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ILHIE Medicaid Work Group Minutes - January 24 2011 

January 24, 2011

Attendees (phone and in-person):

  • Scott Allen, American Academy of Pediatrics
  • Steve Bandy, Department of Healthcare and Family Services (HFS)
  • Dave Barnes, HFS
  • Julie Bonello, Access Community Health Network
  • Patricia Borrowdale, Pediatric Health Associates
  • 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 (ILHITREC)
  • Peter Ingram, Sinai Health System
  • Vince Keenan, Illinois Academy of Family Physicians
  • Mike Koetting, HFS
  • Stan Krok, Children's Memorial Hospital
  • John Lekich, HFS
  • Lisa Lenc, Children's Memorial Hospital
  • Marvin Lindsey, Community Behavioral Healthcare Association of IL
  • Mary McGinnis, OHIT
  • Susan Melczer, Metropolitan Chicago Healthcare Council
  • Pat Merryweather, Illinois Hospital Association
  • Renee Perry, HFS
  • Fred Rachman, Chicago Health Information Technology Regional Extension Center
  • Gwen Smith, HFS
  • Wesley Valdez, University of Illinois/OHIT
  • Theresa Walunas, Chicago Health Information Technology Regional Extension Center
  • Matthew Werner, Consultant
  • Harrison White, Gateway Foundation

Review Minutes of Previous Meeting

There were a few minor changes to the meeting minutes from the January 10, 2011, meeting. With those changes, the minutes were approved.

HFS Updates (Renee Perry)

  1. Reminder: Eligible Professionals must enroll as an HFS Provider and register in MEDI
  2. Patient Volume Calculation Worksheet Update – work in progress
  3. Attestation Update – work in progress
  4. CHIPRA Update – collaboration continues
  5. SMHP Timeline Update – anticipate submitting to CMS by mid-February

Renee Perry reported on a conference call conducted by the Centers for Medicare and Medicaid Services (CMS) earlier today. Lessons learned from states that have begun making incentive payments included a caution for providers of the need to know their NPPES (National Plan and Provider Enumeration System) user ID and password. This information will be included in the upcoming HFS Provider Notice. Many common questions that providers have can be to be answered at the CMS Frequently Asked Questions Section of their Web site. One of the most common reasons that providers were deemed ineligible is that they were not enrolled with their states' Medicaid program.

Peter Ingram inquired about the status of the HFS Provider Notice. Renee indicated that the draft notice is due to be discussed at the next Policy Review System (PRS) committee meeting. Renee said that an emergency PRS committee meeting could be scheduled, if it is determined to be necessary. Renee will provide an update at the next work group meeting.

  1. Reminder: EPs must enroll as HFS Provider and register in MEDI
    Renee said that HFS decided that providers must enroll in the HFS MEDI (Medical Electronic Data Interchange) system and that providers can begin enrolling now.
  2. Patient Volume Calculation Worksheet Update – work in progress
    Renee indicated that the worksheet is a work in progress and plans to have a draft available at the next work group meeting.
  3. Attestation Update – work in progress
    Renee said that the content is a work in progress. HFS is researching what other states have submitted in this regard.
  4. CHIPRA Update
    Gwen Smith reported that the CHIPRA work group received comments from CMS on the CHIPRA final operational plan; the comments were minor in nature. The CHIPRA work group submitted responses to CMS. An exit conference with CMS will be scheduled following their review. Gwen referenced the CHIPRA core set of measures distributed to the group and said that the final version will be available in February. Gwen will add a data source column and a column identifying NQF measures and data stewards to the document per the request of the work group.
  5. SMHP Timeline Update
    Renee Perry updated the group, indicating that the SMHP is slated to be submitted to CMS in mid-February. Renee will send a copy of the SMHP to this work group for review. A quick turn-around for feedback is requested. Renee requested that one person gather any suggestions and to send to her in one document.

Children's Memorial Hospital Case Study

Stan Krok and Lisa Lenc discussed the draft Children's Memorial Hospital qualification form and process flow chart used for validating whether providers are eligible for the Medicaid IT incentive payments. Lisa indicated that Children's included 15 months of data in order to perform a match with the number of encounters that HFS has documented. Overall, the validation process was relatively easy to accomplish.

Lisa reviewed the flow chart for provider groups indicating that the goal is to try to match the number of encounters with HFS data. The first step in doing this is to run the providers' number of encounters, which is defined as per patient, per day. HFS will also run the total number of encounters and the number of eligible encounters. The data sets will be reviewed to see if the HFS data matches the hospitals/providers data. The form calculates the percent of Medicaid patients that a provider serves, which determines the eligibility for the Medicaid incentive payments. Lisa indicated that providers should first register in the CMS NLR system, MEDI and complete an attestation form. Renee Perry said that HFS has reviewed this validation method and is comfortable with it. She will send this process to Fox Systems to review.

Provider attestation was discussed and Lisa Lenc said that it may be burdensome for large groups if each individual provider has to complete an attestation. Peter Ingram commented that the information can be calculated individually or as a group. Fred Rachman said that he thinks attestation is for each EMR and not for more than one location. Renee Perry will research the CMS final rule and review the CMS FAQs and will report on her findings. She will also review Oklahoma's SMHP patient volume count methodology.

Collaborative Business Plan of RECs in Support of HIE and Provider Incentive Payments

Fred Rachman introduced a discussion about the State HIT Plan and the feasibility of exploring federal support of 90% match for administration of the program. Among the topics for consideration are: 1) what is the process to think through all of the mechanisms and tools to support for practices achieving meaningful use; 2) how do we develop a strategy to assist providers with ongoing compliance with meaningful use; 3) determine if there is an opportunity to build on to the infrastructure that's being developed by the RECs; 4) what are the steps needed to develop a long term plan. Developing a matrix with a list of support services and what areas need support was discussed. Roger Holloway indicated that as providers go through installation of electronic medical records the REC's will gather vendor information to continue to redefine the process on implementation to make it more efficient and less burdensome. This topic will be discussed again at the Medicaid work group meeting on February 22, 2011.

Develop Agenda for Next Meeting

  • Items suggested for the next agenda:
  • Review of draft SMHP
  • Provider information notices
  • Draft of provider volume calculation sheet
  • Multiple practices
  • CHIPRA update

The next meeting is scheduled on Monday, February 7, 2011. Meeting adjourned.