UTAH PROMOTING INTEROPERABILITY (PI) PROGRAM (FORMERLY KNOWN AS EHR INCENTIVE PROGRAM)

Electronic Health Record (EHR) Meaningful Use Incentive Payments

Utah Medicaid is participating in the Medicaid Promoting Interoperability Payment Program (formerly known as the EHR Incentive Program). This program is supported through the Centers for Medicare and Medicaid Services and the Office of the National Coordinator for Health Information Technology, as part of the American Recovery and Reinvestment Act of 2009.

Details regarding the program are available in the State Medicaid Health Information Technology Plan (SMHP). This document explains how Utah makes EHR incentive payments to eligible Medicaid providers and hospitals as they adopt, implement, upgrade, or demonstrate meaningful use of certified EHR technology.

CMS goals for this program include:

  1. Enhancing care coordination and patient safety
  2. Reducing paperwork and improving efficiencies
  3. Facilitating electronic information sharing across providers, payers, and state lines, and
  4. Enabling data sharing using state Health Information Exchanges (HIEs) and the National Health Information Network (NHIN).

Achieving these goals will improve health outcomes, facilitate access, simplify care, and reduce the costs of healthcare nationwide.

As of October 1, 2018, Utah has approved 2700 payments to eligible professionals and hospitals totaling $93,895,499.

Eligibility:

All participating providers must have Certified Electronic Health Record Technology (CEHRT) which is specifically certified for this incentive program.  To view and search a list of certified EHR products, please consult the Certified Health IT Product List.

Program Requirements for Eligible Professionals:

  2018 2019
EHR Reporting Period Minimum of any continuous 90 days between January 1 and December 31, 2018 Minimum of any continuous 90 days between January 1 and December 31, 2019
Certified EHR Technology 2014 Edition, 2015 Edition or a 2014/2015 combination

2015 Edition or a 2014/2015 combination

Meaningful Use Stage Modified Stage 2 or Stage 3 (if CEHRT is capable) Stage 3
eCQM Reporting Period Full Year Full Year
Total eCQMs Required for Reporting 6

6 – if reporting manually

4 – if reporting electronically

Total Number of CQMs Available 53 56

You may review the CQM reporting requirements for 2017 and 2018 here.  The 2019 CQM reporting requirements are here.

How to Participate:

To get started, you must first register with CMS.  More information and resources to assist you in eligibility determination and patient volumes is available on the Medicare and Medicaid EHR Incentive Programs Website.

Click here for links to the PRISM Provider Portal Access.  Eligible providers that would like assistance navigating PRISM and eMIPP may refer to our User Guide here, or the training videos here.

UPCOMING DATES AND UPDATES FROM CMS:

2016 was the last year new providers were able to join the program as a first-year adopter of EHR.  Program year 2018 will be open for attestations January 1, 2019.  The deadline to submit a 2018 attestation is March 31, 2019.  Participating providers can access the 2018 meaningful use requirements and other CMS guidance here.

Providers that also treat a large volume of Medicare beneficiaries will also need to participate in QPP (Quality Payment Program).  There is some overlap between the Medicare QPP Program and the Medicaid Promoting Interoperability Program, but it is not a complete crossover.  For additional information, including checking your participation status with QPP, go to https://qpp.cms.gov/.

POST PAYMENT AUDITS

Payments from this program are subject to audit according to federal regulations.  Post-payment audits will be conducted in order to ensure that state and federal funds are expended appropriately and accounted for in a transparent manner.  Please retain all supporting documentation for your attestation for six years, and refer to this audit documentation guide for recommended documentation sources.  Utah Medicaid has contracted with Myers & Stauffer LC to perform the post-payment audits.  Providers who are selected for audit will be notified directly.  Any questions about the audit documentation requests should be directed to Myers & Stauffer at (800) 336-7721 or by email to UtahEHR@mslc.com.  

ADDITIONAL RESOURCES:

Utah Public Health Reporting for Meaningful Use
2018 Program Requirements for Medicaid EPs and EHs
Security Risk Assessment Fact Sheet
eMIPP Provider Training
Guide for EPs practicing in Multiple Locations
eMIPP Provider User Guide
Frequently Asked Questions

For questions or concerns, please call (801) 538-6929 or send an e-mail to: EHRIncentive@utah.gov
Business hours: Monday – Friday, 8:00 a.m. – 5:00 p.m., closed on all state and federal holidays.