentive dollars.
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Unfortunately, though Pharmacists are playing a larger and larger role on the clinical care team (especially within FQHCs) and offering additional patients services, such as Medication Therapy Management (MTM), “pharmacists are not eligible professionals for the EHR incentive programs” under the legislation passed by congress (CMS-0033-F, page 196).
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The signer must be duly authorized by the Provider Organization to act on its behalf. Signers are not limited by title, only by delegated authority as set by the Provider Organization.
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There is not currently an expectation that a provider must be a member of any REC to receive CMS EHR Adoption Incentive dollars, though the State will likely encourage providers to take advantage of these federally-subsidized programs to help ensure that they are receiving the most up to date information and education. However, when the State guidance is finalized for the Medicaid EHR Incentive Program, they may ask the RECs to help providers complete the attestation documentation required. Final guidance is anticipated in early 2011.
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For providers who meet the Medicaid eligibility thresholds (click here for a table that explains those levels), you will register intially with the CMS National Level Repository. When the State launches the incentive program for Florida providers, they will pull in the information from the repository to begin the enrollment process, and anticipate that incentives will begin to be distributed in August 2011. Please see the State's detailed program information by clicking here.
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While these terms are often used interchangeably in the marketplace, there is actually a distinction between "EMR" and "EHR."
- An EMR (electronic medical record) is defined as: "an electronic record of health-related information on an individual that can be created, gathered, managed, and consulted by authorized clinicians and staff within one health care organization."
- An EHR (electronic health record) is defined as: "an electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be created, managed, and consulted by authorized clinicians and staff across more than one health care organization."
To meet the criteria for Meaningful Use, providers must adopt a certified EHR system (also referred to in the industry as an "EHRs"). Only systems intended to meet interoperability standards, rather than systems to be used solely as stand-along solutions for one practice, will be considered eligible for certification.
For more technology terms and information from the ONC, click here.
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According to the ONC, yes, Title X clinic providers may qualify as PPCP's.
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Yes, a provider with a dual specialty may qualify as a PPCP under certain circumstances. For the purposes of defining Primary Care Providers (as Relates to Dual-Specialty), the REC defines private practice providers as Primary Care Providers if a minimum of 50% of their annual patient encounters fall within the scope of primary care and he or she provides care within a primary care setting. This determination is based upon provider self-reporting, or reporting from his/her designated practice administrator.
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Each practice should ensure that it is in regular contact with legal counsel for questions about specific Florida statutes. The Meaningful Use Core Objectives for Stage 1 only require that you report the percentage of patients for whom a valid entry about race and ethnicity is documented, not the specific details. In the case of collecting and documenting patient demographic information, we recommend that practices institute workflows that ensure that patients are provided the opportunity to self-report their race, ethnicity, and other demographic information, and that staff only record the choices made by the patients. This must include the opportunity to decline to report any element, and the certified EHR system must be able to document declined/refused to report as a valid entry. Your practice should consult with counsel and determine the best way for your team to modify its workflows and documentation practices to both meet Meaningful Use and keep you in good stead with Florida's privacy guidelines.
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County Health Departments and other Florida Department of Health health delivery sites will be adopting the HMS system, developed by the FL DOH. The DOH plans to seek certification from the ONC for this system in 2012. The system will need to have its ONC certification number in order for providers to register and apply for the first year Adopt/Implement/Upgrade (A/I/U) incentive payment under Florida Medicaid, Administered by the Agency for Healthcare Administration. Click here for more about the Medicaid incentive program in Florida.
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We have received our first payment from the Medicaid incentive program, but aren't sure which providers are included on this payment and which are still outstanding. Is there a way to find out this information?
Practices with questions on which provider received a Medicaid incentive payment can call the Florida EHR Helpline at 855-231-5472. The EHR Helpline can provide that information.
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No. Healthy Kids is funded by Title XXI. The Medicaid volume is defined as Title XIX encounters only. Private practices cannot include Children's Health Insurance Program (CHIP) encounters in their calculations to qualify for the EHR Incentive program.
Healthy Kids (part of CHIP) can be included as part of the needy patient encounter volume for FQHC/RHC providers only.
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Should you have additional questions, please email: info@AdvanceHealthIT.org
Answers to questions received throughout this process will be posted here. Check back often!
CHCA wishes to acknowledge support from the Office of the National Coordinator, Department of Health and Human Services, Award #90RC0051/01.