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ILHIE Medicaid Work Group Meeting Minutes - June 27 2011 

June 27, 2011

Attendees (by phone):

  • Janet Barrett OSF Healthcare
  • Ann Bobb Children's Memorial Hospital
  • Steve Bradley Department of Healthcare and Family Services (HFS)
  • Kelly Carter Illinois Primary Health Care Association
  • Connie Christen Department of Healthcare and Family Services
  • Mari Franks Metropolitan Chicago Healthcare Council
  • Patrick Gallagher Illinois State Medical Society
  • Andrew Garrett Department of Healthcare and Family Services
  • Ivan Handler Office of Health Information Technology (OHIT)
  • Krysta Heaney Office of Health Information Technology (OHIT)
  • Roger Holloway Illinois Health Information Technology Regional Extension Center (IL-HITREC)
  • Peter Ingram Sinai Health System
  • Kevin Ko Office of Health Information Technology (OHIT)
  • Stan Krok Children's Memorial Hospital
  • John Lekich Department of Healthcare and Family Services
  • Mary McGinnis Office of Health Information Technology
  • Elizabeth McKnight Chicago Health Information Technology Regional Extension Center (CHITREC)
  • Susan Melczer Metropolitan Chicago Healthcare Council
  • Renee Perry Department of Healthcare and Family Services
  • Ehtesham Shafique Office of Health Information Technology
  • Cory Verblen Office of Health Information Technology
  • Theresa Walunas Chicago Health Information Technology Regional Extension Center
  • Matt Werner Consultant

Status of State Medicaid Health IT Plan (SMHP)

  • Submission Deadline Friday, 7/1
  • Update Timeline
  • Final Methodology for Proxy Value for Medicaid Patient Volume

Submission Deadline Friday, 7/1

Renee Perry updated the group by reporting that HFS is finalizing the SMHP responses and plans to resubmit it on Friday, July 1. The Centers for Medicare and Medicaid Services (CMS) requested more detailed information on the HFS audit strategy. The response to this request was formalized after many internal meetings and information gathering. Renee also reported that CMS is reviewing the revised SMHPs as quickly as possible so that states can move forward with their incentive programs. There are currently 17 states that have launched their programs and approximately 30 states waiting to have their SMHPs approved.

Updated Timeline

HFS has estimated that the program will be launched on September 1, 2011 which means that providers will be able to register with CMS in the National Level Registry at that time. However, providers will not be able to attest at that time. By launching before the beginning of the next Federal Fiscal Year (FFY), October 1, 2011, the payment year will be locked in for FFY 2011.

Per CMS, states must be able to accept attestation within 3 months of their launch date which will be around December 1st for HFS. HFS is mandated to make payments within 5 months of launching the program and so that timeframe is estimated to be February 1, 2012. Peter asked what the cutoff date is for providers to attest for a previous FFY. Renee will check.

A representative from CMS will participate in the next work group call. If anyone has questions to ask him, please e-mail them to Renee before the meeting.

Peter asked what needs to be accomplished by HFS to meet the deadlines. Renee indicated that in order to meet the first deadline of the launch, HFS is building the transaction interfaces and databases to store the transactions that come from CMS, as well as building the system edits and response files that will be sent to CMS. HFS will test the system with CMS and receive their approval upon completion of the testing. For the second deadline, a Web application is being built for attestation. Another aspect of the program includes a pre-payment audit which must be conducted by HFS, prior to payments being made. In addition, there is a series of internal approvals that are needed before sending the payment. In addition to the systematic changes that have to happen, HFS staff have to be trained to administer the program.

Final Methodology for Proxy Value for Medicaid Patient Volume

Renee and other HFS staff are reviewing what other states are doing for their incentive programs and are focusing on the plans from South Carolina and Ohio. South Carolina uses proxy value at the county level to calculate the number of Medicaid patient encounters per provider and is using a percentage by county. HFS generated similar reports by using the National Provider Identification (NPI) number for several providers to determine if this method is the best way for Illinois to calculate Title XIX encounters. It was decided that a list of NPI numbers and the percentage of Title XIX patient volume for each NPI number will be posted on the HFS EHR Web site. The percentage is based on claims for Calendar Year 2010. Patrick Gallagher asked what the range in percentages was when various NPI numbers were run. Steve Bradley responded that it was from 0 up to 100 percent. Steve felt that providing a specified percentage by NPI is much more accurate than using the county average because some percentages will be brought down by providers that have less Title XIX patients. Only the percentage will be posted on the Web site and not the denominator or numerator. The Patient Volume Calculation Worksheet will be redrafted and sent to this work group in the next month for review and input.


Peter noted that the HIT Policy committee in Washington developed recommendations for the National Coordinator for Stage 2 of Meaningful Use and he will circulate it to the group.

Susan Melczer asked if HFS had the survey results from the recent provider survey distributed. Mary McGinnis answered that the results were very strong with almost 600 responses. The survey responses indicated a high degree of providers will apply for the incentive benefits.

The next meeting is scheduled for July 11. Meeting adjourned.