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ILHIE Medicaid Work Group Notes - January 10 2011 

January 10, 2011

Attendees (phone and in-person):

  • Dave Barnes, Department of Healthcare and Family Services (HFS)
  • Kelly Carter, Illinois Primary Health Care Association
  • Connie Christen, HFS
  • Patrick Gallagher, Illinois State Medical Society
  • Andrew Garrett, HFS
  • Ivan Handler, HFS
  • Jill Hayden, Illinois Primary Health Care Association
  • Krysta Heaney, Office of Health Information Technology (OHIT)
  • Joe Holler, HFS
  • Roger Holloway, Illinois Health Information Technology Regional Extension Center (IL-HITREC)
  • Peter Ingram, Sinai Health System
  • Vince Keenan, Illinois Academy of Family Physicians
  • Abel Kho, Chicago Health Information Technology Regional Extension Center (CHITREC)
  • Mike Koetting, HFS
  • John Lekich, HFS
  • John Lewis, IL-HITREC
  • Mary McGinnis, OHIT
  • Mike Moss, HFS
  • Renee Perry, HFS
  • Sharon Post, SEIU Healthcare Illinois
  • Fred Rachman, CHITREC
  • Katherine Sherman, Fox Systems
  • Gwen Smith, HFS
  • Wesley Valdez, University of Illinois/OHIT
  • Theresa Walunus, CHITREC
  • Harrison White, Gateway Foundation
  • Laura Zaremba, OHIT

Review Minutes of Previous Meeting

The meeting minutes from the December 13, 2010, meeting were approved.

Children's Health Insurance Program Reauthorization Act (CHIPRA) – Introductions and Brief Overview

Renee Perry introduced Gwen Smith from Healthcare and Family Services (HFS). Gwen is the project director for the CHIPRA Quality Grant. Renee indicated that she thought it would be beneficial to the work group to include Gwen since the Medicaid work group and the CHIPRA Quality Grant project are working towards some of the same goals.

Gwen Smith provided an overview of the CHIPRA Quality Grant project saying that the grant was received in February 2010, and it is a five year grant. Illinois partnered with the state of Florida, and the goal of the project is to improve the quality of child healthcare. States were given five options to propose, and Florida and Illinois chose to participate in four categories. Those categories are:

  1. Child health measures – 24 metrics that the Centers for Medicare and Medicaid Services (CMS) want the ten grantee states to test.
  2. HIT/HIE – A work group was formed, and they are looking at how to demonstrate ways to improve child health quality. Efforts must not be duplicated, and must be coordinated.
  3. Improve and enhance medical homes.
  4. Demonstrate how Illinois can improve quality. Illinois has chosen perinatal as the category for quality improvement.

Gwen is working with the HFS Office of Information Services and the OHIT office to coordinate efforts. Gwen said that an operational plan was submitted to CMS in November, and she has received comments back from CMS.

Elimination of Net Average Allowable Cost Requirement

Renee Perry reported that CMS eliminated the net average allowable cost requirement for providers. CMS is going to send a Frequently Asked Questions document soon.

CMS NLR Registration Process

Peter Ingram said that CMS opened the National Level Registry (NLR) site for providers to register. Renee Perry indicated that for states that are not ready to accept registration from Medicaid providers, the state will not be listed in the drop-down box on the registration site. Hospitals can register for both Medicare and Medicaid. If someone registers for either but doesn't choose a state, the registration will be put on hold until their state is ready to administer the provider incentive payments. It is planned to have the Medicare registration site ready in April.

Peter suggested addressing this information in a provider notice, saying that if Illinois providers don't see Illinois in the selection of states, they may unintentionally sign up for Medicare. Renee said that a draft provider notice for hospitals and providers is being developed, and hopes to have that ready by mid-January.

Update on SMHP Submission Timeline

Renee Perry reported that the SMHP will be ready to go to CMS in February. If there is time before submission, Renee may send the SMHP to the group for review. The CMS approval process for the SMHP is expected to take six weeks.

Review Revised Draft of Phase I Provider Patient Volume Calculation Worksheet

Renee Perry said that she has been working with Stan Krok on the sample data that he provided to Frank Kopel. Stan may review the results of this at the next work group meeting. Peter Ingram suggested that Stan provide a process flow document. Patrick Gallagher inquired if HFS still plans to have a piece on the Web site that shows the numerator and Renee replied that it will be posted on the Web site.

Review Methodologies for Calculating and Validating the Medicaid Share for Providers Who Work in Multiple Practices

Renee Perry reported that she had not yet discussed this with Frank Kopel. Peter Ingram suggested looking at the worksheets of the eleven states that have had their SMHP approved. Mike Koetting indicated that he spoke to Jessica Kahn at the ONC conference, and that she said the multiple practice issue is too complicated, and that providers should work this out with their lawyers. Fred Rachman suggested that the state should take a pro-active approach and provide examples and models of how an electronic health record could look. Fred said that the Regional Extensions Centers could help with this.

Develop Agenda for Next Meeting

Items discussed for inclusion in the agenda for the next work group meeting were:

  • Updates on NLR
  • Worksheet Update
  • Communication Plan Update
  • Update on CHIPRA

The next meeting is schedule on January 24, 2011. Meeting adjourned.