CMS was appropriated $140 million a year for FY 2009 through 2015 and $65 million for FY2016 for admin funding, (funds available until expended). Some funds assess systems to see they meet requirements of incentive program.Funding used to modify, develop, implement, operate, maintain systems needed to support incentive payments to hospitals/eligible professionals, (e.g. systems for eligibility/enrollment, payment, quality reporting, and accounting or monitoring).
With Office of the National Coordinator (ONC) for HIT, CMS develops incentive program policies to require broad provider education/outreach ensuring providers understand policies/requirements related to provider eligibility, selection of Medicare/Medicaid incentive programs for eligible providers, incentive payments, meaning of “meaningful use.” States making Medicaid incentive payments must start multi-state workgroups to create criteria for State HIT planning, implementation, and system changes.Proof of payment accuracy/audits to prevent improper payment of incentives are vital.Federal/State staff must modify accounting/payment data systems.Admin funds support execution of incentives programs for meaningful use of certified EHRs. EPs get information to choose between incentives under Medicare/Medicaid.With ONC, we define “meaningful use” and identify if a provider is a meaningful user.We calculate payments that require integration of information with multiple data sources.
In FY09, CMS begins to: Coordinate with ONC to develop policies to implement statutory requirements; Establish Medicare/Medicaid payment policies, processes, tracking methods; Develop/publish proposed regs for public notice and comment;Conduct initial assessments of potential systems/measures required to pay incentives (including calculation of incentive payments, capturing attestations, tracking, accepting quality measures);Plan extensive provider outreach on Medicare/Medicaid incentives and Medicare penalties;Plan audit/reimbursement work; With contractor support, ONC and regional extension programs, provide States with assistance thru guidance, outreach, education, hire federal employees to implement provisions.FY10 funds allow continued education/outreach, analysis, contractor support to make system changes or develop new systems.
Based on initial assessment, systems need to process incentive process selection, to determine payments, assess meaningful use, make/track payments, capture quality data. Additional analysis determines if existing systems are modified or new systems are needed. We develop/modify systems to post recipients of EHR incentives online after we start to make incentive payments. In Medicaid, proper staging of activities is critical to ensure a smooth implementation.CMS implements Medicaid incentives program in 2011 consistent with Medicare.CMS strategies are coordinated with ONC, AHRQ, to provide clear guidance/direction to States, vendors, potential participants in incentives programs.
Medicaid Administrative funds are used to:Develop implementation strategy to issue incentive payments to providers;Track, report, oversee incentive payments to assure no duplication of funds;Assess data from providers, practitioners/hospitals, Medicaid, CHIP, uncompensated care patient volume/mix data;Conduct scan of current State EHR/HIT environment;Create vision document to analyze current to future State activities with plan for transition/milestones to achieve EHR technology goal; Conduct outreach, training, education to providers and State personnel;Develop infrastructure for health information exchange; Harmonize EHR/HIT technology with current State initiatives such as Medicaid IT Architecture(MITA); With States, develop infrastructures needed to provide oversight of Recovery Act initiatives/coordinate activities involving stakeholders.Some work closely coordinated with ONC initiatives authorized by Recovery Act such as grants to States for information exchanges (sec 3013).