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WV EHR 2nd Year Eligible Professional User Manual

1. 33 Figure 16 Registration Tab Registration Home 34 Figure 17 Registration Tab No Records to 1 35 Figure 18 Registration Tab Add Registration ccccecccccccccccccceeeeeeeeeseeeeeeeeeeceeeeeeeeeeneaaaaaas 36 Figure 19 Registration Tab Registration Information WindOW cccsseeeeeeeeeeeeeeeeeeeeeees 37 Figure 20 Add Registration Error Message 37 Figure 21 Registration Tab Registration Information 1 38 Figure 22 Registration Tab Remove 38 o E Pr oS 0 Brel c 40 Figure 24 Attestations Tab Attestation Selection 4 Figure 25 Attestation Tab Attestation Topic Listing esses 42 Figure 26 Attestation Tab Verify Registration nnne nnne 43 Figure 27 Attestation Tab Service 47 Figure 28 Attestation Tab Eligibility Window ccccccccccccssssssssecceeceecaaeeeseeeceeeeesaaaeseeeeeess 47 Figure 29 Attestation Tab Medicaid Patient Volume 50 Figure 30 Attestation Tab Out o
2. 175 Figure 136 CQM Question 39 Prostate Cancer Avoidance of Overuse of Bone Scan for Staging Low Rish Prostate Cancer Patients ine esent oen aen 176 Figure 137 COM Question 40 HIV AIDS Medical 1 176 Figure 138 COM Question 41 HIV AIDS PCP Prophylaxis 177 Figure 139 COM Question 42 HIV AIDS RNA Control for Patients with HIV 178 Figure 140 COM Question 43 Preventive Care and Screening Screening for Clinical Depression dnd Follow Up Plas 178 Figure 141 COM Question 44 Documentation of Current Medications in the Medical Record Q 179 Figure 142 COM Question 45 Preventive Care and Screening BMI Screening and Follow up sere 180 Figure 143 COM Question 46 Cataracts Complications within 30 days Following Cataract Surgery Requiring Additional Surgical 181 Figure 144 COM Question 47 Cataracts 20 40 or Better Visual Acuity within 90 days Ty LNG C atardcb SUIT eee teenie etta inest nance 182 Figure 145 COM Question 48 Pregnant Women That had HBsAg Testing 182 Figure 146 COM Question 49 Depression Rem
3. eee eee eee eee eee eee ee eee eee e ete 86 12 Submitted Attestation 87 13 Error Occurred When Processing Registration Email 88 14 Attestation Accepted BNA ies siccosccasesecesvecsessenecsvceseecensenasesvexseuscedevsassvesstesedetsasesvesstuceseee 89 15 Error Occurred While Processing Registration Medicaid Enrollment Failed Email 90 16 Attestation Error Practice Predominately in a Hospital Setting Email 91 17 Attestation Error Medicaid Claims Count Failed Email 92 18 Attestan on 93 19 Attestation Payment Denied Email 4 4 4 e e eee eee o ee 94 20 Attestation Payment Denied Pay Hold Found ecce eere eee eee eene 95 21 Attestation Excluded from Payment Email cccsssssccccsssssssccccccssssccccccsssssccccesess 96 22 Attestation Rejected Email ecce eee ee eee ee en e ree erae no oae eee ne 97 23 Attestation Pended for Out of State Entries ccce ccce eere ee eee eee eee eene neun 98 24 Attestation Failed Meaningful Use soccccecascescccesscsceccsaessatusssocecasauevecuseseceeteasevstsasesseuniatnes 99
4. Figure 40 Meaningful Use Menu Measure Question List e checkmark indicates that you have selected that question The application will allow you to select more than 3 questions Potential Error Messages on this Screen The following are the error messages if the minimum requirements are not meant MESSAGE 2 User receives the following error and cannot continue attestation process until error is fixed e Selects less than three items the following error message displays Page 70 of 192 Confidential and Proprietary Department of Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Meannigrul Lise fernw teasures Aagi atang AA st Use Manu Plmeasurms Questionnaire You must resolve the following error s to continue Please select 3 menu mescure Application Question Display for Menu Measures The application will only display the questions that were selected The navigation is the same as was outlined in the Meaningful Use Core section as show again below The application will not validate if the required score has been met at the time of entry it will only tell the user if the appropriate questions have been completed or not The validation of EHR usage percentiles is done after the attestation is submitted 9 5 1 Meaningful Use Menu Measures Question General Workflow Functionality Link to
5. Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed Eg PREVIOUS PAGE SAVE AND CONTINUE amp Figure 138 COM Question 41 HIV AIDS PCP Prophylaxis Confidential and Proprietary Page 177 of 192 WEST VIRGINIA rt nt of Healt Human BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 42 of 64 Red asterisk indicates a required field CMS77v2 Title HIV AIDS RNA Control for Patients with HIV Description Percentage of patients aged 13 years and older with a diagnosis of HIV AIDS with at least two visits during the measurement year with at least 90 days between each visit whose most recent HIV RNA level is 200 copies mL For CQM field descriptions and additional information Clinical Quality Measure Page Numerator Denominator Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 139 COM Question 42 HIV AIDS RNA Control for Patients with HIV Questionnaire 43 of 64 Red asterisk indicates a required field CMS2v3 NQF 0418 Title Preventive Care and Screening Screening for Clinical Depression and Follow Up Plan Description Percentage of patients aged 12 years and older screened for clinical depression on the date of the encounter using an age appropriate stan
6. Red asterisk indicates a required field CMS169v2 NQF 0110 Title Bipolar Disorder and Major Depression Appraisal for alcohol or chemical substance use Description Percentage of patients with depression or bipolar disorder with evidence of an initial assessment that includes an appraisal for alcohol or chemical substance use For field descriptions and additional information Clinical Quality Measure Page C Numerator Denominator Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed B PREVIOUS PAGE SAVE AND CONTINUE 83 Figure 132 Question 35 Bipolar Disorder and Major Depression Appraisal for alcohol or chemical substance use Questionnaire 36 of 64 Red asterisk indicates a required field CMS157v2 NQF 0384 Title Oncoloqy Medical and Radiation Pain Intensity Quantified Description Percentage of patient visits regardless of patient age with a diagnosis of cancer currently receiving chemotherapy or radiation therapy in which pain intensity is quantified For COM field descriptions and additional information Clinic 1 sure Pag Numerator Denominator Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 0 PREVIOUS PAGE SAVE AND CONTINUE Figure 133 Question 36 Oncology Medical and Radiation Pain Intensity Quantified Page 174 of 192 Confidential and Proprietary WE
7. Add nnns 82 Figure 44 Attestation Tab Submission Receipt Window 83 Figure 45 Attestation D1 ANUS ES duse S aao 85 Figure 46 MU Core Question 1A CPOE for Medication Radiology and Laboratory 100 Figure 47 MU Core Question CPOE for Medication Radiology and Laboratory 101 Figure 48 MU Core Question 1B Numerator amp Denominator Entry Screen 102 Figure 49 MU Core 1 Question CPOE Medication Radiology and Laboratory Orders 103 Figure 50 MU Core Numerator amp Denominator Entry screen eeeeeeeeeeees 104 Figure 51 MU Core Question 2 e Prescribing 105 Figure 52 MU Core Question 2 Numerator amp Denominator Entry 106 Figure 53 MU Core Question 3 Record 1 107 Figure 54 MU Core Question 4 Record Vital Signs 108 Figure 55 MU Core Question 4 Numerator amp Denominator Entry 109 Figure 56 MU Core Question 5 Record Smoking 110 Figure 57 MU Core Question 5 Numerator amp Denominator Entry 111
8. Numerator The number of patients in the denominator who have all the elements of demographics or a specific notation if the patient declined to provide one or more elements or if recording an element is contrary to state law recorded as structured data Denominator Number of unique patients seen by the EP during the EHR reporting period Numerator Denominator For additional information CMS Specification Sheet Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed G PREVIOUS PAGE SAVE AND CONTINUE 23 Figure 53 MU Core Question 3 Record Demographics Confidential and Proprietary Page 107 of 192 WEST VIRGINIA D t of tua BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 4 of 17 Red asterisk indicates a required field Record Vital Signs Objective Record and chart changes in the following vital signs height length and weight no age limit blood pressure ages 3 and over calculate and display body mass index BMI and plot and display growth charts for patients 0 20 years including BMI Measure More than 80 percent of all unique patients seen by the EP have blood pressure for patients age 3 and over only and or height and weight for all ages recorded as structured data EXCLUSION Any EP who 1 Sees no patients 3 years or older is excluded from
9. Exceptions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 0 PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 141 COM Question 44 Documentation of Current Medications in the Medical Record Confidential and Proprietary Page 179 of 192 WEST VIRGINIA rt nt of Healt Human BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 45 of 64 Red asterisk indicates a required field CMS69v2 NQF 0421 Title Preventive Care and Screening Body Mass Index BMI Screening and Follow Up Description Percentage of patients aged 18 years and older with a documented BMI during the encounter or during the previous six months AND when the BMI is outside of normal parameters a follow up plan is documented during the encounter or during the previous six months of the encounter Normal Parameters Age 65 years and older BMI gt 23 and lt 30 Age 18 64 years BMI gt 18 5 and lt 25 For CQM field descriptions and additional information Clinical Quality Measure Page e Population criteria 1 Numerator 1 Denominator 1 Exclusions Population criteria 2 Numerator 2 Denominator 2 Exclusions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed B PREVIOUS PAGE SAVE AND CONTINUE Figure 142 COM Question
10. Page 78 of 192 Confidential and Proprietary WEST VIRGINIA Healt Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Title Child and Adolescent Major Depressive Disorder Suicide Risk Assessment Description Percentage of patient visits for those patients aged 6 through 17 years Patient Safety S with a diagnosis of major depressive disorder with an assessment for suicide risk Title Maternal Depression Screening Description The percentage of children who tumed 6 months of age during the measurement year who had a face to face visit between the clinician and the child during child s first 6 months and who had a maternal depression screening for the mother at least once between 0 and 6 months of life Title Primary Caries Prevention Intervention as Offered by Primary Care Providers including Dentists Clinical r Description Percentage of children age 0 20 years who received a fluoride varnish Process Effectiveness application during the measurement period CMS177v2 1365 CMS82v1 Population Public r NQF 1401 Health CMS74v3 Title Preventive Care and Screening Cholesterol Fasting Low Density Lipoprotein LDL C Test Performed Clinical r Description Percentage of patients aged 20 through 79 years whose risk factors have Process Effectiveness been assessed and a fasting LDL C test has been performed Title Pre
11. 12 of 17 Red asterisk indicates a required field Preventive Care Objective Use clinically relevant information to identify patients who should receive reminders for preventive follow up care and send these patients the reminders per patient preference Measure More than 10 percent of all unique patients who have had 2 or more office visits with the EP within the 24 months before the beginning of the EHR reporting period were sent a reminder per patient preference when available EXCLUSION If an EP has had no office visits in the 24 months before the EHR reporting period that EP is excluded from this requirement Does this exclusion apply to you C Yes C No For additional information CMS Specification Sheet Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed E PREVIOUS PAGE SAVE AND CONTINUE 8 Figure 71 MU Core Question 12 Preventive Care Confidential and Proprietary Page 125 of 192 west VIRGINIA ihn BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 12 of 17 Red asterisk indicates a required field Preventive Care Objective Use clinically relevant information to identify patients who should receive reminders for preventive follow up care and send these patients the reminders per patient preference Measure More than 10 percent of all unique patients
12. 34 of 64 Red asterisk indicates a required field CM5136v3 NQF 0108 Title ADHD Follow Up Care for Children Prescribed Attention Deficit Hyperactivity Disorder ADHD Medication Description Percentage of children 6 12 years of age and newly dispensed a medication for attention deficit hyperactivity disorder ADHD who had appropriate follow up care Two rates are reported a Percentage of children who had one follow up visit with a practitioner with prescribing authority during the 30 Day Initiation Phase b Percentage of children who remained on ADHD medication for at least 210 days and who in addition to the visit in the Initiation Phase had at least two additional follow up visits with a practitioner within 270 days 9 months after the Initiation Phase ended For CQM field descriptions and additional information Population Criteria 1 Numerator 1 Denominator 1 Exclusions Population Criteria 2 Numerator 2 Denominator 2 Exclusions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS SAVE AND CONTINUE 0 Figure 131 CQM Question 34 ADHD Follow up Care for Children Prescribed ADHD Medication Confidential and Proprietary Page 173 of 192 Department de Hurtin BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 35 of 64
13. Intervention NQF 0028 Description Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who recerved cessation counseling intervention if identified as a tobacco user CMS125v2 Title Breast Cancer Screening Description Percentage of women 40 69 years of age who had mammogram to NQF 0031 screen for breast cancer CMS124v2 Title Cervical Cancer Screening NQF 0032 Description Percentage of women 21 64 years of age who received one or more Pap tests to screen for cervical cancer CMS153y2 Title Chlamydia Screening for Women NQF 0033 Description Percentage of women 16 24 years of age who were identified as sexually active and who had at least one test for chlamydia during the measurement period CMS130v2 Title Colorectal Cancer Screening Description Percentage of adults 50 75 years of age who had appropriate screening NQF 0034 for colorectal cancer Title Use of Appropriate Medications for Asthma CMS126 2 Description Percentage of patients 5 64 years of age who were identified as having NQF 0036 persistent asthma and were appropriately prescribed medication during the measurement penod Title Childhood Immunization Status Percentage of children 2 years of age who had four diphtheria tetanus CMS11742 and acellular pertussis DTaP three polio IPV one measles mumps and rubella NQF 0038 MMR three H influenza type B HiB three hepatitis B Hep B one
14. M 21 8 1 BAC bulbs o ee E MM MM CMM EMEN ME PME CMM UR EE 21 8 2 Use or the Navigation accxinscccstticateussateseuntanccestiheonesiteseteusenzorabatauatedsetienosstaietouiengedauntans 21 e a ys sce tnt rcs m 21 8 22 WV EHR Incentive Program Account 22 MMIS ue qe NE 22 oad 22 Ee PRC CIS ALON m 23 VEU MP ir o T 24 B The Aa ID 26 9 Using the WV EHR Incentive Program Application eee eee ee eee e eee eene 27 9 Login to the WV EHR Incentive nennen nennen 28 9 1 1 Starting WV EHR Incentive Program Application 20 9 2 Registering a Provider within WV EHR Incentive 32 921 Reeistration Add Optom 36 29 2 2 Resistaton Select ODBODB eb cQ Ye Edu cr 38 9 2 Registration Remove Optom ANENE ERER AAEE 38 9 3 PRLS IE gees eee 39 LES Attestation Te T TTE 45 DL Encounter soU duae dE RIPE NDA Ac GR 46 9 3 1 2 Eligibility Screen 1 Service irnn ireira nennen nennen nnns 46 93 1 3 Eligibility Screen 2
15. Red asterisk indicates a required field Family Health History Objective Record patient family health history as structured data Measure More than 20 percent of all unique patients seen by the EP during the EHR reporting period have a structured data entry for one or more first degree relatives EXCLUSION An EP who have no office visits during the EHR reporting period would be excluded from this requirement Does this exclusion apply to you C yes No For additional information Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 0 PREVIOUS PAGE SAVE AND CONTINUE 2 Figure 92 Menu Measures Question 4 Family Health History Page 146 of 192 Confidential and Proprietary Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 4 of 6 Red asterisk indicates a required field Family Health History Objective Record patient family health history as structured data Measure More than 20 percent of all unique patients seen by the EP during the EHR reporting period have a structured data entry for one or more first degree relatives Complete the following information All information entered may be subject to audit that could result in payment recoupment Numerator number of patients in the denominator with a structured data entry for one or more first
16. de Hon BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 5 of 17 Red asterisk indicates a required field Record Smoking Status Objective Record smoking status for patients 13 years old or older Measure More than 80 percent of all unique patients 13 years old or older seen by the EP have smoking status recorded as structured data EXCLUSION An EP that neither sees nor admits any patients 13 years old or older would be excluded from this requirement Does this exclusion apply to you C Yes C No For additional information Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed B PREVIOUS PAGE SAVE AND CONTINUE amp Figure 56 MU Core Question 5 Record Smoking Status Page 110 of 192 Confidential and Proprietary WEST VIRGINIA D rtment of Healt H Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 5 of 17 Red asterisk indicates a required field Record Smoking Status Objective Record smoking status for patients 13 years old or older Measure More than 80 percent of all unique patients 13 years old or older seen by the EP have smoking status recorded as structured data Complete the following information All information entered may
17. Denominator Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 0 PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 150 COM Question 53 Maternal Depression Screening Questionnaire 54 of 64 Red asterisk indicates a required field CMS74v3 Title Primary Caries Prevention Intervention as Offered by Primary Care Providers including Dentists Description Percentage of children age 0 20 years who received a fluoride varnish application during the measurement period For COM field descriptions and additional information Cliniza ity asuri ge Numerator Denominator Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE amp Figure 151 CQM Question 54 Primary Caries Prevention Intervention as Offered by Primary Care Providers including Dentists Page 186 of 192 Confidential and Proprietary Department de unn BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 55 of 64 Red asterisk indicates a required field CMS61v3 Title Preventive Care and Screening Cholesterol Fasting Low Density Lipoprotein LDL C Test Performed Description Percentage of patients aged 20 through 79 years whose risk factors have been assessed and a fasting LDL C test has been performed For COM field desc
18. Figure 58 MU Question Clinical Decision Support 112 Figure 59 MU Core Question 6B Clinical Decision Support 113 Figure 60 MU Core Question Question 6B Attest for clinical decision support rule 114 Figure 6l MU Core Question 7A Patient Electronic Access eese 115 Figure 62 MU Core Question 7A Numerator amp Denominator Entry Screen 116 Figure 63 MU Core Question 7B Patient Electronic Access essere 117 Figure 64 MU Core Question 7B Numerator amp Denominator Entry Screen 118 Figure 65 MU Core Question 8 Clinical Summaries 0 0 0 eese 119 Figure 66 MU Core Question 8 Numerator amp Denominator Entry 120 Figure 67 MU Core Question 9 Protect Electronic Health Information 121 Figure 68 MU Core Question 10 Clinical Lab Test 1 5 122 Figure 69 MU Core Question 10 Numerator amp Denominator Entry 123 Confidential and Proprietary Page 7 of 192 Department of UM BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Figure 70 MU Core Question 11 Patient Lists 124 Figure 71
19. Provider Potential Error Messages on this Screen The following are the error messages if the minimum requirements are not met MESSAGE 2 User select 7 CQMs You must resolve the following error s to continue Please select 2 more Clinical Quality Measures v The error message displays the number of questions that need to be selected to meet the minimum requirement Application Question Display for Clinical Quality Measures Link to CMS definition Each screen has a link to the CMS definition and detail of each question for the provider to access to review the specific requirements for completing the numerator Denominator for each question and if elected what the exception criteria must be for an organization to claim and exemption for that question Save and Continue Button When selected a check is executed to determine if all required fields have information entered o If required fields are not filled the page will continue to display until required fields are corrected o If required fields are filled the next screen displays Previous Button Displays the previous screen 9 7 Submit Attestation and payment status The Submit Attestation button remains disabled if the eligibility checks failed or not all required questions have been answered If the eligibility checks passed and all required questions are answered then the Submit Attestation button 1s available On selection of the Submit Attestation button the
20. Provider The figure below is a pictorial view of the WV EHR Incentive Program application steps Accesses link to PIP solution on Provider gt Logs into NJMMIS com Transferred to PIP solution Transferred to PIP Home Page b N 3 J Provider Portal Portal PIP Provider Portal User 9 1 Registration Select Screen User selects a registration to attest for IF Medicaid volume not met display attestation Questionnaire 4 Question y y Presented with Attestation Topics Screen with list of components to Payment Schedule View Screen complete Provider Respond to Certified Registration EHR_ Screen Confirmation Screen questions Attestation Questionnaire 1 Question Respond to 17 Core Questions Y Y Attestation Questionnaire 2 Question Select 3 Menu Measures and respond Attestation Submit Page a Same not met display Attestation Questionnaire 3 Question Y Select 9 COMs Submission Confirmation Screen Figure 10 Attestation Flowchart Login to the WV EHR Incentive Solution Attestation Status Screen Y Payment Attestation history Details Screen This section provides instructio
21. myocardial infarction AMI coronary artery bypass graft CABG or percutaneous coronary interventions PCI in the 12 months prior to the measurement period or who had an active diagnosis of ischemic vascular disease IVD during the measurement period and who had documentation of use of aspirin or another antithrombotic during the measurement period For field descriptions and additional information Clinical Quality Measure Page Numerator Denominator Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 0 PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 119 COM Question 22 IVD Use of Aspirin or Another Antithrombotic Questionnaire 23 of 64 Red asterisk indicates a required field CMS154v2 NQF 0069 Title Appropriate Treatment for Children with Upper Respiratory Infection URI Description Percentage of children 3 months 18 years of age who were diagnosed with upper respiratory infection URI and were not dispensed an antibiotic prescription on or three days after the episode For CQM field descriptions and additional information Clinical Quality Measure Page Numerator Denominator Exclusions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed B PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 120 COM Question 23 Appropriate Treatment for Children with URI Confidential and Proprietary Page
22. 1 44 PM To Wy test org Subject PIP Registration Medicaid Eligibility Check Failed Attestation not allowed The provider whose details are listed below is not allowed to participate in the payment incentive program at the current time for the reason listed below NPI ID 18 Provider Name PROVIDER NAME Organization Name ORGANIZATION NAME Reporting Period Name CY2011 Reason for rejection Provider not found to participate in the WY Medicaid system For more information on eligible providers for the EHR Provider Incentive Program please visit www wymmis com and refer to the instructions and FAQ s If you need any other assistance regarding eligibility for the EHR s Provider Incentive Program please contact 888 483 0793 option 8 for the Provider Service EHR Provider Incentive Program help desk Thank you for using the PIP system Version 1 0 0 1 WEST VIRGINIA Healt Human BUREAU FOR MEDICAL SERVICES Page 88 of 192 Confidential and Proprietary m Healt Hu Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 14 Attestation Accepted Email This email 1s sent when either one of the two scenarios occur The 48 hour time span that allowed for changes has expired The attestation is no longer accessible for changes within the application The attestation details will be sent to the NLR to check if any payments have been
23. 25 Meaningful Use Core Measures Screen Shots ccccccccssssssssscccccssssssssssssccccssssssees 100 26 Meaningful Use Menu Measures Screen Shots ssssssseeeccccssssscceccocssssssceccosssssssceeoooo 141 21 Clinical Quality Measures Screen Shots ccce ecce eee eee e eee eee eee ee eee eese sanos 152 Confidential and Proprietary Page 5 of 192 Department of UM BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Table of Figures and Tables Figure L Example Ot Workbook E E 15 Figure 2 Certified Health IT Product List 1 19 Titore Be AAC NS Sio second Sante teta UU Ea mma un MMM SRM PAM MUNI eats 21 Ae Ae D Oh 21 Ficure 5 Update Account era an EEEE Ea E aean 22 Pae o TAOS DOPO ara E 23 Figure Registration ELA WOW P r E 24 E 25 26 Igi PRO EM Ire SCATEONME HOW C WALD assena 28 igure LL WV LOS 29 Ersute 12 WV VVC CONN see mtus EDIDI ESOS 30 Figure 13 Provider Incentive About this Site nennen 3 Lure 414 PON derum E E 32
24. Complete the following information All information entered may be subject to audit that could result in payment recoupment Numerator Number of office visits in the denominator where the patient or a patient authorized representative is provided a clinical summary of their visit within one 1 business day Denominator Number of office visits conducted by the EP during the EHR reporting period Numerator Denominator For additional information CMS Specification Sheet Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 66 MU Core Question 8 Numerator amp Denominator Entry Screen Page 120 of 192 Confidential and Proprietary WEST VIRGINIA D t t of Healt H Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 9 of 17 Red asterisk indicates a required field Protect Electronic Health Information Objective Protect electronic health information created or maintained by the certified EHR technology CEHRT through the implementation of appropriate technical capabilities Measure Conduct or review a security risk analysis in accordance with the requirements under 45 CFR 164 308 1 including addressing the encryption security of data stored in accordance with requirements under 45 CFR 164 31
25. D rtment of Healt H Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 28 of 64 Red asterisk indicates a required field CMS143v2 NQF 0086 Title Primary Open Angle Glaucoma POAG Optic Nerve Evaluation Description Percentage of patients aged 18 years and older with a diagnosis of primary open angle glaucoma POAG who have an optic nerve head evaluation dunng one or more office visits within 12 months For CQM field descriptions and additional information Clinical Quality Measure Page Numerator Denominator Exceptions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 0 PREVIOUS PAGE SAVE AND CONTINUE 83 Figure 125 COM Question 28 POAG Optic Nerve Evaluation Questionnaire 29 of 64 Red asterisk indicates a required field CMS167v2 NQF 0088 Title Diabetic Retinopathy Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy Description Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed which included documentation of the level of severity of retinopathy and the presence or absence of macular edema during one or more office visits within 12 months For field descriptions and additional information Cli
26. D wld uua d ie AEP icha miri s oF 1 Provider Marne BERET Te Gm Om Oo urbes oa ras 33 Wa Figure 24 Attestations Tab Attestation Selection Confidential and Proprietary Page 41 of 192 Department of Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 2 Review the Attestation status displayed on the Attestation Topics Page If the provider is not listed please select the Status tab The Status tab will display the current attestation Locate the provider in the list to see the error that prevented the provider from executing the attestation process 3 The topics available on this page are as follows Topics The data required for this attestation rs grouped mto topics n order to complete your attestation you mist complete ALL of the follow topecs Select the START ATTESTATION button to modify any previously entered informabon The system will show checks for each item when completed Completed Topic listing d Note When all topes are marked as completed or N A please select the SUBMIT amp ATTEST button to complere the attesrabon process Figure 25 Attestation Tab Attestation Topic Listing topic listing identifies the completed topic by placing an indicator next to the topic A
27. Description Percentage of patients aged 18 years and older with primary total hip Patient and Family r arthroplasty THA who completed baseline and follow up patient reported Engagement functional status assessments Title Functional Status Assessment for Complex Chronic Conditions Patient and Family CMS90v3 Description Percentage of patients aged 65 years and older with heart failure who xS Lj completed initial and follow up patient reported functional status assessments sg Title ADE Prevention and Monitoring Warfann Time in Therapeutic Range Description Average percentage of time in which patients aged 18 and older with CMS179v2 atrial fibrillation who are on chronic warfarin therapy have International Normalized Patient Safety Li Ratio INR test results within the therapeutic range i e TTR during the measurement period Title Preventive Care and Screening Screening for High Blood Pressure and Follow Up Documented Population Public r CMS22v2 Description Percentage of patients aged 18 years and older seen during the reporting Health period who were screened for high blood pressure AND a recommended follow up plan is documented based on the current blood pressure BP reading as indicated Figure 41 Clinical Quality Measures List Confidential and Proprietary Page 79 of 192 Department of de Huron BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE
28. FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 2 of 4 Red asterisk indicates a required field To be eligible to participate in the Medicaid EHR Incentive Program an EP must either 15 Meet certain Medicaid patient volume thresholds with in state Medicaid patients or visiting out af state Medicaid patients or 2 practice predominantly in an FQHE or RHO where 30 percent of the patient volume is derived from needy individuals Medicaid Patient Volume Enter your Medicaid patient volume figures in the section below for the patients you see within the current Medicaid State If you see Medicaid patients from an out of state Medicaid payer please reflect thase numbers in the Out of State Medicaid Patient Volume section below Select any 90 day period in the previous calendar year for your patient volume figures Start Date 10 3 2010 End Date 12 31 2010 E Complete the following information All information entered may be subject to audit that could result in payment recoupment Numerator Number af patient encounters in which care was delivered under Medicaid fee for service FFS Number af Medicaid patient encounters treated during the 90 day period Denominator managed care Oo Cc All patient encounters over the same 90 day period Mote encounter should be reflected in the count as one or mor
29. Ongoing Diabetes Care Questionnaire 31 of 64 Red asterisk indicates a required field CM5139v2 NQF 0101 Title Falls Screening for Future Fall Risk Description Percentage of patients 65 years of age and older who were screened for future fall nsk during the measurement period For field descriptions and additional information Cli Numerator Denominator Exceptions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed SAVE AND CONTINUE amp Bg PREVIOUS PAGE Figure 128 COM Question 31 Falls Screening for Future Fall Risk Page 170 of 192 Confidential and Proprietary WEST VIRGINIA D rtment of Healt de unn BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 32 of 64 Red asterisk indicates a required field CMS161v2 NQF 0104 Title Adult Major Depressive Disorder MDD Suicide Risk Assessment Description Percentage of patients aged 18 years and older with a diagnosis of major depressive disorder MDD with a suicide risk assessment completed during the visit in which a new diagnosis or recurrent episode was identified For CQM field descriptions and additional information Clinical Quality Measure Page Numerator Denominator Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to pro
30. Page Numerator 1 Denominator Exclusions Numerator 2 Denominator Exclusions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 99 COM Question 2 Initiation and Engagement of Alcohol amp Other Drug Dependence Treatment Confidential and Proprietary Page 153 of 192 Health Hunian BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 3 of 64 Red asterisk indicates a required field CMS165v2 NQF 0018 Title Controlling High Blood Pressure Description Percentage of patients 18 85 years of age who had a diagnosis of hypertension and whose blood pressure was adequately controlled lt 140 90mmHg during the measurement period For CQM field descriptions and additional information Clinical Quality Measure Page Numerator Denominator Exclusions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE Figure 100 COM Question 3 Controlling High Blood Pressure Page 154 of 192 Confidential and Proprietary Department de unn BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 4 of 64 Red asterisk indi
31. Patient Electronic Access Objective Provide patients the ability to view online download and transmit their health information within four business days of the information being available to the EP Measure More than 50 percent of all unique patients seen by the EP dunng the EHR reporting period are provided timely available to the patient within 4 business days after the information is available to the EP online access to their health information EXCLUSION If an EP neither orders nor creates any of the information listed for inclusion as part of this measure except for Patient name and Provider s name and office contact information they would be excluded from this requirement Does this exclusion apply to you C yes No For additional information Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE Figure 61 MU Core Question 7A Patient Electronic Access Confidential and Proprietary Page 115 of 192 west VIRGINIA TM Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 7A of 17 Red asterisk indicates a required field Patient Electronic Access Objective Provide patients the ability to view online download and transmit their health information within four business days of the information being available
32. Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE 23 Figure 157 COM Question 60 Functional Status Assessment for Knee Replacement Page 190 of 192 Confidential and Proprietary WEST VIRGINIA D rtment of Healt de unn BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 61 of 64 Red asterisk indicates a required field CMS56v2 Title Functional Status Assessment for Hip Replacement Description Percentage of patients aged 18 years and older with primary total hip arthroplasty THA who completed baseline and follow up patient reported functional status assessments For field descriptions and additional information Clinical Quality Measure Page Numerator Denominator Exclusions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE 83 Figure 158 COM Question 61 Functional Assessment for Hip Replacement Questionnaire 62 of 64 Red asterisk indicates a required field CMS90v3 Title Functional Status Assessment for Complex Chronic Conditions Description Percentage of patients aged 65 years and older with heart failure who completed initial and follow up patient reported functional status assessments For CQM field descriptions an
33. Provider Incentive Program please contact 888 483 0793 option 8 for the Provider Service EHR Provider Incentive Program help desk Thank you for using the PIP system Version 1 0 0 1 WEST VIRGINIA Depart t of Human BUREAU FOR MEDICAL SERVICES Page 96 of 192 Confidential and Proprietary WEST VIRGINIA Department of Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 22 Attestation Rejected Email WV Medicaid and WV Medicaid Provider Services staff has the ability to review attestation and reject a submitted attestation When the attestation 1s rejected an email 1s sent to notify the user of the status change To find out more information please contact the Medicaid Provider Services staff at 1 888 483 0793 option 8 From PIP Administrator Vv Date Wednesday August 10 2011 1 40 PM To WY test org sunil matte molinaheatthcare com Subject PIP Attestation rejected The attestation whose details are listed below has been rejected during an internal audit NPIID 18 Provider Name PROVIDER NAME Organization Name ORGANIZATION NAME Reporting Period Name CY2011 Submitted Date 8 4 2011 9 55 12 AM For more information on eligible providers for the EHR Provider Incentive Program please visit www wymmis com and refer to the instructions and FAQ s If you need any other assistance regarding eligibility for the EHR s Provider
34. Volume Check eeeeieitodicccee seran teres rhon eae 48 Page 4 of 192 Confidential and Proprietary BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 9 3 1 3 1 Out of State Encounters ssesssesessesseseeee nennen nennen nnne nens ssn enr n nnne essen an 49 9 3 1 3 2 Volume Screen 3 If initial Eligibility volume is not met esesuussse 53 9 3 1 3 3 Volume Screen 4 Needy Patient 55 Do S IBI AMICI EET OO EET ETT 61 D EHR Technology rsrsrsr 05 25 99 0599100 eaea Made nM aiaeei 63 9 4 Meanmotul Use Core MeASUfeS scarps sonacccacesdssscsnuacncasena 655002059 2800 192 5002 0 295 enairar keirin 66 9 4 1 Meaningful Use Core Question General Workflow Functionality ssssssse 69 9 5 Meanimefal Use Menu Meds Ures aimes tui See tomar 69 9 5 1 Meaningful Use Menu Measures Question General Workflow Functionality 71 9 6 o OO TOO 71 9 7 Submit Attestation and payment status sessi nennen eene enses nnn nnns 80 9 8 aE araa 82 10 CAIUS GEG e 85 11 Successful Registration with CMS Email
35. attestation You will be asked to upload your supporting documents at the end of this attestation on the Submit Attestation page Add State Total Medicaid Encounters Total Fatient Encounters Complete the following information information entered will be subjectto audit that could result in payment recoupment Supporting documentation af Out of State encounters claimed are required to be Uploaded for validation Any registration claiming Gut af State encounters will suspend until supporting documentation has been uploaded and validated Supporting documentation is defined as e Certification on official letter head fram the state Medicaid agency to the provider declaring the information provided was derived from their MMS and is accurate e An accompanying repart generated by the state Medicaid agency which identifies the total encounters and the reporting period used in the development of the report Mote The reporting period far GS encounters must match the reporting period indicated during registration State ISelecti Denominator All patient encounters over the same 90 day period Numerator Total number of Medicaid patient encounters treated during the 90 day period Please selectthe ADD button to add outotstate patient volume to the list Mo Medicaid patient volume records Figure 31 Out of State Entry Add Edit Screen To Add Out of State entry 1 Select Add State to display the screen abov
36. be subject to audit that could result in payment recoupment Numerator The number of patients in the denominator with smoking status recorded as structured data Denominator Number of unique patients age 13 or older seen by the EP during the EHR reporting penod Numerator Denominator E For additional information CMS Specification Sheet Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed B PREVIOUS PAGE SAVE AND CONTINUE Figure 57 MU Core Question 5 Numerator amp Denominator Entry Screen Confidential and Proprietary Page 111 of 192 WEST VIRGINIA rtment of Healt Hu Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 6A of 17 Red asterisk indicates a required field Clinical Decision Support Rule Objective Use clinical decision support to improve performance on high priority health conditions Measure Implement five clinical decision support interventions related to four or more clinical quality measures at a relevant point in patient care for the entire EHR reporting period Absent four clinical quality measures related to an EP s scope of practice or patient population the clinical decision support interventions must be related to high priority health conditions Complete the following information EPs must attest YES to implementing five clin
37. button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 153 CQM Question 56 Preventive Care and Screening Risk Stratified Cholesterol Fasting LDL C Page 188 of 192 Confidential and Proprietary Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 57 of 64 Red asterisk indicates a required field CMS149v2 Title Dementia Cognitive Assessment Description Percentage of patients regardless of age with a diagnosis of dementia for whom an assessment of cognition is performed and the results reviewed at least once within a 12 month period For CQM field descriptions and additional information Clinic Numerator Denominator Exceptions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed Ga PREVIOUS PAGE SAVE AND CONTINUE Figure 154 CQM Question 57 Dementia Cognitive Assessment Questionnaire 58 of 64 Red asterisk indicates a required field CMS65v3 Tithe Hypertension Improvement in Blood Pressure Description Percentage of patients aged 18 85 years of age with a diagnosis of hypertension whose blood pressure improved during the measurement period For COM field descriptions and additional information Numerator Denominator Exclusions Please select the PREVIOUS PA
38. chicken pox VZV four pneumococcal conjugate PCV one hepatitis A Hep A two or three rotavirus RV and two influenza flu vaccines by their second birthday Title Preventive Care and Screening Influenza Immunization CMS147v2 Description Percentage of patients aged 6 months and older seen for a visit between 0041 October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization Title Pneumonia Vaccination Status for Older Adults Description Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine Title Use of Imaging Studies for Low Back Pain CMS166v3 Description Percentage of patients 18 50 years of age with a diagnosis of low back NQF 0052 pain who did not have an imaging study plain X ray MRI CT scan within 28 days of the diagnosis CMS127v2 NQF 0043 Page 74 of 192 Population Public Health Population Public Health Clinical r Process Effectiveness Clinical r Process Effectiveness Population Public r Health Clinical r Process Effectiveness Clinical r Process Effectiveness Population Public Health Population Public r Health Clinical r Process Effectiveness Efficient Use of Healthcare Resources Confidential and Proprietary WEST VIRGINIA t t of Healt H Resources Page 75 of 192 BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provi
39. establishes for the Measure An EP rust satisfy one of the following criteria Conducts one or more successful electronic exchanges of summary of care document part of which is counted in measure 27 for EPs the measure at 5495 6 14 n B with a recipient who has EHR technology that was developed or designed by a different EHR technology developer than the sender technology certified to 45 CFR 170 314 b 2 Conductsz one or more successful tests with the CMS designated test EHR during the EHR reporting pened Successful ongoing submission of electronic immunization data from CEHRT to an immunization registry or immunization information system for the entire EHR A secure message was sent using the electronic messaging function of CEHRT by more than 5 percent of unique patients or their authorized representatives seen by the EP during the EHR reporting period Figure 39 M Page 68 of 192 eaningful Use Core Measures Question List Confidential and Proprietary BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 9 41 Meaningful Use Core Question General Workflow Functionality Link to CMS definition Each screen has a link to the CMS definition and detail of each question for the provider to access to review the specific requirements for completing the numerator Denominator for each question and if elected what the
40. exception criteria must be for an organization to claim and exemption for that question Save and Continue Button When selected a check is executed to determine if all required fields have information entered o If required fields are not filled the page will continue to display until required fields are corrected o If required fields are filled the next screen displays Previous Button Displays the previous screen 9 5 Meaningful Use Menu Measures CMS has defined a total of six Meaningful Use Menu Measures CMS is requiring the provider to select three questions Meaningful Use Menu Measures Screenshots section displays each question The following screen shots list the Meaningful Use Menu Measures questions Confidential and Proprietary Page 69 of 192 Department Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire Instructions Eligible professionals must report three Meaningful Use Menu Measure Objectives Select 3 of the 6 Meaningful Use Menu Measures listed below Objective Capability to submit electronic syndromic surveillance data to public health agencies except where prohibited and in accordance Measure Successful ongoing submission of electronic syndromic surveillance data from CEHRT to a public health agency for the entire EHR reporting period with applicable law and practice Enter at le
41. following screen displays Page 80 of 192 Confidential and Proprietary WEST VIRGINIA Department ot Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Verify Attestation Attezstatianz gt Attest gt Submit Attestation Attestation Information Please review the summary below to ensure this is the correct attestation information and reason you wish to submit If the summary below is correct select the CONTINUE button at the bottom of this page For changes to the Registration Data you need to please return to the CMS website IE to edit the information To make changes to your Attestation Details cick the PREVIOUS button Registration Data Registration ID 10 Business Address Name JUDIE PO BOX 1 TIN XXX XX 5789 SSM Ashland KY 41101 0 MPI 138 i Phone 6060004000 Payee NPI 185 E Mail kKiinealthcare com Payee TIN 123546796 Incentive Program Medicaid Verify Email Address Confirm or update the email address to which you would like to receive notifications about the status of the attestation Email Address Supporting Documentation Please upload supporting documentation PDF word Excel or JPG related to out of state numbers Cif provided and or EHR documentation Supporting documentation of Out of State encounters claimed are required to be uploaded for validation Any registration claiming Gut of State enco
42. having been declared resolved by your state s Medicaid office or the U S Department of Health and Human Services GHHS The provider must make all records and documentation available upon request to your state s Medicaid office andar DHHS Such records and documentation must include but not be limited to Financial Records Practicing Provider Information credentials Identification of Service Sites Dates of Service for Each Service Component by Patient Patient Records Invoices lease agreement supporting Adopt Implementation Utilization i 0 o XD EMR Reports supporting Meaningful Use attestation e FOR AIL evidence CMS and State recommends that a least or more of the following documentation is retained a signed contract a user agreement o purchase order o purchase receipt or o license agreement CMS and your state s Medicaid office recommends documentation are retained in case of audit Providers must maintain records in accordance with Federal regulations for a period of 5 years or 3 years after audits with any and all exceptions having been declared resolved by your state s Medicaid office or the U S Department of Health and Human Services DIHHS3 44 festatiorr Sefectrosrr the Geter SSSR fee ae Ce Tse HCE Yori cele hee to Ser Porn PIS Oh OF Cee Cam Se ft c Lift OF Pas aoe Eat de rovidmar Fann aoe Po iugi LE ML
43. information Clinical Quality Measure Page Numerator Denominator Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 0 PREVIOUS PAGE SAVE AND CONTINUE 83 Figure 109 COM Question 12 Childhood Immunization Status Questionnaire 13 of 64 Red asterisk indicates a required field CMS147v2 NQF 0041 Title Preventive Care and Screening Influenza Immunization Description Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization For field descriptions and additional information Clinical Quality Measure Page t Numerator Denominator Exceptions Please select the PREVIOUS PAGE button to go back the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 1 COM Question 13 Preventive Care and Screening Influenza Immunization Page 160 of 192 Confidential and Proprietary WEST VIRGINIA D rtment of Healt de unn BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 14 of 64 Red asterisk indicates a required field CM5127v2 NQF 0043 Title Pneumonia Vaccination Status for Older Adults Description Percentage of patients 65 years of age and older who have ever received a pneu
44. is received log into the Provider Portal to register and attest for this provider From PIP Administrator vvYy Date Wednesday August 10 2011 1 40 PM To WV atest org Subject Medicaid Registration Received and Processed Successfully Proceed with Attestation Your NLR registration details have been successfully processed by WY Medicaid EHR Provider Incentive System NPI ID 18 Provider Name PROVIDER NAME Organization Name ORGANIZATION NAME Reporting Period Name CY2011 You may now log into the WY EHR system at www wymmis com to download the instruction manual provider worksheets and frequently asked questions to document and attest that you have adopted implemented or upgraded a certified EHR technology system that demonstrates meaningful use If you need any other assistance regarding how to attest please contact 888 483 0793 option 8 for the Provider Service EHR Provider Incentive Program help desk Thank you for using the PIP system Version 1 0 0 1 WEST VIRGINIA Healt Human Resources BUREAU FOR MEDICAL SERVICES Page 86 of 192 Confidential and Proprietary WEST VIRGINIA Department of Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 12 Submitted Attestation Email This email is sent after submitting the attestation The system will wait two days to provide time for modifications After the two days
45. of Service for Each Service Component by Patient Patient Records Invoices lease agreement supporting Adopt Implementation Utilization AIU EMR Reports supporting Meaningful Use attestation OUT OF STATE DOCUMENTATION If the provider plans to include encounter counts from another payer s state the following documentation is required in an electronic format pdf Microsoft Word or Excel or jpeg and will need to be included with the electronic attestation This is optional Certification on official letterhead from the state Medicaid agency declaring the numbers obtained were derived from the state s MMIS and are accurate Report generated by the State Medicaid agency with the total Fee for Service and Managed Care Organization encounter count and reporting period Please review the BMS requirements and applicable provider manuals for the specific service requirements retention periods and lists Page 16 of 192 Confidential and Proprietary BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 4 Obtaining an West Virginia WV Medicaid Management Information System WVMMIS Login WV Medicaid providers must first have an account in West Virginia Provider Web portal www wvmmis com in order to gain access to the WV Provider Incentive payment system To sign up for a login and password to the West Virginia Health PAS Online Provider p
46. participate in the program For detailed information visit CMS website B ciigibie Hospitals B ciigibie Professionals EPs CONTINUE Figure 13 Provider Incentive About this Site Page 4 On the Provider Incentive About This Site window select the Continue button to display the Provider Incentive Program Notifications window Refer to Figure 14 Confidential and Proprietary Page 31 of 192 Department Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Put Registration Attestation Status First Successful Login Unsuccessful Login Attempts 0 Notifications Welcome to the Provider Incentbve Payment System Medicaid EHR incentive program participants can complete their attestation and receive incentive payments using this system You will need to demonstrate adoption implementation upgrading or meaningful use of certified technology am your first Year and demonstrata use for the Pereira vean an thes program Instructions Select ery tab te continue Please select the Registration tab above to perform any of the following actions Associate one or more Incentive Program Registrations with your user account Venty the content of an associated registration Ae Saar eb Please select the Attestation tab above to perform any of the following achons Attest for the Incentive Program Continu
47. that could result in payment recoupment Numerator The number of orders in the denominator recorded using CPOE Denominator Number of laboratory orders created by the EP during the EHR reporting period Numerator Denominator For additional information CMS Specification Sheet Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 0 PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 50 MU Core 1C Numerator amp Denominator Entry screen Page 104 of 192 Confidential and Proprietary WEST VIRGINIA D tment of Healt H Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 2 of 17 Red asterisk indicates a required field e Prescribing eRx Objective Generate and transmit permissible prescriptions electronically eRx Measure More than 50 percent of all permissible prescriptions or all prescnptions written by the EP are queried for a drug formulary and transmitted electronically using CEHRT EXCLUSION Any EP who 1 Writes fewer than 100 permissible prescriptions during the EHR reporting period or 2 does not have a pharmacy within their organization and there are no pharmacies that accept electronic prescriptions within 10 miles of the EP s practice location at the start of his her EHR reporting period Please select the exclusion option that applies to y
48. the ADO REGISTRATION button Registration Selection identity the desired registration and select the Action you would like to perform Natora Dover NX lees ee t xxx xx 1234 Provider Name xxx xx 1234 Please select the ADD REGISTRATION Sutton to add registration to the bat ABO REGS TRATION Figure 7 Registration Window 8 2 6 Attestation Tab The Attestation tab displays the Attestation home page Refer to Figure 8 Page 24 of 192 Confidential and Proprietary WEST VIRGINIA Department of eal Human BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Atestations Attestation instructions Welcome to the Attestation Page Depending an the current status of your attestation please select one of the follawing actions Attest Please select the Attest link to start attestation e Attest for an EHR incentive programs payment year e Continue an incomplete attestation Rescind Please select the Rescind link to Cancel processing of a submitted attestation Resubmit Please select the Resubmit link ta Resubmit an attestation that was previously deemed ineligible e Please follow along using the WY Provider Incentive Payment Hospital Provider Workbook as a companion quide as you complete the attestation process Questions on the application or the program overall can be directed to the WY Provider Services Help Desk a
49. these patients tawards your total Medicaid Patient volume for incentive qualification please record the numbers by clicking the Add State text below Please note that any out of state Medicaid patients that you add must be verified by a report from Medicaid State payer identified showing claims volume for the time frame specified and attached to this attestation You willbe asked to upload your supporting documents at the end of this attestation on the Submit Attestation page Add State State z Total Me d i aid Enc nters crate Tota Patient En oU nters ee Edit V 201 300 Remove Figure 30 Attestation Tab Out of State Medicaid Patient Volume Select Add State display the following screen Confidential and Proprietary Page 51 of 192 WEST VIRGINIA Department of Healt Human BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Out of State Medicaid Patient Volume If you or your proxy provider saw patients who belong to another Medicaid payer out of State and wish ta count these patients towards your tatal Medicaid Patient volume for incentive qualification please record the numbers by clicking the Add State text below Please note that any out of state Medicaid patients that you add must be verified by a report from Medicaid State payer identified showing claims volume for the time frame specified and attached to this
50. visits during the EHR reporting penod or any EP who conducts 50 percent or more of his or her patient encounters in a county that does not have 50 percent or more of its housing units with 3Mbps broadband availability according to the latest information available from the FCC on the first day of the EHR reporting period Please select the exclusion option that applies to you EPs who have no office visits during the EHR reporting period would be excluded from this requirement Any EP that conducts 50 percent or more of his or her patient encounters in a county that does not have 50 percent or more of its housing units with 3Mbps broadband availability according to the latest information available from the FCC on the first day of the EHR reporting period C None of the above exclusions apply to me For additional information CMS Specification Sheet amp Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 0 PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 85 MU Core Question 17 Use Secure Electronic Messaging Confidential and Proprietary Page 139 of 192 west VIRGINIA TM Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 17 of 17 Red asterisk indicates a required field Use Secure Electronic Messaging Objective Use secure electronic messaging to communicate with patie
51. was achieved Registration of intent to initiate ongoing submission was made by the deadline and the EP is still engaged in testing and validation of ongoing electronic submission Registration of intent to initiate ongoing submission was made by the deadline and the EP is awaiting invitation to begin testing and validation Yes No Please select the criteria that was met and enter the registry name Ongoing submission was already achieved for an EHR reporting period in a prior year and continues throughout the current EHR reporting period Registration with the PHA or other body to whom the information is being submitted of intent to initiate ongoing submission was made by the deadline within 60 days of the start of the EHR reporting period and ongoing submission was achieved Registration of intent to initiate ongoing submission was made by the deadline and the EP is still engaged in testing and validation of ongoing electronic submission Registration of intent to initiate ongoing submission was made by the deadline and the EP is awaiting invitation to begin testing and validation Registry Name For additional information CMS Specification Sheet Please se ect the PREVIOUS PAGE button to gc back or tha SAVE amp CONTINUE button to proceed B PREVIOUS PAGE SAVE AND CONTINUE a Figure 88 Menu Measure Question 1 Additional Information Entry Screen Page 142 of 192 Confidential and Proprietary WEST VIRGI
52. xxx xx dz34 Provider Mame xxx xx l1234 Mapia Gelert tha ADDREGCISTRATION b to pad Peoria ADO REGISTRATION Figure 21 Registration Tab Registration Information Window Click the Select hyperlink and the registration details displays for the registration ID selected Refer to Figure 21 9 2 3 Registration Remove Option Registration Selection identity the cadired ngiatration d elect the Action yeu weld like to perform Tis TI a Du x KEEOKN 1T234 125 id Provider xxx xx 1234 456 palett the ADD REGISTRATION Gutter to add reg gtrabon to th bgt ADO REGISTRATION Figure 22 Registration Tab Remove Option Page 38 of 192 Confidential and Proprietary BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider The Remove hyperlink next to a registration ID removes the registration ID from the user ID The registration ID no longer displays in the registration and in the Attestation window Refer to Figure 22 The registration ID is still available for the user to reassign by executing the add registration steps The data that was entered is saved NOTE If someone else registered to attest for the provider the data that was entered by this user will display 9 3 Attestation The provider will select the registration and continue with populating the provi
53. you will need to register and follow the Add Registration instructions Please ensure that you have the provider s permission to attest on his behalf e If provider s information has changed you may need to update CMS information on the CMS registration page Be sure to submit or complete the action on the CMS page This includes the action of reviewing the information on the CMS page If you do not submit or complete this will stop your attestation from processing The Register tab associates one or more provider registrations to a user ID view registration IDs that are attached to a user ID and removes any provider registrations Please obtain authorization with the provider to enter the data on their behalf 1 To view add and remove registrations click the Registration tab on the navigation bar Home Registration Attestation Status Figure 15 Registration tab 2 The Registration home page displays Refer to Figure 16 Confidential and Proprietary Page 33 of 192 WEST VIRGINIA D rt nt of m BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Back To WV MMIS Portal Help My PIP Account Meme Regntraton Attestation Status Registrations Registration Instructions Welcome to t e Registration Pase g 5le Professionals and Ehgidle Hospitalis ca register for the Medicaid Ent Incentive Program a
54. 020 5 665 5 667 TOTAL 42 500 42 500 42 500 42 500 42 500 42 500 Figure 36 Pediatrician 20 volume payment calendar Calendar of Payments for Providers Calendar Medicaid EPs who begin adoption in Year 2011 2012 2013 2014 2015 2014 8 500 8 500 8 500 2021 8 500 Total 63 750 63 750 63 750 63 750 63 750 63 750 Figure 37 Eligible Providers Payment calendar Page 62 of 192 Confidential and Proprietary BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 9 3 3 Certified EHR Technology The Office of the National Coordinator Authorized Testing and Certification Body ONC ATCB is the body that tests and certifies EHR systems If the EHR system is approved it is assigned a certification number The web site below 1s the Certified Health IT Product List website to look up EHR certification number or even to register an EHR Please contact the Help Contacts listed on the Certified Health IT Product List web site if you have questions http onc chpl force com ehrcert Confidential and Proprietary Page 63 of 192 Healt Hu Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Certified EHR Technology Attestations gt Attest gt Certified Technology Red asterisk indicates a required field Instructions The Medicare and Medicai
55. 1 Children Who have Dental Decay or Cavities Questionnaire 52 of 64 Red asterisk indicates a required field CM5177v2 1365 Title Child and Adolescent Major Depressive Disorder Suicide Risk Assessment Description Percentage of patient visits for those patients aged 6 through 17 years with a diagnosis of major depressive disorder with an assessment for suicide risk For CQM field descriptions and additional information Clini Numerator Denominator Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 0 PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 149 COM Question 52 Child and Adolescent Major Depressive Disorder Suicide Risk Assessment Confidential and Proprietary Page 185 of 192 Health Hunian BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 53 of 64 Red asterisk indicates a required field CMS82v1 NQF 1401 Title Maternal Depression Screening Description The percentage of children who turned 6 months of age during the measurement year who had a face to face visit between the clinician and the child during child s first 6 months and who had a maternal depression screening for the mother at least once between 0 and 6 months of life For field descriptions and additional information Clinical Quality Measure Page Numerator
56. 161 Figure 112 COM Question 15 Use of Imaging Studies for Low Back Pain 161 Figure 113 COM Question 16 Diabetes Eye 162 Figure 114 Question 17 Diabetes Foot 162 Figure 115 COM Question 18 Diabetes Hemoglobin AIC Poor Control 163 Figure 116 COM Question 19 Hemoglobin test for Pediatric Patients 163 Figure 117 COM Question 20 Diabetes Urine Protein Screening eseeeeeeessss 164 Figure 118 COM Question 21 Diabetes Low Density LDL Management 164 Figure 119 COM Question 22 IVD Use of Aspirin or Another Antithrombotic 165 Figure 120 COM Question 23 Appropriate Treatment for Children with URI 165 Figure 121 COM Question 24 CAD Beta Blocker Therapy Prior MI or LVEF lt 40 166 Figure 122 COM Question 25 IVD Complete Lipid Panel and LDL Control 167 Figure 123 COM Question 26 HF ACE Inhibitor or ARB Therapy for LVSD 168 Figure 124 COM Question 27 HF Beta Blocker Therapy for LVSD 168 Figure 125 COM Question 28 POAG Optic Nerve Evaluation 169 Figure 126 COM Question 29 Diabetic Retinopathy Documentation of Presence or Absen
57. 165 of 192 Department de Hon BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 24 of 64 Red asterisk indicates a required field CM5145v2 0070 Title Coronary Artery Disease CAD Beta Blocker Therapy Prior Myocardial Infarction MI or Left Ventricular Systolic Dysfunction LVEF lt 40 Description Percentage of patients aged 18 years and older with a diagnosis of coronary artery disease seen within a 12 month period who also have a prior MI or a current or prior LVEF lt 40 who were prescribed beta blocker therapy For CQM field descriptions and additional information Population criteria 1 Numerator 1 Denominator 1 Exceptions Population criteria 2 Numerator 2 Denominator 2 Exceptions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed amp PREVIOUS PAGE SAVE AND CONTINUE 83 Figure 121 CQM Question 24 CAD Beta Blocker Therapy Prior MI or LVEF lt 40 Page 166 of 192 Confidential and Proprietary WEST VIRGINIA D rtment of Healt H Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 25 of 64 Red asterisk indicates a required field CMS182v3 NQF 0075 Title Ischemic Vascular Disease IVD Complete Lipid
58. 2 a 2 iv and 45 CFR 164 306 d 3 and implement security updates as necessary and correct identified security deficiencies as part of the provider s risk management process for EPs Complete the following information Eligible professionals EPs must attest YES to conducting or reviewing a security risk analysis and implementing security updates as needed to meet this measure C Yes C No For additional information CMS Specification Sheet Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed B PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 67 MU Core Question 9 Protect Electronic Health Information Confidential and Proprietary Page 121 of 192 Health Hunian BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 10 of 17 Red asterisk indicates a required field Clinical Lab Test Results Objective Incorporate clinical lab test results into Certified EHR Technology CEHRT as structured data Measure More than 55 percent of all clinical lab tests results ordered by the EP during the EHR reporting penod whose results are either in a posibive negative or numerical format are incorporated in Certified EHR Technology as structured data EXCLUSION If an EP orders no lab tests where results are either in a postive negative affirmation or numeric format during the EHR reporting period they wo
59. 44 of 192 Confidential and Proprietary WEST VIRGINIA rtment of Healt Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 3 of 6 Red asterisk indicates a required field Imaging Results Objective Imaging results consisting of the image itself and any explanation or other accompanying information are accessible through CEHRT Measure More than 10 percent of all tests whose result is one or more images ordered by the EP dunng the EHR reporting period are accessible through CEHRT Complete the following information All information entered may be subject to audit that could result in payment recoupment Numerator The number of results in the denominator that are accessible through CEHRT Denominator Number of tests whose result is one or more images ordered by the EP during the EHR reporting period Numerator NEN Denominator For additional information CMS Specification Sheet t Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 0 PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 91 Menu Measures Question 3 Numerator amp Denominator Entry Screen Confidential and Proprietary Page 145 of 192 Department de Hon BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 4 of 6
60. 45 Preventive Care and Screening BMI Screening and Follow up Page 180 of 192 Confidential and Proprietary WEST VIRGINIA rtment of Healt Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 46 of 64 Red asterisk indicates a required field CMS132v2 NQF 0564 Title Cataracts Complications within 30 Days Following Cataract Surgery Requinng Additional Surgical Procedures Description Percentage of patients aged 18 years and older with a diagnosis of uncomplicated cataract who had cataract surgery and had any of a specified list of surgical procedures in the 30 days following cataract surgery which would indicate the occurrence of any of the following major complications retained nuclear fragments endophthalmitis dislocated or wrong power IOL retinal detachment or wound dehiscence For field descriptions and additional information Clinical Quality Measure Page Numerator Denominator Exclusions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed B PREVIOUS PAGE SAVE AND CONTINUE 8 Figure 143 COM Question 46 Cataracts Complications within 30 days Following Cataract Surgery Requiring Additional Surgical Procedures Confidential and Proprietary Page 181 of 192 Health Hunian BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health
61. 88 483 0793 option 8 for the Provider Service EHR Provider Incentive Program help desk Thank you for using the PIP system Version 1 0 0 1 Heal Resources BUREAU FOR MEDICAL SERVICES Confidential and Proprietary Page 95 of 192 uere Healt ltu Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 21 Attestation Excluded from Payment Email This email indicates that CMS has already has a payment on record from this provider Please contact the CMS NLR for questions and concerns From PIP Administrator Date Wednesday August 10 2011 1 40 PM To WV test org sunil matte molinaheatthcare com Subject PIP Attestation excluded from payment The attestation whose details are listed below has been excluded from payment by CMS due to a record of duplicate payment for Medicaid attestation in this State or another State during the current attestation period If you think your payment is not duplicated at the national level please work with the NLR to resolve NPI ID 18 Provider Name PROVIDER NAME Organization Name ORGANIZATION NAME Reporting Period Name CY2011 Attestation Submitted Date 8 4 2011 9 55 12 AM For more information on eligible providers for the EHR Provider Incentive Program please visit www wymmis com and refer to the instructions and FAQ s If you need any other assistance regarding eligibility for the EHR s
62. AVE amp CONTINUE button to proceed gy PREVIOUS PAGE SAVE AND CONTINUE Figure 9 Standard Buttons Page 26 of 192 Confidential and Proprietary BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 9 Using the WV EHR Incentive Program Application The WV EHR Incentive Program application guides the user through the CMS required questions to determine if a provider is eligible to receive provider incentive payments A workbook that contains the questions and the rules outlined by CMS is available and provides areas where answers may be recorded A provider may enter the information or assign someone to enter the information on their behalf The list below contains the different sections Each section 1s discussed 1n detail Pre eligibility checks which is executed on the receipt of a registration ID from CMS Log into WV EHR Incentives instructions O How to Register a provider Entry of Eligibility responses Respond to practice setting Respond with Medicaid volume and determine if the amount is accurate If not then determine if certain criteria are met Q Payment Schedule Entry of CMS EHR information Submit Attestation Confidential and Proprietary Page 27 of 192 WEST VIRGINIA Department of Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE
63. Beta Blocker Therapy for Left Ventricular Systolic Dysfunction LVSD Description Percentage of patients aged 18 years and older with a diagnosis of heart failure HF with a current or prior left ventricular ejection fraction LVEF 40 who were prescribed beta blocker therapy either within a 12 month period when seen in the outpatient setting OR at each hospital discharge Title Primary Open Angle Glaucoma POAG Optic Nerve Evaluation Description Percentage of patients aged 18 years and older with a diagnosis of primary open angle glaucoma POAG who have an optic nerve head evaluation during one or more office visits within 12 months Title Diabetic Retinopathy Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy Description Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed which included documentation of the level of severity of retinopathy and the presence or absence of macular edema during one or more office visits within 12 months Title Diabetic Retinopathy Communication with the Physician Managing Ongoing Diabetes Care Description Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed with documented communication to the physician who manages the ongoing care of the patient with diabetes mellitus regarding the finding
64. CMS definition Each MU question screen has a link to the CMS definition and detail of each question for the provider to access to review the specific requirements for completing the numerator Denominator for each question and if elected what the exception criteria must be for an organization to claim and exemption for that question Save and Continue Button When selected a check is executed to determine if all required fields have information entered o If required fields are not filled the page will continue to display until required fields are corrected o If required fields are filled the next screen displays Previous Button Displays the previous screen 9 6 Clinical Quality Measures CMS requires that the provider select nine of the 64 CQMs CMS has also published a recommended core set of COMs for eligible professionals that focus on high priority health conditions and best practices for care delivery Nine for adult populations that meet all of the program requirements Confidential and Proprietary Page 71 of 192 Department of de Huron BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Nine CQMs for pediatric populations that meet all of the program requirements Page 72 of 192 Confidential and Proprietary WEST VIRGINIA D t t of Healt H Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Recor
65. CONTINUE button to proceed E PREVIOUS PAGE SAVE AND CONTINUE Figure 59 MU Core Question 6B Clinical Decision Support Rule Confidential and Proprietary Page 113 of 192 WEST VIRGINIA rt nt of Healt de Hon BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 6B of 17 Red asterisk indicates a required field Clinical Decision Support Rule Objective Use clinical decision support to improve performance on high priority health conditions Measure The EP has enabled and implemented the functionality for drug drug and drug allergy interaction checks for the entire EHR reporting penod Complete the following information EPs must attest YES to enabling and implementing functionality for drug drug and drug allergy interaction for the length of the EHR reporting period to meet the measure C Yes C No For additional information CMS Specification Sheet Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 60 MU Core Question 6B Attest for clinical decision support rule Page 114 of 192 Confidential and Proprietary Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 7A of 17 Red asterisk indicates a required field
66. Confidential and Proprietary Page 43 of 192 Department of fo lunam Resources BUREAU FOR MEDICAL SERVICES Page West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider O Select Medicaid ID Purpose if provider matches on more than one Medicaid ID the provider may select which Medicaid ID attesting to or wishing to pay Displays the NLR submitted NPI number s matching Medicaid IDs for the payee that was registered for along with their active Medicaid ID enrollment dates Please note that the provider does not have to be an actively enrolled in Medicaid to be paid The provider needs to have a pay to affiliation active at the time of the attestation period submitted for volume and Meaningful Use Dropdown box displays the Medicaid IDs Select drop down box option to display the Medicaid IDs that were found Highlight the desired ID and click mouse to select O Select Payee Medicaid ID Select the Medicaid ID that will be used for payment A provider may have one to many Medicaid IDs on file matching to the provider s single NPI on record The designated NPI for payee should be matched to the corresponding Medicaid ID that the provider wishes to have the payment sent to ensure the appropriate match to the local Medicaid payee affiliation records Q Dropdown box displays the Medicaid IDs Select drop down box to display the Medicaid IDs that were found Select election
67. Denominator Entry Screen Page 118 of 192 Confidential and Proprietary Department de Huron BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 8 of 17 Red asterisk indicates a required field Clinical Summaries Objective Provide clinical summaries for patients for each office visit Measure Clinical summaries provided to patients or patient authorized representatives within one business day for more than 50 percent of office visits EXCLUSION EPs who have no office visits during the EHR reporting period would be excluded from this requirement Does this exclusion apply to you C Yes No For additional information Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 0 PREVIOUS PAGE SAVE AND CONTINUE 83 Figure 65 MU Core Question 8 Clinical Summaries Confidential and Proprietary Page 119 of 192 WEST VIRGINIA D nt of tua BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 8 of 17 Red asterisk indicates a required field Clinical Summaries Objective Provide clinical summanes for patients for each office visit Measure Clinical summaries provided to patients or patient authorized representatives within one business day for more than 50 percent of office visits
68. E AND CONTINUE 83 Figure 63 MU Core Question 7B Patient Electronic Access Confidential and Proprietary Page 117 of 192 west VIRGINIA TM Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 7B of 17 Red asterisk indicates a required field Patient Electronic Access Objective Provide patients the ability to view online download and transmit their health information within four business days of the information being available to the EP Measure More than 5 percent of all unique patients seen by the EP during the EHR reporting period or their authorized representatives view download or transmit to a third party their health information Complete the following information All information entered may be subject to audit that could result in payment recoupment Numerator The number of unique patients or their authorized representatives in the denominator who have viewed online downloaded or transmitted to a third party the patient s health information Denominator Number of unique patients seen by the EP during the EHR reporting period Numerator Denominator For additional information CMS Specification Sheet Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 64 MU Core Question 7B Numerator amp
69. Exceeded From Paymenr Prowdess egstrat0n dd rot pass the elo cet creck Powders reg st 3t0 7 has processed successful but the prowder Pas ncc yet logged into the PIP solus0r and begun ther Sttesiator Powder as coe gt ed ter attestaoon aedis aciwely Tes states etter for 5 mrs 145 final powder checi srun Powder ce cancelan ard re 44 for 2 days ser prorto ft being feaiced Powder sees Perded P owdersees Resacm and te Scorocoete message forte elo aty eet Powder wo see er One Srtatesitead Tre status wi be Accested A iTtesziston emus or the Status tad only Waiting For payment validation From NLR Figure 45 Attestation Status Page 85 of 192 WEST VIRGINIA Department of Human Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 11 Successful Registration with CMS Email After registering with CMS it may take 48 hours before this message 1s received e The delay is for CMS processing registration and sending them to the appropriate State repository The Provider Portal application will have the registration in this State repository and process registration The Provider Portal application checks that the provider is a valid provider type and has active enrollment in Medicaid When this message
70. FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Enter start date or end date of the EP s patient volume attestation period by typing in the date or selecting the Calendar Icon to the right of either box The system will automatically calculate the appropriate 90 day window for the provider s chosen attestation period 2 Enter the number of Medicaid fee for service and managed care patient encounters for EP or proxy entity being used by the EP for the 90 day attestation period calculated at the top of the screen The sum of these two numbers will be the numerator for the patient volume calculation Do not add commas System will format with commas after entry 3 Enter the total number of patient encounters for the EP or proxy entity being used by the EP for the 90 day attestation period calculated at the top of the screen This amount will be the Denominator for the EP s patient volume calculation Do not add commas System will format with commas after entry 4 Out of State Encounters Optional The screen allows for entry of out of state entries The following is a sample of a screen to display the different options available to the user Each option s instructions are bulleted sections following this screen shot Out of State Medicaid Patient Volume If vou or your proxy provider saw patients who belong to another Medicaid payer out of State and wish to count
71. GE button to go back or the SAVE amp CONTINUE button to proceed Figure 155 Question 58 Hypertension Improvement Blood Pressure Confidential and Proprietary Page 189 of 192 Department de Hon BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 59 of 64 Red asterisk indicates a required field CMS50v2 Title Closing the Referral Loop Receipt of Specialist Report Description Percentage of patients with referrals regardless of age for which the referring provider receives a report from the provider to whom the patient was referred For COM field descriphons and additional information Clinic Numerator Denominator Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE 83 Figure 156 CMQ Question 59 Closing the Referral Loop Receipt of Specialist Report Questionnaire 60 of 64 Red asterisk indicates a required field CMS66v2 Title Functional Status Assessment for Knee Replacement Description Percentage of patients aged 18 years and older with primary total knee arthroplasty TKA who completed baseline and follow up patient reported functional status assessments For CQM field descriptions and additional information Clinical li re P e Numerator Denominator Exclusions
72. Healt BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider WESI VIRGINIA Department of West Virginia Electronic Health Records EHR Provider Incentive Program PIP For Eligible Providers Meaningful Use Attestation Guide Date of Publication 01 29 2014 Document Version 1 0 Confidential and Proprietary Page 1 of 192 Department of UM BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Privacy Rules The Health Insurance Portability and Accountability Act of 1996 HIPAA Public Law 104 191 and the HIPAA Privacy Final Rule and the American Recovery and Reinvestment Act ARRA of 2009 provides protection for personal health information Protected health information PHI includes any health information and confidential information whether verbal written or electronic created received or maintained by Molina Healthcare It is healthcare data plus identifying information that would allow the data to tie the medical information to a particular person PHI relates to the past present and future physical or mental health of any individual or recipient the provision of healthcare to an individual or the past present or future payment for the provision of healthcare to an individual Claims data prior authorization information and attachments such as medical records and consent fo
73. Healt H Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 4 of 17 Red asterisk indicates a required field Record Vital Signs Objective Record and chart changes in the following vital signs height length and weight no age limit blood pressure ages 3 and over calculate and display body mass index BMI and plot and display growth charts for patients 0 20 years including BMI Measure More than 80 percent of all unique patients seen by the EP have blood pressure for patients age 3 and over only and or height and weight for all ages recorded as structured data Complete the following information All information entered may be subject to audit that could result in payment recoupment Numerator Number of patients in the denominator who have at least one entry of their height length and weight all ages and or blood pressure ages 3 and over recorded as structured data Denominator Number of unique patients seen by the EP during the EHR reporting period Numerator Denominator For additional information CMS Specification Sheet Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 0 PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 55 MU Core Question 4 Numerator amp Denominator Entry Screen Confidential and Proprietary Page 109 of 192 Department
74. IA TM Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 15A of 17 Red asterisk indicates a required field Summary of Care Objective The EP who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care should provide summary care record for each transition of care or referral Measure The EP who transitions or refers their patient to another setting of care or provider of care provides a summary of care record for more than 50 percent of transitions of care and referrals Complete the following information All information entered may be subject to audit that could result in payment recoupment Numerator The number of transitions of care and referrals in the denominator where a summary of care record was provided Denominator Number of transitions of care and referrals during the EHR reporting period for which the EP was the transferring or referring provider Numerator Denominator For additional information CMS Specification Sheet Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 0 PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 78 MU Core Question 15A Numerator amp Denominator Entry Screen Page 132 of 192 Confidential and Proprietary WEST VIRGINIA rtment of Healt Re
75. II Colon Cancer Patients Description Percentage of patients aged 18 through 80 years with AJCC Stage III cpg colon cancer who are referred for adjuvant chemotherapy prescribed adjuvant aaah chemotherapy or have previously received adjuvant chemotherapy within the 12 month reporting period Title Breast Cancer Hormonal Therapy for Stage IC IIIC Estrogen Receptor CMS140v2 Progesterone Receptor ER PR Positive Breast Cancer Clinical NQF 0387 Description Percentage of female patients aged 18 years and older with Stage IC Process Effecti a through IIIC ER or PR positive breast cancer who were prescribed tamoxifen or aromatase inhibitor AI during the 12 month reporting period Title Prostate Cancer Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients Description Percentage of patients regardless of age with a diagnosis of prostate 25 ME cancer at low risk of recurrence receiving interstitial prostate brachytherapy OR sias external beam radiotherapy to the prostate OR radical prostatectomy OR cryotherapy who did not have a bone scan performed at any time since diagnosis of prostate cancer Title HIV AIDS Medical Visit CMS62v2 Description Percentage of patients regardless of age with a diagnosis of HIV AIDS Clinical r NQF 0403 with at least two medical visits during the measurement year with a minimum of 90 Process Effectiveness days between each visit CMSS22 Title HIV AIDS Pneumocystis jirovec
76. INUE Figure 145 COM Question 48 Pregnant Women That had HBsAg Testing Page 182 of 192 Confidential and Proprietary WEST VIRGINIA rtment of Healt Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 49 of 64 Red asterisk indicates a required field CMS159v2 NQF 0710 Title Depression Remission at Twelve Months Description Adult patients age 18 and older with major depression or dysthymia and an initial PHQ 9 score 9 who demonstrate remission at twelve months defined as PHQ 9 score less than 5 This measure applies to both patients with newly diagnosed and existing depression whose current PHQ 9 score indicates a need for treatment For field descriptions and additional information Clinical Quality Measure Page Numerator Denominator Exclusions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 0 PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 146 COM Question 49 Depression Remission at Twelve Months Confidential and Proprietary Page 183 of 192 Department de Hon BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 50 of 64 Red asterisk indicates a required field CMS160v2 NQF 0712 Title Depression Utilization of the 9 Tool Des
77. Incentive Program please contact 888 483 0793 option 8 for the Provider Service EHR Provider Incentive Program help desk Thank you for using the PIP system Version 1 0 0 1 WEST VIRGINIA Department of Heal Human Resources BUREAU FOR MEDICAL SERVICES Confidential and Proprietary Page 97 of 192 WEST VIRGINIA Department of Human Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 23 Attestation Pended for Out of State Entries If a submitted attestation has passed volume checks and has OOS entries the attestation will be Pended The WV Medicaid and WV Medicaid Provider Services staff will review the required documentation and determine if the attestation is acceptable The following email indicates that the attestation was Pended To find out more information please contact the Medicaid Provider Services staff at 1 888 483 0793 Option 8 From PIP A dministrator vyvy Date Monday February 13 2012 11 49 AM To Subject PIP Attestation pended for review The attestation whose details are listed below is being reviewed by the state NPI ID 19 Provider Name ProviderName Organization Name Reporting Period Name FY2011 Submitted Date 10 1 2011 10 55 12 AM Reason for pending review Attestation contains Out of State Patient volumes For more information on eligible providers for the EHR Provider Incenti
78. L USE Provider Questionnaire 6 of 6 Red asterisk indicates a required field Report Specific Cases Objective Capability to identify and report specific cases to a specialized registry other than a cancer registry except where prohibited and in accordance with applicable law and practice Measure Successful ongoing submission of specific case information from to a specialized registry for the entire EHR reporting period Complete the following information EPs must attest YES to successfully submitting specific case information from to a specialized registry for the entire reporting period to meet this measure Ongoing submission was already achieved for an EHR reporting period in a prior year and continues throughout the current EHR reporting period Registration with the PHA or other body to whom the information is being submitted of intent to initiate ongoing submission was made by the deadline within 60 days of the start of the EHR reporting period and ongoing submission was achieved Registration of intent to initiate ongoing submission was made by the deadline and the EP is still engaged in testing and validation of ongoing electronic submission Registration of intent to initiate ongoing submission was made by the deadline and the EP is awaiting invitation to begin testing and validation Yes No If you answered YES then complete the following information Plea
79. MU Core Question 12 Preventive 125 Figure 72 MU Core Question 12 Numerator amp Denominator Entry 126 Figure 73 MU Core Question 13 Patient Specific Education 127 Figure 74 MU Core Question 13 Numerator amp Denominator Entry 128 Figure 75 MU Core Question 14 Medication Reconciliation 129 Figure 76 MU Core Question 14 Numerator amp Denominator Entry 130 Figure 77 MU Core Question 15A Summary of Care nnn 131 Figure 78 MU Core Question 15A Numerator amp Denominator Entry Screen 132 Figure 79 MU Core Question 15B Summary of 133 Figure 80 MU Core Question 15B Numerator amp Denominator Entry Screen 134 Figure 81 MU Core Question 15C Summary of 135 Figure 82 MU Core Question 15C Additional Information Entry Screen 136 Figure 83 MU Core Question 16 Immunization Registries Data Submission 137 Figure 84 MU Core Question 16 Additional Information Entry Screen 138 Figure 85 MU Core Question 17 U
80. NIA rtment of Healt Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 2 of 6 Red asterisk indicates a required field Electronic Notes Objective Record electronic notes in patient records Measure Enter at least one electronic progress note created edited and signed by an EP for more than 30 percent of unique patients with at least one office visit during the EHR reporting period The text of the electronic note must be text searchable and may contain drawings and other content Complete the following information All information entered may be subject to audit that could result in payment recoupment Numerator The number of unique patients in the denominator who have at least one electronic progress note from an eligible professional recorded as text searchable data Denominator Number of unique patients with at least one office visit during the EHR reporting period for EPs during the EHR reporting period Numerator Denominator For additional information C Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 0 PREVIOUS PAGE SAVE AND CONTINUE 83 Figure 89 Menu Measure Question 2 Electronic Notes Confidential and Proprietary Page 143 of 192 WEST VIRGINIA D nt of ilh Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic He
81. NPI ID 18 Provider Name PROVIDER NAME Organization Name ORGANIZATION NAME Reporting Period Name CY2011 Submitted Date 8 4 2011 9 55 12 AM Reason for rejection Provider has no Medicaid claims in the State s Medicaid system For more information on eligible providers for the EHR Provider Incentive Program please visit ww w w vmrmis com and refer to the instructions and FAQ s If you need any other assistance regarding eligibility for the EHR s Provider Incentive Program please contact 888 483 0793 option 8 for the Provider Service EHR Provider Incentive Program help desk Thank you for using the PIP system Version 1 0 0 1 WEST VIRGINIA Department of Heal Hu n Resources BUREAU FOR MEDICAL SERVICES If the solution found that claims counts could not be validated then the following email is sent From PIP Administrator Date Monday February 13 2012 11 49 AM To Subject PIP Attestation rejected The provider whose details are listed below has been found to be not eligible for the payment incentive program due to the below reason NPI ID 19 Provider Name Provider Name Organization Name Reporting Period FY2011 Name Submitted Date 10 1 2011 10 55 12 AM Reason for Medicaid Encounter volume is not able to be validated by the state s EHR Provider Incentive Payment solution s encounter count for rejection the provider or their proxy within the MMIS system For more information on el
82. ONTINUE Figure 105 COM Question 8 Cervical Cancer Screening Questionnaire 9 of 64 Red asterisk indicates a required field CMS153v2 NQF 0033 Title Chlamydia Screening for Women Description Percentage of women 16 24 years of age who were identified as sexually active and who had at least one test for chlamydia during the measurement period For CQM field descriptions and additional information Clini Numerator Denominator Exclusions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE amp Figure 106 CQM Question 9 Chlamydia Screening for Women Page 158 of 192 Confidential and Proprietary WEST VIRGINIA D rtment of Healt de unn BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 10 of 64 Red asterisk indicates a required field CMS130v2 0034 Title Colorectal Cancer Screening Description Percentage of adults 50 75 years of age who had appropriate screening for colorectal cancer For field descriphons and additional information Clini li asur Numerator Denominator Exclusions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 9 PREVIOUS PAGE SAVE AND CONTINUE Figure 107 COM Question 10 Colorectal Cancer Screenin
83. OR MEDICAL SERVICES Confidential and Proprietary Page 89 of 192 WEST VIRGINIA Department of Human Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 15 Error Occurred While Processing Registration Medicaid Enrollment Failed Email The following checks are made when an attestation is received from the NLR The email below displays all the possible error messages for the following checks e Check if the provider is enrolled in Medicaid program during the attestation period e Check if the provider type that was selected when registering on the CMS site matches the provider type on the provider s enrollment record e Check if the payee NPI entered when registering on the CMS site is found when validating the attesting provider s payees on the Medicaid record From PIP Administrator Date Wednesday August 10 2011 1 40 PM To WV icotest ora Subject PIP Registration Medicaid Eligibility Check Failed Attestation not allowed The provider whose details are listed below is not allowed to participate in the payment incentive program at the current time for the reason listed below NPI ID 18 Provider Name PROVIDER NAME Organization ORGANIZATION NAME Name Reporting Period Nani CY2011 Provider is not enrolled with Medicaid for the current MU attestation period or selected Medicaid volume attestation period Provide
84. PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE 8 Figure 87 Menu Measures Question 1 Syndromic Surveillance Data Submission Confidential and Proprietary Page 141 of 192 WEST VIRGINIA Healt Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 1 of 6 Red asterisk indicates a required field Syndromic Surveillance Data Submission Objective Capability to submit electronic syndromic surveillance data to public health agencies except where prohibited and in accordance with applicable law and practice Measure Successful ongoing submission of electronic syndromic surveillance data from CEHRT to a publie health agency for the entire EHA reporting period Complete the following information EPs must attest YES to successful ongoing submission of electronic syndromic surveillance data from CEHRT te a public health agency for the entire EHR reporting period Ongoing submission was already achieved for an EHR reporting period in a prior year and continues throughout the current EHR reporting period Registration with the PHA or other body to whom the information is being submitted of intent to initiate ongoing submission was made by the deadline within 60 days of the start of the EHR reporting period and ongoing submission
85. PAGE button to go back or the SAVE A CONTINUE butt Q PREVIOUS PAGE SAVE AND CONTINUE Wy Medicaid Provider Services Sox 2002 Charleston WV 25327 2002 Figure 32 Attestation Tab FOHC RHC Patient Volume 1 Enter the start date or end date by typing in the date or selecting the calendar icon to the right of either box The system will automatically calculate the six month patient volume calculation period 2 Enter the number of patient encounters performed by the EP at an FQHC or RHC in the six month period selected above A patient encounter is defined as a unique patient DOS and place of service combination This count must belong to the EP alone no proxy entity measure such as for a group practice or clinic may be utilized when counting FOHC patient encounters This will be the numerator used to determine if the EP practices predominantly in an FQHC Do not add commas System will format with commas after entry 3 Enter the total number of patient encounter performed by the EP over the six month period selected at the top of the screen This count must belong to the EP alone no proxy entity measure such as a group practice or clinic may be utilized when counting Page 54 of 192 Confidential and Proprietary BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider the total number of encounters This will be the Denominator
86. PIP Account Home EYETAN Attestation Status Registrations Add Registration Red asterisk indicates a required field Add a regsstrabon to your registrations bst so that you can attest for the associated provider simply view the attestation status and payment status of the registration account The registration must have been completed at the CMS Website and received by the State Please allow at least 24 hours for the State to and process a new or updated registration Enter the Registration ID you recerved in the submission receipt at the end of the CMS EHR incentive program registration process Also enter the NPI of the provider associated with the registration WARNING If the registration i5 for a provider other than yourself you must receive authonzation from the provider assoaated with the registration before adding the registration to your list Registration ID NPI n Services e bc e Accessibility WV Medicaid Provider Services PO 2002 Charleston WV 25327 2002 Figure 18 Registration Tab Add Registration Click the Add Registration button on the Registration home page Enter registration ID obtained from the CMS website Enter the provider s NPI Click the Add button E XO xov X The system validates that the registration ID 1s a valid ID assigned by CMS and that the correct NPI was entered 10 If valid the registration ID and NPI is associated with the
87. Page 130 of 192 Confidential and Proprietary WEST VIRGINIA D rtment of Healt de unn BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 15A of 17 Red asterisk indicates a required field Summary of Care Objective The EP who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care should provide summary care record for each transition of care or referral Measure The EP who transitions or refers their patient to another setting of care or provider of care provides a summary of care record for more than 50 percent of transitions of care and referrals EXCLUSION EPs who transfer a patient to another setting or refer a patient to another provider less than 100 times during the EHR reporting period would be excluded from this requirement EPs must enter the number of transfers and referrals during the EHR reporting period in the Exclusion box to attest to exclusion from this requirement Does this exclusion apply to you C Yes No Exclusion Box For additional information CMS Specification Sheet G Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed B PREVIOUS PAGE SAVE AND CONTINUE amp Figure 77 MU Core Question 15A Summary of Care Confidential and Proprietary Page 131 of 192 west VIRGIN
88. Panel and LDL Control Description Percentage of patients 18 years of age and older who were discharged alive for acute myocardial infarction AMI coronary artery bypass graft CABG or percutaneous coronary interventions PCI in the 12 months prior to the measurement period or who had an active diagnosis of ischemic vascular disease IVD during the measurement period and who had a complete lipid profile performed during the measurement period and whose LDL C was adequately controlled lt 100 mg dl For field descriptions and additional information Clinical Quality Measure Page Numerator 1 Denominator Numerator 2 Denominator Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed G PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 122 COM Question 25 IVD Complete Lipid Panel and LDL Control Confidential and Proprietary Page 167 of 192 west VIRGINIA Healt Go Hun BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 26 of 64 Red asterisk indicates a required field CMS135v2 NQF 0081 Title Heart Failure HF Angiotensin Converting Enzyme ACE Inhibitor or Angiotensin Receptor Blocker ARB Therapy for Left Ventricular Systolic Dysfunction LVSD Description Percentage of patients aged 18 years and older with a diagnosis of heart failure HF with a curr
89. Questionnaire Instructions For eligible professionals there are a total of 23 meaningful use objectives To qualify for an incentive payment eligible professionals must report on 20 of these 23 meaningful use objectives There are 17 required core objectives The remaining 3 objectives may be chosen from the list of 6 menu set objectives In addition eligible professionals must report on 9 of the approved 64 clinical quality measures This attestation will begin with the 17 required core objectives listed below Use computerized provider order entry CPOE for medication radiclogy and laboratory orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state local and professional guidelines Generate and transmit permissible prescriptions electronically eRx Record the following demographics preferred language sex race ethnicity date cf birth Record and chart changes in the following vital signs height length and weight no age limit blood pressure ages 3 and over calculate and display body mass index BMI and plot and display growth charts for patients 0 20 years including BMI Record smoking status for patients 13 years old or older Confidential and Proprietary Measure 1 More than 60 percent of medication orders created by the EP during the EHR reporting period are recorded using CPOE Measure 2 More than 30 percent of ra
90. Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 47 of 64 Red asterisk indicates a required field CMS133v2 NQF 0565 Title Cataracts 20 40 or Better Visual Acuity within 90 Days Following Cataract Surgery Description Percentage of patients aged 18 years and older with a diagnosis of uncomplicated cataract who had cataract surgery and no significant ocular conditions impacting the visual outcome of surgery and had best corrected visual acuity of 20 40 or better distance or near achieved within 90 days following the cataract surgery For field descriptions and additional information Clinical Quality Measure Page Numerator Denominator Exclusions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 0 PREVIOUS PAGE SAVE AND CONTINUE Figure 144 COM Question 47 Cataracts 20 40 or Better Visual Acuity within 90 days following Cataract Surgery Questionnaire 48 of 64 Red asterisk indicates a required field CMS158v2 NQF 0608 Title Preqnant Women That Had HBsAg Testing Description This measure identifies pregnant women who had a HBsAg hepatitis B test during their pregnancy For CQM field descriptions and additional information Cli Numerator Denominator Exceptions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONT
91. ST VIRGINIA rtment of Healt Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 37 of 64 Red asterisk indicates a required field CMS141v3 NQF 0385 Title Colon Cancer Chemotherapy for AJCC Stage III Colon Cancer Patients Description Percentage of patients aged 18 through 80 years with AJCC Stage III colon cancer who are referred for adjuvant chemotherapy prescribed adjuvant chemotherapy or have previously received adjuvant chemotherapy within the 12 month reporting period For field descriptions and additional information Clinical Quality Measure Page Numerator Denominator Exceptions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE CJ Figure 134 COM Question 37 Colon Cancer Chemotherapy for AJCC Stage Ill Colon Cancer Patients Questionnaire 38 of 64 Red asterisk indicates a required field CMS140v2 NQF 0387 Title Breast Cancer Hormonal Therapy for Stage IC IIIC Estrogen Receptor Progesterone Receptor ER PR Positive Breast Cancer Description Percentage of female patients aged 18 years and older with Stage IC through IIIC ER or PR positive breast cancer who were prescribed tamoxifen or aromatase inhibitor AI during the 12 month reporting period For CQM field descriptions and a
92. State FQHC RHC entry Confidential and Proprietary Page 59 of 192 Human BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider To Add e Select Add State to display the following screen Out of State Needy Patient Volume at FQHC RHC If you or your proxy provider saw patients who belong to another Medicaid payer out of State and wish to count these patients towards your total Medicaid Patient volume for incentive qualification please record the numbers by clicking the Add State text below Please note that any out of state Medicaid patients that vou add must be verified by a report from Medicaid State payer identified showing claims volume for the time frame specified and attached to this attestation You willbe asked to upload your supporting documents at the end of this attestation on the Submit Attestation page Add State State Total Needy Patient Encounters Total F HC RHC Patient Encounters Complete the following information All information entered may be subjectto audit that could result in payment recoupment Supporting documentation of Qut of State encounters claimed are required to be Uploaded for validation Any registration claiming Gut af State encounters will suspend until supporting documentation has been uploaded and validated Supporting documentation is defined as e Certification an official letter head from the state Medicaid agency to the pro
93. UL USE Provider Figure 158 COM Question 61 Functional Assessment for Hip Replacement 191 Figure 159 COM Question 62 Functional Status Assessment for Complex Chronic Conditions 191 Figure 160 COM Question 63 ADE Prevention and Monitoring Warfarin Time in Therapeutic Cu d 192 Figure 161 COM Question 64 Preventive Care and Screening Screening for High Blood Pressure and Follow Up Docutherted 192 Confidential and Proprietary Page 11 of 192 Department of UM BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 1 Introduction Starting in 2014 providers participating in the EHR Incentive Program who have met Stage 1 Meaningful Use requirements for two years will need to meet Stage 2 Meaningful Use requirements This manual will assist you with your Stage 2 attestation CMS has defined Meaningful Use in the following three stages e Stage 1 sets the baseline for electronic data capture and information sharing Provider must receive two EHR Incentive Program payments for meeting these requirements before moving on to Stage 2 e Stage 2 which is being implemented in 2014 e Stage 3 which is expected to be implemented sometime in the f
94. VE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE Figure 103 COM Question 6 Preventive Care and Screening Tobacco use Screening and Cessation Intervention Questionnaire 7 of 64 Red asterisk indicates a required field CMS125v2 0031 Title Breast Cancer Screening Description Percentage of women 40 69 years of age who had a mammogram to screen for breast cancer For CQM field descnptions and additional information Clinical Quality Measure Pa Numerator Denominator Exclusions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed G PREVIOUSPAGE SAVE AND CONTINUE 83 Figure 104 COM Question 7 Breast Cancer Screening Confidential and Proprietary Page 157 of 192 Department de Hon BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 8 of 64 Red asterisk indicates a required field 5124 2 0032 Title Cervical Cancer Screening Description Percentage of women 21 64 years of age who received one or more Pap tests to screen for cervical cancer For CQM field descriphons and additional information Clinic ali e Numerator Denominator Exclusions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND C
95. a start and end date enter the appropriate data If practiced at multiple locations and the percentage does not meet 50 of encounters at locations If no errors occur the Attestation Topic page displays If all topics have been answered the Submit button will be available 9 4 Meaningful Use Core Measures This section addresses the navigation of the Meaningful Use screens Screen shots are displayed within the Meaningful Use Core Screenshots section CMS requires that providers attest to 17 defined core Meaningful Use criteria The screen below lists the 17 questions currently required for Meaningful Use Stage 2 reporting for eligible providers Providers please note that each MU question is required The application will validate that all questions are completed during attestation but does not validate that the questions meet the percentile required for Meaningful Use of an EHR system until after the questionnaire 1s Page 66 of 192 Confidential and Proprietary WEST VIRGINIA rtment of Healt Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider submitted At this point the system will reject the provider if provider does not meet the requirement percentiles for appropriate EHR usage This manual addresses the navigation of the Meaningful Use screens Screen shots are displayed within the Meaningful Use Core Screenshots section
96. adequately controlled 100 mg dL during the measurement period Title Ischemic Vascular Disease IVD Use of Aspirin or Another Antithrombotic Description Percentage of patients 18 years of age and older who were discharged CMS164v2 alive for acute myocardial infarction AMI coronary artery bypass graft CABG or Clinical NQF 0068 percutaneous coronary interventions PCI in the 12 months prior to the measurement Process Effecti Li period or who had an active diagnosis of ischemic vascular disease IVD during the measurement period and who had documentation of use of aspirin or another antithrombotic during the measurement period Title Appropriate Treatment for Children with Upper Respiratory Infection URI CMS154 2 Description Percentage of children 3 months 18 years of age who were diagnosed Efficient Use of m NQF 0069 with upper respiratory infection URI and were not dispensed an antibiotic Healthcare Resources prescription on or three days after the episode Title Coronary Artery Disease CAD Beta Blocker Therapy Prior Myocardial CMS145v2 Infarction MI or Left Ventricular Systolic Dysfunction LVEF lt 40 Clinical NQF 0070 Description Percentage of patients aged 18 years and older with a diagnosis of Process Effecti a coronary artery disease seen within a 12 month period who also have a prior MI or a current or prior LVEF lt 40 who were prescribed beta blocker therapy Title Ischemic Vascular Disease IVD Complete L
97. alth Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 3 of 6 Red asterisk indicates a required field Imaging Results Objective Imaging results consisting of the image itself and any explanation or other accompanying information are accessible through CEHRT Measure More than 10 percent of all tests whose result is one or more images ordered by the EP during the EHR reporting period are accessible through CEHRT EXCLUSION Any EP who orders less than 100 tests whose result is an image during the EHR reporting period or any EP who has no access to electronic imaging results at the start of the EHR reporting penod Please select the exclusion option that applies to you EPs who order fewer than 100 tests whose result is an image during the EHR reporting period would be excluded from this requirement EPs must enter the number of tests ordered during the EHR reporting period in the Exclusion box to attest to exclusion from this requirement EPs who have no access to electronic imaging results at the start of the EHR reporting period would be excluded from this requirement C None of the above exclusions apply to me Exclusion Box For additional information CMS Specification Sheet Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 0 PREVIOUS PAGE SAVE AND CONTINUE 2 Figure 90 Menu Measures Question 3 Imaging Results Page 1
98. ast one electronic progress note created edited and signed by an EP for more than 30 percent of unique patients with at least one office visit during the EHR reporting period The text of the electronic note must be text searchable and may contain drawings and other content Record electronic notes in patient records Imaging results consisting of the image itself and any explanation or other accompanying information are accessible through CEHRT More than 10 percent cf all tests whose result is one or more images ordered by the EP during the EHR reporting period are accessible through CEHRT More than 20 percent of all unique patients seen by the EP during the EHR reporting period have a structured data entry for one or more first degree relatives Record patient family health history as structured data Capability to identify and report cancer cases to a public health central cancer registry except where prohibited and in accordance with applicable law and practice Capability to identify and report specific cases to a specialized registry other than a cancer registry except where prohibited and in accordance with applicable law and practice Successful ongoing submission of cancer case information from CEHRT to a public health central cancer registry for the entire EHR reporting period Successful ongoing submission of specific case information from CEHRT to a specialized registry for the entire EHR reporting period
99. ation status and payment status of the registration account The registration must have been completed at the CMS Website and received by the State Please allow at least 24 hours for the State to receive and process a new or updated registration Enter the Registration ID you received in the submission receipt at the end of the CMS EHR incentive program registration process Also enter the NPI of the provider associated with the registration WARNING If the registration is for a provider other than yourself you must receive authorization from the provider associated with the registration before adding the registration to your list Registration ID 495idk NPI Bs40304 Figure 20 Add Registration Error Message Confidential and Proprietary Page 37 of 192 Department of Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider The most common reasons why an error occurs Information entered incorrectly If necessary access the CMS website to check the information or add a registration The registration ID will not be found if 48 hours has not expired after registering on the CMS web site The Cancel button is an additional option that 15 available Clicking the Cancel button does not add the registration ID and the Registration home page displays No additional registration ID displays 9 2 2 Registration Select Option
100. ation within four business days of the information being available to the EP Measure More than 5 percent of all unique patients seen by the EP during the EHR reporting period or their authorized representatives view download or transmit to a third party their health information EXCLUSION Any EP that neither orders nor creates any of the information listed for inclusion as part of this measure except for Patient name and Provider s name and office contact information Any EP that conducts 50 percent or more of his or her patient encounters in a county that does not have 50 percent or more of its housing units with 3Mbps broadband availability from the FCC on the first day of the EHR reporting period Please select the exclusion option that applies to you Any EP that neither orders nor creates any of the information listed for inclusion as part of this measure except for Patient name and Provider s name and office contact information Any EP that conducts 50 percent or more of his or her patient encounters in a county that does not have 50 percent or more of its housing units with 3Mbps broadband availability according to the latest information from the FCC on the first day of the EHR reporting period C None of the above exclusions apply to me For additional information CMS Specification Sheet G Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAV
101. back or the SAVE amp CONTINUE button to proceed 0 PREVIOUS PAGE SAVE AND CONTINUE 83 Figure 75 MU Core Question 14 Medication Reconciliation Confidential and Proprietary Page 129 of 192 Department Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 14 of 17 Red asterisk indicates a required field Medication Reconciliation Objective The EP who receives a patient from another setting of care or provider of care or believes an encounter is relevant should perform medication reconciliation Measure The EP who performs medication reconciliation for more than 50 percent of transitions of care in which the patient is transitioned into the care of the EP Complete the following information All information entered may be subject to audit that could result in payment recoupment Numerator The number of transitions of care in the denominator where medication reconciliation was performed Denominator Number of transitions of care during the EHR reporting period for which the EP was the receiving party of the transition Numerator j Denominator For additional information CMS Specification Sheet G Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE 0 Figure 76 MU Core Question 14 Numerator amp Denominator Entry Screen
102. button This displays the Successful Submission screen An example is below Submussion Receipt Attestations gt Attest gt Submission Receipt Successful Submission You have successfully attested for the Medicaid EHR Incentive Program IMPORTANT Please Note You can make a note of the Payment Schedule provided to you You may pnnt this page Registration ID Business Address Name TIN NPI Phone amp Payee NPI E Mail w vaptest orng Payee TIN Incentive Program Medicaid Attestation Tracking Information You are an Eligible Professional attesting for payment year in the incentive program e You have decided to resubmit your attestation information Figure 44 Attestation Tab Submission Receipt Window Confidential and Proprietary Page 83 of 192 Department of UM BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Upon the successful submission the attestation entry process is completed The WV EHR Incentive Program provides 48 hours to make changes If changes are made the 48 hour count restarts Once the 48 hours have expired the WV EHR Incentive Program will execute final eligibility checks These include validating that the Medicaid patient encounter amounts entered by the EP are within a reasonable range of the fee for service claim and managed care encounter volume stored in the WVMMIS and queryin
103. cancer case information from certified electronic health record technology CEHRT to a public health central cancer registry for the entire EHR reporting period Ongoing submission was already achieved for an reporting period in a prior year and continues throughout the current EHR reporting period Registration with the PHA or other body to whom the information is being submitted of intent to initiate ongoing submission was made by the deadline within 60 days of the start of the EHR reporting period and angoing submission was achieved Registration of intent te initiate ongoing submission was made by the deadline and the EP ts still engaged in testing and validation of ongoing electronic submission Registration of intent to initiate ongoing submission was made by the deadline and the EP is awaiting invitation to begin testing and validation Yes Na Please select the criteria that was met and enter the registry name Ongoing submission was already achieved for an EHR reporting period in a prior year and continues throughout the current EHR reporting period Registration with the PHA or other body to whom the information is being submitted of intent to initiate ongoing submission was made by the deadline within 60 days of the start of the EHR reporting period and ongoing submission was achieved Registration of intent to initiate ongoing submission was made by the deadline and the EP is still engaged in testi
104. cates a required field CMS156v2 NQF 0022 Title Use of High Risk Medications in the Elderly Description Percentage of patients 66 years of age and older who were ordered high risk medications Two rates are reported a Percentage of patients who were ordered at least one high risk medication b Percentage of patients who were ordered at least two different high risk medications For CQM field descriptions and additional information Numerator 1 Denominator Numerator 2 Denominator Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed G PREVIOUS PAGE SAVE AND CONTINUE 0 Figure 101 COM Question 4 Use of High Risk Medications in the Elderly Confidential and Proprietary Page 155 of 192 Department de Hon BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 5 of 64 Red asterisk indicates a required field CMS155v2 NQF 0024 Title Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents Description Percentage of patients 3 17 years of age who had an outpatient visit with a Primary Care Physician PCP or Obstetrician Gynecologist OB GYM and who had evidence of the following during the measurement period Three rates are reported Percentage of patients with height weight and body mass index BMI percentile
105. ce of Macular Edema and Level of Severity of 169 Figure 127 COM Question 30 Diabetic Retinopathy Communication with the Physician Managing Ongoing Diabetes eene 170 Figure 128 COM Question 31 Falls Screening for Future Fall Risk 170 Figure 129 COM Question 32 MDD Suicide Risk 5 8 171 Figure 130 COM Question 33 Anti depressant Medication Management 72 Figure 131 COM Question 34 ADHD Follow up Care for Children Prescribed ADHD Moe acis E Eisen Nem Mu d Oed eU MI 173 Figure 132 Question 35 Bipolar Disorder and Major Depression Appraisal for alcohol or chemical SUBSTANCES USS Iona Tees eer vu eva eee 174 Figure 133 COM Question 36 Oncology Medical and Radiation Pain Intensity Quantified 174 Confidential and Proprietary Page 9 of 192 Department of UM BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Figure 134 COM Question 37 Colon Cancer Chemotherapy for AJCC Stage III Colon Cancer PP ACIS m 175 Figure 135 COM Question 38 Breast Cancer Hormonal Therapy for Stage IC IIIC Estrogen receptor Progesterone Receptor Postive Breast
106. ceed 0 PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 129 COM Question 32 MDD Suicide Risk Assessment Confidential and Proprietary Page 171 of 192 Department de Hon BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 33 of 64 Red asterisk indicates a required field CMS128v2 NQF 0105 Title Anti depressant Medication Management Description Percentage of patients 18 years of age and older who were diagnosed with major depression and treated with antidepressant medication and who remained on antidepressant medication treatment Two rates are reported a Percentage of patients who remained on an antidepressant medication for at least 84 days 12 weeks b Percentage of patients who remained on an antidepressant medication for at least 180 days 6 months For CQM field descriptions and additional information Clinical Quality Numerator 1 Denominator Exclusions Numerator 2 Denominator Exclusions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE 83 Figure 130 CQM Question 33 Anti depressant Medication Management Page 172 of 192 Confidential and Proprietary Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire
107. cription Adult patients age 18 and older with the diagnosis of major depression or dysthymia who have a PHQ 9 tool administered at least once during 4 month period in which there was a qualifying visit For field descriptions and additional information Clinical Quality Measure Page Population criteria 1 Numerator 1 Denominator 1 Exclusions 1 Population criteria 2 Numerator 2 Denominator 2 Exclusions 2 Population criteria 3 Numerator 3 Denominator 3 Exclusions 3 Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed G PREVIOUS PAGE SAVE AND CONTINUE a Figure 147 COM Question 50 Depression Utilization of the PHQ 9 Tool Page 184 of 192 Confidential and Proprietary Department de unn BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 51 of 64 Red asterisk indicates a required field CMS 5v2 Title Children Who Have Dental Decay or Cavities Description Percentage of children age 0 20 years who have had tooth decay or cavities during the measurement period For CQM field descriptions and additional information Numerator Denominator Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed E PREVIOUS PAGE SAVE AND CONTINUE ai Figure 148 COM Question 5
108. ctions and FAQ s If you need any other assistance regarding eligibility for the EHR s Provider Incentive Program please contact 888 483 0793 option 8 for the Provider Service EHR Provider Incentive Program help desk Thank you for using the PIP system Version 1 0 0 1 WEST VIRGINIA Healt Human Resources BUREAU FOR MEDICAL SERVICES Page 94 of 192 Confidential and Proprietary WEST VIRGINIA Department of Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 20 Attestation Payment Denied Pay Hold Found Payment is denied if the provider is on pay hold and this email is sent if it is found From AV Date Wednesday Augast 10 2011 1 40 PM To org Subject Attestation rected The provider whose detads are ksted below has been found to be not eligible for the payment incentive program due to the below reason NPI ID 18 Provider Name Mame Organization Name Reporting Period Name CY2011 Submitted Date 8 4 2011 9 55 12 AM Reason for rejection Provider is on pay hold and not ebgble for payment at this time For more information on ebgible providers for the Provider Incentive Program please www wymmis com and refer to the instructions and FAQ s If you need any other assistance regarang eligib ty for the Provider Incentive Program please contact 8
109. d EHR Incentive Programs require the use of certified EHR technology Standards implementation specifications and certification criteria for EHR technology have been adopted by the Secretary of the Department of Health and Human Services technology must be tested and certified by an Office of the National Coordinator ONC Authorized Testing and Certification Body ATCB in order for provider to qualify for EHR incentive payments REMEMBER You do not need to have your certified EHR technology in place to register for the EHR incentive programs However you must adopt implement upgrade or successfully demonstrate meaningful use of certified EHR technology under the Medicaid EHR Incentive Program before you can receive an EHR incentive payment Enter the CMS EHR Certification ID you received from the ONC EHR CHPL Web site CMS EHR Certification Number Current EHR System Usage Status I certify that I adopted implemented upgraded or meaningfully used the above EHR for a 90 day period in the current payment year starting on the following date Please select a 90 day period in the current payment year Start Date 1 1 2013 WW End Date 3 31 2013 E Do at least 8096 of unique patients have their data in the certified EHR during the EHR penod selected above C Yes C No Did you practice at multiple practices or locations during your meaningful use reporting period Yes C No i PTOL 2 J r outpatient e
110. d Provider Incentive Program MEANINGFUL USE Provider Questionnaire Instructions EPs must report on 9 of the 64 approved Clinical Quality Measures The selected CQMs must cover at least 3 of the National Quality Strategy domains You must submit 9 Clinical Quality Measures from the list below You have selected 0 CQMs Recommended core COM for adult population Recommended core COM for pediatric population Domain Identifier s CMS146v2 NQF 0002 CMS137v2 NQF 0004 CMS165v2 NQF 0018 CMS156v2 NQF 0022 Clinical Quality Measure Tithe amp Description Title Appropriate Testing for Children with Pharyngitis Description Percentage of children 2 18 years of age who were diagnosed with pharyngitis ordered an antibiotic and received a group A streptococcus strep test for the episode Title Initiation and Engagement of Alcohol and Other Drug Dependence Treatment Description Percentage of patients 13 years of age and older with a new episode of alcohol and other drug AOD dependence who received the following Two rates are reported a Percentage of patients who initiated treatment within 14 days of the diagnosis b Percentage of patients who initiated treatment and who had two or more additional services with an AOD diagnosis within 30 days of the initiation visit Title Controlling High Blood Pressure Description Percentage of patients 18 85 years of age who had a diagnosis of hypertens
111. d additional information Clinical Quality Measure Page Numerator Denominator Exclusions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed B PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 159 COM Question 62 Functional Status Assessment for Complex Chronic Conditions Confidential and Proprietary Page 191 of 192 Department de Hon BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 63 of 64 Red asterisk indicates a required field CM5179v2 Title ADE Prevention and Monitoring Warfarin Time in Therapeutic Range Description Average percentage of time in which patients aged 18 and older with atrial fibrillation who are on chronic warfarin therapy have International Normalized Ratio INR test results within the therapeutic range 1 TTR during the measurement period For field descriptions and additional information Measurement Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE 83 Figure 160 COM Question 63 ADE Prevention and Monitoring Warfarin Time in Therapeutic Range Questionnaire 64 of 64 Red asterisk indicates a required field CMS22v2 Title Preventive Care and Screening Screening for High Blood Pressure and Follow Up Documented Description Percen
112. dardized depression screening tool AND if positive a follow up plan is documented on the date of the positive screen For field descriptions and additional information Clinic al lity M P a Numerator Denominator Exclusions Exceptions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 0 PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 140 COM Question 43 Preventive Care and Screening Screening for Clinical Depression and Follow Up Plan Page 178 of 192 Confidential and Proprietary WEST VIRGINIA rtment of Healt Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 44 of 64 Red asterisk indicates a required field CMS68v3 NQF 0419 Title Documentation of Current Medications in the Medical Record Description Percentage of visits for patients aged 18 years and older for which the eligible professional attests to documenting a list of current medications using all immediate resources available on the date of the encounter This list must include ALL known prescriptions over the counters herbals and vitamin mineral dietary nutritional supplements AND must contain the medications name dosage frequency and route of administration For CQM field descriptions and additional information Clinical Quality Measure Page Numerator Denominator
113. dditional information Clinical Quality Measure Page Numerator Denominator Exceptions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 0 PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 135 COM Question 38 Breast Cancer Hormonal Therapy for Stage IC IIIC Estrogen receptor Progesterone Receptor Positive Breast Cancer Confidential and Proprietary Page 175 of 192 Health Hunian BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 39 of 64 Red asterisk indicates a required field CMS129v3 NQF 0389 Title Prostate Cancer Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients Description Percentage of patients regardless of age with a diagnosis of prostate cancer at low risk of recurrence receiving interstitial prostate brachytherapy OR external beam radiotherapy to the prostate OR radical prostatectomy OR cryotherapy who did not have a bone scan performed at any time since diagnosis of prostate cancer For CQM field descriptions and additional information Clinical Quality Measure Page Numerator Denominator Exceptions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 0 PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 136 CQM Question 39 Prostate Cancer Avoidance of Overuse o
114. degree relatives Denominator Number of unique patients seen by the EP during the EHR reporting period Numerator Denominator For additional information Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 0 PREVIOUS PAGE SAVE AND CONTINUE amp Figure 93 Menu Measures Question 4 Numerator amp Denominator Entry Screen Confidential and Proprietary Page 147 of 192 WEST VIRGINIA D nt of Healt de Hun BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 5 of 6 Red asterisk indicates a required field Report Cancer Cases Objective Capability to identify and report cancer cases to a public health central cancer registry except where prohibited and in accordance with applicable law and practice Measure Successful ongoing submission of cancer case information from CEHRT to a public health central cancer registry for the entire EHR reporting period EXCLUSION Any EP that meets at least 1 of the following criteria may be excluded from this objective Please select the exclusion option that applies to you C The EP does not diagnose or directly treat cancer The EP operates in a jurisdiction for which no public health agency is capable of receiving electronic cancer case information in the specific standards required for CEHRT at the beginning of their EHR repo
115. der Incentive Program MEANINGFUL USE Provider Title Diabetes Eye Exam CMS131v2 Description Percentage of patients 18 75 years of age with diabetes who had a retinal Clinical NQF 0055 or dilated eye exam by an eye care professional during the measurement period or a Process Effecti a negative retinal exam no evidence of retinopathy in the 12 months prior to the measurement period Title Diabetes Foot Exam A CMS123v2 a Clinical NQF 0056 Description Percentage of patients aged 18 75 years of age with diabetes who had a Bro cens Li foot exam during the measurement period MS122 Title Diabetes Hemoglobin Alc Poor Control 5 ve praia Description Percentage of patients 18 75 years of age with diabetes who had Missae hemoglobin Alc gt 9 0 during the measurement period Title Hemoglobin Alc Test for Pediatric Patients xi Description Percentage of patients 5 17 years of age with diabetes with an HbAlc Pih 0060 Process Effectiveness test during the measurement period Title Diabetes Urine Protein Screening CMS134v2 Description The percentage of patients 18 75 years of age with diabetes who had a Clinical r NQF 0062 nephropathy screening test or evidence of nephropathy during the measurement Process Effectiveness period CMS163v2 Title Diabetes Low Density Lipoprotein LDL Management Clinical NOF 0064 Description Percentage of patients 18 75 years of age with diabetes whose LDL C wes Ea RR
116. der s attestation for that year The solution will walk the eligible provider through a series of Incentive Attestation screens that directly relate to the provider workbook the State has provided to assist the provider with completing attestation The provider must complete these questions in order to proceed with submitting the attestation and potentially receiving payment The workbook provides the answers that will be entered in the appropriate screen so that the provider is prepared to answer all related questions prior to beginning the attestation process The Attestation workflow consists of the following topics The application will guide the user through the topics A topic does not become active until the prerequisite topic is completed Each topic will be addressed O Verify Registration Information Verify the provider information is the correct provider Ability to indicate proxy usage O Eligibility Screens These screens walk the provider through the attestation specific eligibility questions that they must complete in order to be validated as an eligible provider for the Incentive Program These screens include Questions on provider practice location Questions on provider Medicaid volume Q Payment Screens These screens walk the provider through the expected payment schedule and questions related O Certified EHR Technology This screen validates that the provider is indeed using a valid EHR solution for the
117. der section 1115 of ARRA demonstration project under section 1115 of the Act paid for part or all of the service or paid all or part of the premiums co payments and or cost sharing not add commas The system will format with commas after entry 3 Enter the number of patients served in FOHC or RHC that received CHIP assistance DEFINITION Services rendered on any one day to an individual where CHIP or CHIP demonstration project under section 1115 of ARRA demonstration project under section 1115 of the Act paid for part or all of the service or paid all or part of their premiums co payments and or cost sharing not add commas The system will format with commas after entry 4 Enter the number of FQHC or RHC patient s furnished uncompensated care DEFINITION Services rendered to an individual on any one day that were uncompensated Do not add commas The system will format with commas after entry 5 Enter the number of FQHC or RHC patients encounters provided services at either no cost or reduced cost based on the sliding scale determined by the individual s ability to pay DEFINITION Services rendered to an individual on any one day on a sliding scale Do not add commas The system will format with commas after entry Page 58 of 192 Confidential and Proprietary WEST VIRGINIA Department of Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Prog
118. diclogy orders created by the EP during the EHR reporting period are recorded using CPOE Measure 3 More than 30 percent cf laboratory orders created by the EP during the EHR reporting period are recorded using CPOE More than 50 percent of all permissible prescriptions or all prescriptions written by the EP are queried for a drug formulary and transmitted electronically using CEHRT More than 80 percent of all unique patients seen by the EP have demographics recorded as structured data More than 80 percent of all unique patients seen by the EP have blood pressure for patients age 3 and over only and or height and weight for all ages recorded as structured data More than 80 percent of all unique patients 13 years old or older seen by the EP have smoking status recorded as structured data Page 67 of 192 WEST VIRGINIA rt of Healt Hu Resources BUREAU FOR MEDICAL SERVICES 9 Use clinical decision support to improve performance on high priority health conditions Provide patients the ability to view online download and transmit their health information within four business days of the information being available to the EP Provide clinical summaries for patients for each office visit Protect electronic health information created or maintained by the certified EHR technclogy CEHRT through the implementation of appropriate technical capabilities Incorporate clinical lab test results into Ce
119. documentation Percentage of patients with counseling for nutrition Percentage of patients with counseling for physical activity For field descriptions and additional information Clinical Quality Measure Page Numerator 1 Denominator Exclusions Numerator 2 Denominator Exclusions Numerator 3 Denominator Exclusions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE amp Figure 102 CQM Question 5 Weight Assessment and Counseling for Nutritional amp Physical activity for Children and Adolescents Page 156 of 192 Confidential and Proprietary WEST VIRGINIA D rtment of Healt de unn BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 6 of 64 Red asterisk indicates a required field CMS138v2 NQF 0028 Title Preventive Care and Screening Tobacco Use Screening and Cessation Intervention Description Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received cessation counseling intervention if identified as a tobacco user For field descriptions and additional information Clinical Quality Measure Page Numerator Denominator Exceptions Please select the PREVIOUS PAGE button to go back or the SA
120. e 1 of 6 Red asterisk indicates a required field Syndromic Surveillance Data Submission Objective Capability to submit electronic syndromic surveillance data to public health agencies except where prohibited and in accordance with applicable law and practice Measure Successful ongoing submission of electronic syndromic surveillance data from CEHRT to a public health agency for the entire EHR reporting period EXCLUSION Any EP that meets one or more of the following criteria may be excluded from this objective Please select the exclusion option that applies to you The EP is not in a category of providers that collect ambulatory syndromic surveillance information on their patients during the EHR reporting period The EP operates in a jurisdiction for which no public health agency is capable of C receiving electronic syndromic surveillance data in the specific standards required by CEHRT at the start of their EHR reporting period C The EP operates in a jurisdiction where no public health agency provides information timely on capability to receive syndromic surveillance data The EP operates in a jurisdiction for which no public health agency that is capable of C accepting the specific standards required by CEHRT at the start of their EHR reporting period can enroll additional EPs C None of the above exclusions apply to me For additional information CMS Specification Sheet Please select the PREVIOUS
121. e Select a State from the drop down list Enter encounters Enter in Denominator which is the total patient encounters for the State Select Add button To enter in more States encounters repeat Steps 1 5 a iuc Page 52 of 192 Confidential and Proprietary BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider To Modify Out of State entry e Select Edit e Screen display with entries correct entries e Select Update button To Delete Out of State entry e Select Remove e Respond appropriately to the Are you sure question If the eligible professional EP meets or exceeds the Medicaid patient volume required to receive a WV EHR Incentive Program payment the application will display the Payment Calculation page Once the EP has completed and submitted their attestation for processing their Medicaid patient volume information will be verified against the claims and encounter data available in WVMMIS information entered into the application is subject to post payment audit If the eligible professional does not meet the required Medicaid patient threshold after entering all of their patient volume information additional screens will appear presenting a possible alternative patient volume calculation 9 3 1 3 2 Volume Screen 3 If initial Eligibility volume is not met The purpose of this screen 1s to provide another opportunity to me
122. e Incomplete Attestation Modify Existing Attestation Hote You can attest for any r getraton associated with your user account Please select the Status tab above to perform any of the following actions View current status of your Attestation and Payments s for the Incentive Program Note Tou can view the status of any registration associated with your user account WV Medicaid Provider Services PO Box 2002 Charleston WV 25327 2002 Figure 14 Home Page 9 2 Registering a Provider within WV EHR Incentive Program The registration process is used to associate the CMS registration with the West Virginia EHR Incentive Program attestation For Stage 2 the following bulleted items are different scenarios and indicate if the registration process is executed Page 32 of 192 Confidential and Proprietary BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider e If you have submitted prior attestation and are eligible for Stage 2 you do not need to register Your attestation will be ready when the Stage 2 attestation is opened in the WV EHR Provider Incentive Program application Use the attestation tab e If you have not submitted any attestations you are not eligible for Stage 2 Meaningful Use stage Please use the appropriate manual for your payment year e If you are a new user to submit on behalf of a provider who is eligible for Stage 2
123. e Professionals EP and Eligible Hospitel s can register for the Medicaid EHR Incentive Program at the CMS Website Please allow at least 24 hours for the State to receive and process your reg strabon Once the State as received and processed your registradon you can add the registration to the lst below Registrations in this list wll apoeer on the Attestation tab and the Status tab Select one of the follovning actions to manage the registrations assocated wth your Provider Incentive Payment System PIP user account Add Registration Please select the ADD REGISTRATION button to associate registration with your PIP user account for any of t e following restons e You ere an EP or eligible hospital and have completed the Medicaid EHR Incentive Program registration at the CMS Website You want to sstociste the registration wth your PIP account to begin attestation e You are working on behalf of an EP or eligible hospital and ment to view the provider s EHR Incentive Program records and or attest on behalf of the provider View Registration Please select the View action next to the registration in the hat to view the regutration information that wes entered at the CMS Website Remove Registration Please select the Remove action next to t e registration i the bet to disassociate the registration from your user account The registration and attestation information rill not be lost You can re associate the registration by selecting
124. e claims for the same patient for the same rendering physician for the same Date of service DOS This should be a count of unduplicated per patient per date of service Medicaid Claim Based Encounters in the 90 day periad This includes all Medicaid paid encounters including inpatient outpatient and emergency room services The EHR Incentive Payment solution will run a report from the MMIS system ta validate the FFS encounter count within the numerator Out of State Medicaid Patient Volume If you or your proxy provider saw patients who belong to another Medicaid payer out of State and wish ta count these patients towards your total Medicaid Patient volume for incentive qualification please record the numbers bw clicking the Add State text below Please note that any aut of state Medicaid patients that you add must be verified by a report from Medicaid State payer identified showing claims volume for the time frame specified and attached to this attestation You will be asked to upload your supporting documents at the end of this attestation on the Submit Attestation page Total Medicaid Encounters Total Patient Eneoaunters Mo Medicaid patient volume records Please select the PREYIOUS PAGE button ta go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE amp Figure 29 Attestation Tab Medicaid Patient Volume Page 50 of 192 Confidential and Proprietary Department of Resources BUREAU
125. e measurement period For CQM field descriptions and additional information Clini Numerator Denominator Exclusions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE 83 Figure 117 COM Question 20 Diabetes Urine Protein Screening Questionnaire 21 of 64 Red asterisk indicates a required field CMS163v2 NQF 0064 Title Diabetes Low Density Lipoprotein LDL Management Description Percentage of patients 18 75 years of age with diabetes whose LDL C was adequately controlled 100 mg dL during the measurement period For field descriptions and additional information Clini Numerator Denominator Exclusions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE 83 Figure 118 COM Question 21 Diabetes Low Density LDL Management Page 164 of 192 Confidential and Proprietary WEST VIRGINIA D tment of Healt H Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 22 of 64 Red asterisk indicates a required field CMS164v2 NQF 0068 Title Ischemic Vascular Disease IVD Use of Aspirin or Another Antithrombotic Description Percentage of patients 18 years of age and older who were discharged alive for acute
126. e the FFS encounter count within the numerator Confidential and Proprietary Page 45 of 192 Department of UM BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 9 3 1 1 Encounter Calculation For purposes of calculating EP eligible patient volume a Medicaid encounter as defined by the WV EHR Incentive Program as An encounter should be reflected in the count as one or more claims for the same patient for the same rendering physician for the same DOS This should be a count of unduplicated per patient per DOS Medicaid Claim Based Encounters in the 90 day period This includes all Medicaid paid encounters including inpatient outpatient and emergency room services The West Virginia EHR Incentive Payment solution will run a report from the MMIS system to validate the FFS encounter count within the numerator In other words Eligible Professionals should count the following as one patient encounter One to many claims for the same patient where the claim has the same DOS and the same rendering attending provider claims related to the actual encounter with the patient for the same date and same provider 9 3 1 2 Eligibility Screen 1 Service Setting To determine if the majority of services were hospital based evaluate 1f 9096 or more of services were performed in a hospital inpatient or emergency room setting The following section aids in this proces
127. ealth agencies in their jurisdiction The EP operates in a jurisdiction for which no specialized registry sponsored by a public health agency or by a national specialty society for which the EP is eligible is capable of receiving electronic specific case information in the specific standards required by CEHRT at the beginning of their EHR reporting period The EP operates in a jurisdiction where no public health agency or national specialty C society for which the EP is eligible provides information timely on capability to receive information into their specialized registries The EP operates in a jurisdiction for which no specialized registry sponsored by a public health agency or by national specialty society for which the EP is eligible that C is capable of receiving electronic specific case information in the specific standards required by CEHRT at the beginning of their EHR reporting period can enroll additional EPs C None of the above exclusions apply to me For additional information CMS Specification Sheet ee _ _ _ Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE 2 Figure 96 Menu Measures Question 6 Report Specific Cases Page 150 of 192 Confidential and Proprietary WEST VIRGINIA t t of Healt Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFU
128. ed eye exam by an eye care professional during the measurement period or a negative retinal exam no evidence of retinopathy in the 12 months prior to the measurement period For field descriptions and additional information Clinical Quality Measure Page Numerator Denominator Exclusions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 0 PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 113 Question 16 Diabetes Eye Exam Questionnaire 17 of 64 Red asterisk indicates a required field CM5123v2 NQF 0056 Title Diabetes Foot Exam Description Percentage of patients aged 18 75 years of age with diabetes who had a foot exam during the measurement pernod For CQM field descriptions and additional information Clinica lity Measur ge Numerator Denominator Exclusions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed ff PREVIOUS SAVE AND CONTINUE amp Figure 114 Question 17 Diabetes Foot Exam Page 162 of 192 Confidential and Proprietary Department de unn BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 18 of 64 Red asterisk indicates a required field CMS122v2 NQF 0059 Title Diabetes Hemoglobin Alc Poor Control Description Percentage of patients 18 75 years
129. edicaid patients that you add must be verified by a report from Medicaid State payer identified showing claims volume for the time frame specified and attached to this attestation You will be asked to upload your supporting documents at the end of this attestation on the Submit Attestation page Add State State Total Needy Patient Encounters Total FGHCIEHU Patient Encounters Mo needy patient volume records L d Please select the PREVIOLS PAGE button to go back or the SAVE amp CONTINUE button to proceed E PREVIOUS PAGE SAVE AND CONTINUE Figure 33 Attestation Tab Needy Patient Volume at FQHC RHC Confidential and Proprietary Page 57 of 192 Department of UM BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Enter start date or end date of the EP s patient volume attestation period by typing in the date or selecting the calendar icon to the right of either box The application will then automatically calculate the appropriate 90 day window for the provider s chosen attestation period For the 90 day period enter the number of patient encounters that meet the criteria for each question 2 Enter the number of patients served in FQHC or RHC that received medical assistance from Medicaid DEFINITION Services rendered on any one day to an individual where Medicaid or Medicaid demonstration project un
130. egistries or immunization information systems except where prohibited and in accordance vith applicable law anc practice Measure Successful ongoing submission of electronic immunization data from CEHRT to an immunization registry or immunization information system for the entire EHR reporting period Complete the following information The EP must attest YES to meeting one of the following criteria under the umbrella of ongoing submission Ongoing submission was already achieved for an EHR reporting period in a prior year and continues throughout the current EHR reporting period using either the current standard at 45 CFR 170 314 1 and f 2 or the standards included in the 2011 Edition EHR certification Registration with the PHA or other body to whom the information is being submitted of intent to initiate ongoing submission was made by the deadline within 60 days of the start of the EHR reporting period and ongoing submission was achieved Registration of intent to initiate ongoing submission was made by the deadline and the EP is still engaged in testing and validation of ongoing electronic submission Registration of intent to initiate ongoing submission was made by the deadline and the EP is awaiting invitation to begin testing and validation Yes No Please select the criteria that was met and enter the registry name Ongoing submission was already achieved for an EHR reporting period in a prior year a
131. enominator Please enter the appropriate data If all fields have been answered AND the entries meet the volume percentages the Incentive Payment schedule screen displays If the provider does not meet the volume percentages listed above the provider is ineligible and will not be allowed to continue Attestation status will state Attestation Not Allowed Contact WV Medicaid Provider Services Help Desk at 1 888 483 0793 option 8 for questions and assistance 9 3 2 Attestation Payment The payment schedule is a proposed schedule based on the answers provided in the Eligibility section The WV EHR Incentive Program application will execute behind the scenes to validate questions that asked for claims volume If the volume was not found the application will set the eligibility status to Ineligible and the Attestation status to Attestation Not Allowed Confidential and Proprietary Page 61 of 192 WEST VIRGINIA D nt of tua BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Pediatrician EHR Incentive Payments Between 20 29 Percent P crm oam crans ovans s LL CY 2014 5 667 5 667 5 667 14 167 CY 2015 5 667 5 667 5 667 5 667 14 167 CY 2016 5 665 5 667 5 667 5 667 5 667 14 167 CY 2017 5 667 5 667 5 667 5 667 CY 2018 5 667 5 667 5 667 CY 2019 5 665 5 667 5 667 CY 2
132. ent or prior left ventricular ejection fraction LVEF lt 40 who were prescribed ACE inhibitor or ARB therapy either within a 12 month period when seen in the outpatient setting OR at each hospital discharge For field descriptions and additional information Clinical Quality Measure Page Numerator Denominator Exceptions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 0 PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 123 COM Question 26 HF ACE Inhibitor or ARB Therapy for LVSD Questionnaire 27 of 64 Red asterisk indicates a required field CMS144v2 NOF 0083 Title Heart Failure HF Beta Blocker Therapy for Left Ventricular Systolic Dysfunction LVSD Description Percentage of patients aged 18 years and older with a diagnosis of heart failure HF with a current or prior left ventricular ejection fraction LVEF 4096 who were prescribed beta blocker therapy either within a 12 month period when seen in the outpatient setting OR at each hospital discharge For CQM field descriptions and additional information Clinical Quality Measure Page Numerator Denominator Exceptions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 0 PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 124 COM Question 27 HF Beta Blocker Therapy for LVSD Page 168 of 192 Confidential and Proprietary WEST VIRGINIA
133. ependence jii 153 Figure 100 COM Question 3 Controlling High Blood Pressure 154 Figure 101 COM Question 4 Use of High Risk Medications in the Elderly 155 Figure 102 COM Question 5 Weight Assessment and Counseling for Nutritional amp Physical activity for Children and 156 Page 8 of 192 Confidential and Proprietary BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Figure 103 COM Question 6 Preventive Care and Screening Tobacco use Screening and Cessalon II RS BOITE 157 Figure 104 COM Question 7 Breast Cancer 157 Figure 105 COM Question 8 Cervical Cancer Screening sss 158 Figure 106 COM Question 9 Chlamydia Screening for Women ccccceceeeeeeeeeeeeeeeeeees 158 Figure 107 COM Question 10 Colorectal Cancer 159 Figure 108 COM Question 11 Use of Appropriate Medications for Asthma 159 Figure 109 COM Question 12 Childhood Immunization Status 160 Figure 110 COM Question 13 Preventive Care and Screening Influenza Immunization 160 Figure 111 COM Question 14 Pneumonia Vaccination Status for Older Adults
134. et the eligibility volume for those providers practicing predominately in an FQHC The following is the volume criteria if the provider practiced at an FOHC or RHC Eligible professionals that perform 50 of more of their overall patient encounters over a six month period in an FOHC or RHC are eligible to use an alternative Needy Individual patient volume calculation to become eligible to participate 1n the WV EHR Incentive Program Volume Screen 3 shown below in Figure 36 asks the EP to provide the necessary information to determine if they are eligible to use the Needy Individual patient volume calculation Confidential and Proprietary Page 53 of 192 WEST VIRGINIA Department of Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Back To WV MMIS Portal Help My PIP Account Mome Registration Questionnaire 3 of 4 Red asterisk indicates a required field FOHC RHC Patient Volume Although you do not meet the required Medica d patient volume threshold you may tice predorninmantly im federally qualrtied healt enter FOHC onth penod in the previous calendar year for your patient volume figures Start Date i End Date Complete the following information Numerator Number of patient encount RPC during the 6 month pe Denominator patent encounters overt Numerator Denominator Plesse select the PREVIOUS
135. ey qualify for EPs that practice predominantly at a Federally Qualified Health Center FQHC or a Rural Health Clinic RHC and not did meet the EP 30 Medicaid patient volume threshold will be able to indicate volume and exclusions which will be discussed with the Eligibility Screen 3 and 4 9 3 1 3 1 Out of State Encounters If the provider has significant Medicaid encounters from another state payer then you may add to your in state encounter count to achieve the required encounter volume The Volume page provides functionality to add and maintain out of state OOS volume counts When an attestation with OOS entries is submitted the attestation will be placed in a Pend status provided the in state volume counts are valid WV Medicaid department will review the attestation to ensure the appropriate documentation was provided and also to review the documentation to determine if the attestation will be accepted or rejected The provider must obtain the counts from the out of state s Medicaid MMIS and be prepared to submit the following documentation Certification on official letterhead from the State Medicaid agency declaring the numbers obtained were derived from the State s MMIS and are accurate Report generated by the State Medicaid agency with the total fee for service and Managed Care Organization encounter count and reporting period Confidential and Proprietary Page 49 of 192 WEST VIRGINIA Healt Resources BUREAU
136. f Bone Scan for Staging Low Risk Prostate Cancer Patients Questionnaire 40 of 64 Red asterisk indicates a required field CMS62v2 NQF 0403 Title HIV AIDS Medical Visit Description Percentage of patients regardless of age with a diagnosis of HIV AIDS with at least two medical visits during the measurement year with a minimum of 90 days between each visit For CQM field descriptions and additional information Clini Numerator Denominator Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 8 PREVIOUS PAGE SAVE AND CONTINUE 83 Figure 137 COM Question 40 HIV AIDS Medical Visit Page 176 of 192 Confidential and Proprietary Department de unn BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 41 of 64 Red asterisk indicates a required field CM552v2 NQF 0405 Title HIV AIDS Pneumocystis jiroveci pneumonia PCP Prophylaxis Description Percentage of patients aged 6 weeks and older with a diagnosis of HIV AIDS who were prescribed Pneumocysts jiroveci pneumonia PCP prophylaxis For field descriptions and additional information Clinica Population Criteria 1 Numerator 1 Denominator 1 Exceptions Population Criteria 2 Numerator 2 Denominator 2 Exceptions Population Criteria 3 Numerator 3 Denominator 3
137. f State Medicaid Patient Volume 51 Figure 31 Out of State Entry Add Edit Screen Figure 32 Attestation Tab FOHC RHC Patient 54 Figure 33 Attestation Tab Needy Patient Volume at FQHC RHC eeeeeeeesss 57 Page 6 of 192 Confidential and Proprietary BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Figure 54 Out or state POC REC Eni Vus eias 59 Figure 35 Out of state Needy Patient Volume Entry Edit 8 60 Figure 36 Pediatrician 20 volume payment calendar eese 62 Figure 37 Eligible Providers Payment 1 4 62 Figure 38 Attestation Tab Certified EHR Technology Page 64 Figure 39 Meaningful Use Core Measures Question 118 68 Figure 40 Meaningful Use Menu Measure Question 1 70 Clinical Measures 79 Figure 42 Attestation Tab Submit Attestation Check Email Address 81 Figure 43 Supporting Documentation
138. g Questionnaire 11 of 64 Red asterisk indicates a required field CMS126v2 NQF 0036 Title Use of Appropriate Medications for Asthma Description Percentage of patients 5 64 years of age who were identified as having persistent asthma and were appropnately prescnbed medication dunng the measurement penod For CQM field descriptions and additional information Clinical Quality Measure Page Numerator Denominator Exclusions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 0 PREVIOUS PAGE SAVE AND CONTINUE 23 Figure 108 COM Question 11 Use of Appropriate Medications for Asthma Confidential and Proprietary Page 159 of 192 WEST VIRGINIA D nt of Healt de Hun BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 12 of 64 Red asterisk indicates a required field CMS117v2 NOF 0038 Title Childhood Immunization Status Description Percentage of children 2 years of age who had four diphtheria tetanus and acellular pertussis DTaP three polio IPV one measles mumps and rubella MMR three H influenza type B HiB three hepatitis B Hep B one chicken pox VZV four pneumococcal conjugate PCV one hepatitis A Hep A two or three rotavirus RV and two influenza flu vaccines by their second birthday For field descriptions and additional
139. g CPOE Complete the following information All information entered may be subject to audit that could result in payment recoupment Numerator The number of orders in the denominator recorded using CPOE Denominator Number of radiology orders created by the EP during the EHR reporting period Numerator Denominator For additional information CMS Specification Sheet Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 0 PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 48 MU Core Question 1B Numerator amp Denominator Entry Screen Page 102 of 192 Confidential and Proprietary WEST VIRGINIA D tment of Healt H Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Attestations gt Attest gt Meaningful Use Core Measures gt Core Measure Questionnaire 1C of 17 Red asterisk indicates a required field CPOE for Medication Radiology and Laboratory Orders Objective Use computerized provider order entry CPOE for medication radiology and laboratory orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state local and professional guidelines Measure More than 30 percent of laboratory orders created by the EP during the EHR reporting period are recorded using CPOE EXCLUSION EPs who write fewer than 100 labo
140. g for Children with Pharyngitis Description Percentage of children 2 18 years of age who were diagnosed with pharyngitis ordered an antibiotic and received a group A streptococcus strep test for the episode For CQM field descriptions and additional information Clinical Quality Measure Page a Numerator Denominator Exclusions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE Figure 98 COM Question 1 Appropriate Testing for Children with Pharyngitis Page 152 of 192 Confidential and Proprietary WEST VIRGINIA D rtrment of Healt s Huan BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 2 of 64 Red asterisk indicates a required field CMS137v2 NQF 0004 Title Initiation and Engagement of Alcohol and Other Drug Dependence Treatment Description Percentage of patients 13 years of age and older with a new episode of alcohol and other drug AOD dependence who received the following Two rates are reported a Percentage of patients who initiated treatment within 14 days of the diagnosis b Percentage of patients who initiated treatment and who had two or more additional services with an AOD diagnosis within 30 days of the initiation visit For CQM field descriptions and additional information Clinical Quality Measure
141. g the CMS NLR to determine if the attesting EP has already received an EHR Incentive Program payment from Medicare or another state s Medicaid EHR Incentive Program This processing will take time and the payment will not be sent immediately after submitting the attestation After the eligibility checks and payment checks are executed the WV EHR Incentive Program will send an email with the status that was found If an eligibility or payment error has occurred and assistance is needed please contact the WV Medicaid Provider Services Help Desk at 1 888 483 0793 option 8 The WV EHR Incentive Program application will display the errors Select the Status tab to display the current Attestation status Page 84 of 192 Confidential and Proprietary WEST VIRGINIA t of Healt Resources BUREAU FOR MEDICAL SERVICES 10 Status Grid The table lists the attestation status that may occur Provider Screon Status West Virginia Electronic Health Record Provider Incentive Program Admin Portai MEANINGFUL USE Provider Description Provider ADestaton Nor Alowed Arestspon Not Sts ed Atestston in Frooress Sobmted Perded Provder mas faced final Eg check B POS Ercoe Voimme eror Pay hol enor Acceoned Locked for Payer E xcoded from cayrent Confidential and Proprietary Not lowed Attesteton7 Not Steere Attestatbon in Progress Submaeed Result Locked For Payment
142. grading or meanangful use of certified EHR technelegy im your first year and demenstrate use for the years ain the program Instructions Select any tab to continue Please select the Registration tab above to perform any of the following actions Associate one or more Incentive Program Registrations with your user account Venfy the content of an associated registration Please select the Attestation tab above to perform any of the following actions Attest for the Incentive Program Continue Incomplete Attestation Modify Existing Attestation Becerra Mote You can attest for any registration associated with your user account Please select the Status tab above to perform any of the following actions View current status of your Attestation and Payments s for the Incentive Program Note You can view the status of amy registration associated with your user account WY Medicaid Provider Services PO Bax 2002 Charleston Wy 25327 2002 Figure 6 Home page 8 2 5 Registration Tab The Registration tab displays the registration instruction window Refer to Figure 7 Confidential and Proprietary Page 23 of 192 Healt Human BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Home ETT TTE Attestation Status Registrations Registration Instructions Welcome to the Registration Page Eligibl
143. gram MEANINGFUL USE Provider Title ADHD Follow Up Care for Children Prescribed Attention Deficit Hyperactivity Disorder ADHD Medication Description Percentage of children 6 12 years of age and newly dispensed a medication for attention deficit hyperactivity disorder ADHD who had appropriate follow up care Two rates are reported CMS136v3 Percentage of children who had one follow up visit with a practitioner with Clinical NQF 0108 prescribing authority during the 30 Day Initiation Phase Process Effectiveness b Percentage of children who remained on ADHD medication for at least 210 days and who in addition to the visit in the Initiation Phase had at least two additional follow up visits with a practitioner within 270 days 9 months after the Initiation Phase ended Title Bipolar Disorder and Major Depression Appraisal for alcohol or chemical substance use Description Percentage of patients with depression or bipolar disorder with evidence a NQF 0110 Process Effectiveness of an initial assessment that includes an appraisal for alcohol or chemical substance use Title Oncology Medical and Radiation Pain Intensity Quantified CMS157v2 Description Percentage of patient visits regardless of patient age with a diagnosis of Patient and Family r NQF 0384 cancer currently receiving chemotherapy or radiation therapy in which pain intensity Engagement Title Colon Cancer Chemotherapy for AJCC Stage I
144. gram please visit soe ewrpenbs com and refer fo the insteuctians and FAC IF yau need ans other assset armce regarding for the EHE s Proveter Incentive Program pleace contact 858 q481 D793 aphan 8 for the Serre Provider Incentive Program help desk Thank you ter thee FOP imbems Vs amp rsinr 2 01 ee d Healt co Huron Resources BUREAU FOR MEDICAL SERVICES Confidential and Proprietary Page 99 of 192 Human BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 25 Meaningful Use Core Measures Screen Shots CMS requires a response to the 17 core measure questions All possible screens are displayed below The core question displays However the core question s supporting screens display is dependent on your response to the exclusion An example of a supporting screen is the entry for numerator and Denominator or to add results Attestations gt Attest gt Meaningful U re M res Core Measure Questionnaire 1A of 17 Red asterisk indicates a required field CPOE for Medication Radiology and Laboratory Orders Objective Use computerized provider order entry CPOE for medication radiology and laboratory orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state local and professional guidelines Measure More than 60 percent of medication orde
145. have passed the system will execute the final edits From PIP Administrator Date Wednesday August 10 2011 1 40 PM To WV test org sunil matte molinaheatthcare com Subject PIP Attestation submitted Your PIP attestation has been successfully submitted you have two more days to change the attestation details before it will be processed NPI ID 18 Provider Name PROVIDER NAME Organization Name ORGANIZATION NAME Reporting Period Name CY2011 Submitted Date 8 4 2011 9 55 12 AM For more information on eligible providers for the EHR Provider Incentive Program please visit www wymmis com and refer to the instructions and FAQ s If you need any other assistance regarding eligibility for the EHR s Provider Incentive Program please contact 888 483 0793 option 8 for the Provider Service EHR Provider Incentive Program help desk Thank you for using the PIP system Version 1 0 0 1 WEST VIRGINIA Healt Hunan BUREAU FOR MEDICAL SERVICES Confidential and Proprietary Page 87 of 192 uere Healt ltu Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 13 Error Occurred When Processing Registration Email When the registration arrives from the NLR to the application validation of the provider is required This email occurs if the provider does not exist in the MMIS From PIP Adrministrator V Date wednesday August 10 2011
146. he system will validate the provider s attestation and that they practice predominately outside a hospital by checking the place of service for the attesting provider s or the proxy claims for the period specified within the system to validate Medicaid volume If the providers are performing encounters in an inpatient or emergency room setting the solution will PEND the attestation for further review The Provider may then contact the Provider Services Help desk to review their attestation and work the PEND The user will not be able to continue entering attestation data 9 3 1 3 Eligibility Screen 2 Volume Check The purpose of this screen is to determine if the volume in the practice is eligible for the incentives In order to be eligible for the Medicaid EHR Incentive Program Eligible professionals EPs must meet eligible patient volume thresholds For most professionals this means a 30 eligible patient volume based on total patient encounters for the Attestation period Pediatricians for the Attestation period Page 48 of 192 Confidential and Proprietary BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider O If Pediatricians have greater than 20 but less than a 30 eligible patient volume their annual incentive cap is reduced to 2 3 Pediatricians who achieve 30 eligible patient volume are eligible to receive the full incentive amount th
147. her in a positive negative or numerical format are incorporated in Certified EHR Technology as structured data Generate at least one report listing patients of the EP with specific condition More than 10 percent of all unique patients who have had 2 or more office visits with the EP within the 24 months before the beginning of the EHR reporting period were sent a reminder per patient preference when available Patient specific education resources identified by Certified EHR Technology are provided to patients for more than 10 percent of all unique patients with office visits seen by the EP during the EHR reporting period The EP who performs medication reconciliation for more than 50 percent of transitions of care in which the patient is transitioned into the care of the EP Measure 1 The EP who transitions or refers their patient to another setting of care or provider of care provides a summary of care record for more than 50 percent of transitions of care and referrals Measure 2 The EP who transitions or refers their patient to another setting of care or provider of care provides a summary of care record for more than 10 percent of such transitions and referrals either a electronically transmitted using CEHRT to a recipient or b where the recipient receives the summary of care record via exchange facilitated by an organization that is a NwHIMN Exchange participant or in a manner that is consistent with the governance mechanism OMC
148. hreshold can still qualify for an EHR Incentive Program payment using Medicaid patient volume previously discussed but are not eligible to use the Needy Individual patient volume measure described in this section Needy Individual Encounters Defined For purposes of calculating needy eligible patient volume a needy patient encounters include services rendered to an individual on any one day where any of the following are met Medicaid or Children s Health Insurance Program CHIP or a Medicaid or CHIP demonstration project approved under section 1115 of the Social Security Act paid for part or all of the service Confidential and Proprietary Page 55 of 192 Department of UM BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Medicaid or CHIP or a Medicaid or CHIP demonstration project approved under section 1115 of the Social Security Act paid all or part of the individual s premiums co payments or cost sharing The services were furnished at no cost or The services were paid for at a reduced cost based on a sliding scale determined by the individual s ability to pay Eligibility Patient Volume The solution will look to validate the number of Medicaid patient encounters reported during final attestation review Please review the sample screen below Page 56 of 192 Confidential and Proprietary WEST VIRGINIA Department of Res
149. i pneumonia PCP Prophylaxis Clinical NOF 0405 Description Percentage of patients aged 6 weeks and older with a diagnosis of HIV AIDS who were prescribed Pneumocystis jiroveci pneumonia prophylaxis Title HIV AIDS RNA Control for Patients with HIV CMSTIN2 Description Percentage of patients aged 13 years and older with a diagnosis of Clinical r HIV AIDS with at least two visits during the measurement year with at least 90 days Process Effectiveness between each visit whose most recent HIV RNA level is lt 200 copies mL Confidential and Proprietary Page 77 of 192 WEST VIRGINIA Healt de Hon BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Title Preventive Care and Screening Screening for Clinical Depression and Follow Up Plan CMS2v3 Description Percentage of patients aged 12 years and older screened for clinical Population Public NQF 0418 depression on the date of the encounter using an age appropriate standardized Health depression screening tool AND if positive a follow up plan is documented on the date of the positive screen Title Documentation of Current Medications in the Medical Record Description Percentage of visits for patients aged 18 years and older for which the eligible professional attests to documenting a list of current medications using all immediate resources available on the date of the encounter Th
150. ical decision support interventions for the length of the EHR reporting period to meet the measure C Yes C No The EP implemented a clinical decision support intervention related to Clinical quality measure High priority health condition For additional information Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE 8 Figure 58 MU Question 6A Clinical Decision Support Rule Page 112 of 192 Confidential and Proprietary Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 6B of 17 Red asterisk indicates a required field Clinical Decision Support Rule Objective Use clinical decision support to improve performance on high priority health conditions Measure The EP has enabled and implemented the functionality for drug drug and drug allergy interaction checks for the entire EHR reporting period EXCLUSION EPs who write fewer than 100 medication orders during the EHR reporting period would be excluded from this requirement EPs must enter the number of medication orders recorded during the EHR reporting period in the Exclusion box to attest to exclusion from this requirement Does this exclusion apply to you For additional information Please select the PREVIOUS PAGE button to go back or the SAVE amp
151. igible providers for the EHR Provider Incentive Program please visit ww w wvmmis com and refer to the instructions and FAQ s If you need any other assistance regarding eligibility for the EHR s Provider Incentive Program please contact 888 483 0793 option 8 for the Provider Service EHR Provider Incentive Program help desk Thank you for using the PIP system Version 1 0 0 1 WEST VIRGINIA Department of Healt Human Resources BUREAU FOR MEDICAL SERVICES Page 92 of 192 Confidential and Proprietary WEST VIRGINIA Department of Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 18 Attestation Paid Email If final eligibility checks pass and no payment issues occurred an email 1s sent indicating that payment is approved and being processed The payment will continue with additional processing so payment arrival will take a few days From PIP Administrator Date Wednesday August 10 2011 1 40 PM To WV test org sunil matte molinahealtthcare com Subject Your VV EHR Incentive payment has been created Attestation Paid The attestation whose details are listed below has been paid NPI ID 18 Provider Name PROVIDER NAME Organization Name ORGANIZATION NAME Reporting Period Name CY2011 Attestation Submitted Date 8 4 2011 9 55 12 AM Amount Paid 0 0000 Payment Date For more information on payment or eligibil
152. information Page 40 of 192 Confidential and Proprietary WEST VIRGINIA Department of Human BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Attestations Attestation instructions Welcome to the Attestation Page Depending on the current status of your attestation please select one of the following actions Attest Please select the Attest link to start attestation e Attest for an EHR incentive programs payment year e Continue an incomplete attestation Rescind Please select the Rescind link to Cancel processing of submitted attestation Resubmit Please select the Resubmit link to Resubmit an attestation that was previously deemed ineligible e Please follow along using the WY Provider Incentive Payment Hospital Proavider VWfYorkbook as a companion guide as you complete the attestation process Questions on the application or the program overall can be directed to the Wy Provider Services Help Desk at 888 483 0793 option 8 for the Provider Service EHR e CMS and your state s Medicaid office recommends documentation are retained in case of audit Please review your state s Medicaid requirements and applicable provider manuals for the specific service requirements retention periods and lists Providers must maintain records in accordance with Federal regulations for a period of S years or 3 Years after audits with any and all exceptions
153. ion and whose blood pressure was adequately controlled 140 90mmHg during the measurement period Title Use of High Risk Medications in the Elderly Description Percentage of patients 66 years of age and older who were ordered high risk medications Two rates are reported a Percentage of patients who were ordered at least one high risk medication b Percentage of patients who were ordered at least two different high risk medications Confidential and Proprietary Efficient Use of Healthcare Resources Clinical r Process Effectiveness Clinical r Process Effectiveness Patient Safety a Page 73 of 192 west VIRGINIA isi Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Title Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents Description Percentage of patients 3 17 years of age who had an outpatient visit with a Primary Care Physician PCP or Obstetrician Gynecologist OB GYN and who had CMS155v2 evidence of the following during the measurement period Three rates are reported NQF0024 Percentage of patients with height weight and body mass index BMI percentile documentation Percentage of patients with counseling for nutrition Percentage of patients with counseling for physical activity Title Preventive Care and Screening Tobacco Use Screening and Cessation
154. ipid Panel and LDL Control Description Percentage of patients 18 years of age and older who were discharged CMS182v3 alive for acute myocardial infarction AMI coronary artery bypass graft CABG or Clinical NOF 0075 percutaneous coronary interventions PCI in the 12 months prior to the measurement u A a period or who had an active diagnosis of ischemic vascular disease IVD during the measurement period and who had a complete lipid profile performed during the measurement period and whose LDL C was adequately controlled lt 100 mg dL Confidential and Proprietary WEST VIRGINIA Healt de Hon BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider CMS135v2 NQF 0081 CMS144v2 NQF 0083 CMS143v2 NQF 0086 CMS167v2 0088 CMS142v2 NQF 0089 5139 2 NQF 0101 5161 2 NQF 0104 CMS128v2 NQF 0105 Page 76 of 192 Title Heart Failure HF Angictensin Converting Enzyme ACE Inhibitor or Angiotensin Receptor Blocker ARB Therapy for Left Ventricular Systolic Dysfunction LVSD Description Percentage of patients aged 18 years and older with a diagnosis of heart failure HF with a current or prior left ventricular ejection fraction LVEF 40 who were prescribed ACE inhibitor or ARB therapy either within a 12 month period when seen in the outpatient setting OR at each hospital discharge Title Heart Failure HF
155. ir patient to another provider of care should provide summary care record for each transition of care or referral Measure An EP must satisfy one of the followng criteria Conducts one or more successful electronic exchanges of a summary of care document a part of which is counted in measure 2 for EPs the measure at 495 6 5 14 ii 8 with a recipient who has EHR technology that was developed or designed by a different EHR technology developer than the sender s EHR technology certified to 45 CFR 170 314 b 2 Conducts one or more successful tests with the CMS designated test EHR during the EHR reporting period Complete the following information The EP must attest YES to one of the following two criteria to meet this measure 1 Conducts one or more successful electronic exchanges of a summary of care document a part of which is counted in measure 2 for EPs the measure at 495 6 j 14 ii 8 with a recipient who has EHR technology that was developed or designed by a different EHR technology developer than the sender s EHR technology certified to 45 CFR 170 314 b 2 2 Conducts one or more successful tests vith the CMS designated test EHR during the EHR reporting period Yes No If you answered YES then complete the following information Please select the criteria that was met Successful electronic exchange of a summary of care document with a recipient who has EMR technology that was designed b
156. ired field Service Setting Hospital based eligible professionals are not eligible for incentive payments n eligible professional is considered hospital based if ans or more of his or her services are performed in a hospital inpatient Place Of Service code 21 or emergency room Place Of Service code 235 setting Complete the following information Did wou perform 909 of your services in an inpatient hospital or emergency room hospital setting C ves Figure 28 Attestation Tab Eligibility Window BS Hospital based providers are not eligible to receive the payments Confidential and Proprietary Page 47 of 192 Department of UM BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider BS The application will display an error message You are NOT currently eligible to receive an incentive payment under the Medicaid EHR Incentive Program The Attestation Process is halted and the user will not be allowed to continue entering in information The eligibility status is set to Ineligible 9 Select NO if the provider is NOT hospital based and select Save and Continue button application will continue to Eligibility Screen 2 Volume Check question 10 Select Previous Page button to display the Verify Registration page BS Regardless of the answer after attestation submission and finalization 48hrs after submittal t
157. is list must include ALL Patient Safety a known prescriptions over the counters herbals and vitamin mineral dietary nutritional supplements AND must contain the medications name dosage frequency and route of administration Title Preventive Care and Screening Body Mass Index BMI Screening and Follow Up Description Percentage of patients aged 18 years and older with a documented BMI during the encounter or during the previous six months AND when the BMI is outside f normal parameters a follow up plan is documented during the encounter or M E ren during the previous six months of the encounter ee Normal Parameters Age 65 years and older BMI gt 23 and 30 CMS68v3 NQF 0419 Age 18 64 years BMI z 18 5 and 25 Title Cataracts Complications within 30 Days Following Cataract Surgery Requiring Additional Surgical Procedures Description Percentage of patients aged 18 years and older with a diagnosis of CMS132v2 uncomplicated cataract who had cataract surgery and had any of a specified list of NQF 0564 surgical procedures in the 30 days following cataract surgery which would indicate the occurrence of any of the following major complications retained nuclear fragments endophthalmitis dislocated or wrong power IOL retinal detachment or wound dehiscence Title Cataracts 20 40 or Better Visual Acuity within 90 Days Following Cataract Surgery CMS133v2 Description Percentage of patients aged 18 year
158. ission at Twelve Months 183 Figure 147 COM Question 50 Depression Utiliztion of PHQ 9 Tool 184 Figure 148 COM Question 51 Children Who have Dental Decay or Cavities 185 Figure 149 COM Question 52 Child and Adolescent Major Depressive Disorder Suicide Risk JASSOSSITIE IME 185 Figure 150 COM Question 53 Maternal Depression 1 186 Figure 151 COM Question 54 Primary Caries Prevention Intervention as Offered by Primary Care Providers incl ding Dentists 186 Figure 152 COM Question 55 Preventive Care and Screening Cholestrol Fasting LDL C Test 187 Figure 153 COM Question 56 Preventive Care and Screening Risk Stratified Cholestrol LOC c 188 Figure 154 COM Question 57 Dementia Cognitive 189 Figure 155 COM Question 58 Hypertension Improvement in Blood Pressure 189 Figure 156 CMQ Question 59 Closing the Referral Loop Receipt of Specialist Report 190 Figure 157 COM Question 60 Functional Status Assesment for Knee Replacement 190 Page 10 of 192 Confidential and Proprietary BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGF
159. ity for the EHR Provider Incentive Program please visit www wymmis com and refer to the instructions and FAQ s If you need any other assistance regarding payment or eligibility for the EHR s Provider Incentive Program please contact 888 483 0793 option 8 for the Provider Service EHR Provider Incentive Program help desk Thank you for using the PIP system Version 1 0 0 1 WEST VIRGINIA Department of Healt Human Resources BUREAU FOR MEDICAL SERVICES Confidential and Proprietary Page 93 of 192 uere Healt ltu Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 19 Attestation Payment Denied Email If final eligibility checks did not pass and payment issues occurred an email indicating denial is sent The Medicaid Provider Services staff at 1 888 483 0793 option 8 may be able to address questions From PIP Administrator AA Date Wednesday August 10 2011 1 40 PM To WY test org sunil matte molinaheatthcare com Subject PIP Attestation payment not processed by MMIS The attestation whose details are listed below has been denied payment 18 PROVIDER NAME ORGANIZATION NAME NPI ID Provider Name Organization Name Reporting Period Name CY2011 Submitted Date 8 4 2011 9 55 12 AM For more information on eligible providers for the EHR Provider Incentive Program please visit www wymmis com and refer to the instru
160. lect the Action you would like to perform ae ett 095 Gee xxx xx 1234 n Provider Name xxx xx 1234 456 Diesre select the ADO RECISTRATION button to add eg strato to the bst ADO REGIS TRATION Figure 16 Registration Tab Registration Home Page Page 34 of 192 Confidential and Proprietary WEST VIRGINIA Department of Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 3 The Registration home page lists all registrations that you have added If you have not added any the Registration Selection section will display No records to display as shown in the figure below Registration Selection Identify the desired registration and select the Action you would like to perform Action Mame Tax Identifier Mational Provider Identifier MP Status Action records to display Please select the ADD REGISTRATION button to add a registration to the list ADD REGISTRATION Figure 17 Registration Tab No Records to Display 4 The registration sections below explains the options that are available on the Registration home page which are Add Registration Select and Remove Confidential and Proprietary Page 35 of 192 Human BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 9 2 1 Registration Add option Back To WV MMIS Portal Help My
161. lizing the WV EHR Incentive payment attestation solution It can also hold your responses before accessing the application A sample page from the workbook is shown below Department of u WV Electronic Health Record Provider Incentive Program Resources BUREAU FOR MEDICAL SERVICES Hospital Attestation Provider Worksheet Meaningful Use Core Measures Question Response Meaningful Use Core Measures Responses to all questions are required IF answer Noto IF answer No to exclusion the exclusion the numerator denominator if answered Yes f answered Yes not needed not needed Figure 1 Example of Workbook page Confidential and Proprietary Page 15 of 192 Department of UM BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 3 Required Supporting Documentation CMS and BMS recommends documentation is retained in case of audit Providers must maintain records in accordance with Federal regulations for a period of five years or three years after audits with any and all exceptions having been declared resolved by BMS or the U S Department of Health and Human Services DHHS The provider must make all records and documentation available upon request to BMS and or DHHS Such records and documentation must include but not be limited to Financial Records Practicing Provider Information credentials Identification of Service Sites Dates
162. made for the attesting provider BMS has reviewed the failed attestation details and found that the attestation is acceptable BMS set the status to an accepted status The attestations details will be sent to the NLR to check if any payments have been made for the attesting provider From PIP Administrator WV pip admin amp wv mmis gov Sent Tue 8 9 2011 10 18 To Provider email address Cc Subject PIP Attestation accepted The attestation whose details are listed below has now been accepted by the EHR Incentive Solution after validation process or by the BMS Provider Services staff after an internal review The attestation will now proceed to the next stage of the validation process that checks whether a duplicate payment for Medicaid attestation was made in this State or another State during the current attestation period NPI ID 195 Provider Name PROVIDER NAME Organization Name ORGANIZATION NAME Reporting Period Name FY2011 Submitted Date 8 9 2011 10 09 50 AM For more information on eligible providers for the EHR Provider Incentive Program please visit www wvmmis com and refer to the instructions and FAQ s If you need any other assistance regarding eligibility for the EHR s Provider Incentive Program please contact 888 483 0793 option 8 for the Provider Service EHR Provider Incentive Program help desk Thank you for using the PIP system Version 1 0 1 19 WEST VIRGINIA Department of Human BUREAU F
163. mbs indicate the current position within the site Breadcrumbs are a visual representation of pages and sub pages followed to reach this page Select the underlined name to return to the specific page For the example screen the breadcrumb translates to the following e The Use Core Measures text that is not underlined in the breadcrumb indicates the current section In this case it is the Meaningful Core Measures questions e The underlined text will display the page that it is assigned For example o tss displays the Reason for Attestation page o sususss displays the Attestation Instructions page Home Registration Status Meaningful Use Core Measures gt Attest gt Meaningful Use Care Measures Figure 3 Breadcrumbs 8 2 Use of the Navigation Features Every window of the WV EHR Incentive Program has a set of standard navigation features The features are located on the upper right hand corner of the application Refer to Figure 4 Back To WY IMIS Portal Help My PIP Account Registration Attestation Status Figure 4 Feature Description 8 2 1 Help Hyperlink The Meaningful Use questions provide a Help link When selected the CMS specifications for the question displays in a separate Internet Explorer window An example of the link is below Confidential and Proprietary Page 21 of 192 BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provide
164. mococcal vaccine For CQM field descriptions and additional information Clinic alit Numerator Denominator Please select the PREVIOUS button to go back the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE amp Figure 111 Question 14 Pneumonia Vaccination Status for Older Adults Questionnaire 15 of 64 Red asterisk indicates a required field CMS166v3 NQF 0052 Title Use of Imaging Studies for Low Back Pain Description Percentage of patients 18 50 years of age with a diagnosis of low back pain who did not have an imaging study plain X ray MRI CT scan within 28 days of the diagnosis For field descriptions and additional information Clinical Quality Measure Page Numerator Denominator Exclusions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 0 PREVIOUS PAGE SAVE AND CONTINUE 83 Figure 112 COM Question 15 Use of Imaging Studies for Low Back Pain Confidential and Proprietary Page 161 of 192 WEST VIRGINIA rt nt Healt BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 16 of 64 Red asterisk indicates a required field CMS131v2 NQF 0055 Title Diabetes Eye Exam Description Percentage of patients 18 75 years of age with diabetes who had a retinal or dilat
165. mp CONTINUE button to proceed 3 PREVIOUS PAGE SAVE AND CONTINUE 83 Figure 79 MU Core Question 15B Summary of Care Confidential and Proprietary Page 133 of 192 WEST VIRGINIA t of tha BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 15B of 17 Red asterisk indicates a required field Summary of Care Objective The EP who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care should provide summary care record for each transition of care or referral Measure The EP who transitions or refers their patient to another setting of care or provider of care provides a summary of care record for more than 10 percent of such transitions and referrals either a electronically transmitted using CEHRT to a recipient or b where the recipient receives the summary of care record via exchange facilitated by an organization that is a NwHIN Exchange participant or in a manner that is consistent with the governance mechanism ONC establishes for the NwWHIN Complete the following information All information entered may be subject to audit that could result in payment recoupment Numerator The number of transitions of care and referrals in the denominator where summary of care record was a electronically transmitted using CEHRT to a recipient or b where the recipient
166. n 3 of this document lists required documentation If you have entered OOS encounters you are required to upload two documents which are a certification letter that volumes are from the state s MMIS and the report from the state s MMIS department gt To Add Document 1 Select Add Document to display the following screen Add Document Date and Time File Name Title Description Title Description Please selectthe ADD button to add your document the list Figure 43 Supporting Documentation Add Screen Select File to upload from your computer Select the Select button On Hiles window navigate through your computer and select the file to upload Select Ok Document name displays in the File Name box 2 Enter in Title 3 Enter in Description of file Page 82 of 192 Confidential and Proprietary WEST VIRGINIA Department of Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 4 Select Add add more files Repeat Steps 4 Edit Document Select Edit next to the desired document 2 The Supporting Documentation Add screen fields displays with Update and Cancel buttons instead 3 Modify the information 4 Select Update To Delete Document 1 Select Delete next to the desired document 2 Answer Are you sure question appropriately Select the Submit
167. nd continues throughout the current EHR reporting period Registration with the PHA or other body to whom the information is being submitted of intent to initiate ongoing submission was made by the deadline within 60 days of the start of the EHR reporting period and ongoing submission was achieved Registration of intent to initiate ongoing submission was made by the deadline and the EP is still engaged in testing and validation of ongoing electronic submission Registration of intent to initiate ongoing submission was made by the deadline and the EP is awaiting invitation to begin testing and validation Registry Name m ZR For additional information CMS Specification Sheet Figure 84 MU Core Question 16 Additional Information Entry Screen Page 138 of 192 Confidential and Proprietary WEST VIRGINIA D tment of Healt Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 17 of 17 Red asterisk indicates a required field Use Secure Electronic Messaging Objective Use secure electronic messaging to communicate with patients on relevant health information Measure A secure message was sent using the electronic messaging function of CEHRT by more than S percent of unique patients or their authorized representatives seen by the EP during the EHR reporting period EXCLUSION Any EP who has no office
168. ng and validation of ongoing electronic submission Registration of intent to initiate ongoing submission was made by the deadline and the EP is awaiting invitation to begin testing and validation Registry Name For additional information GMS Specification Sheet Please selec the REVIOLIS PAGE button to za back or the SAVE amp CONTINUE button t3 prozeed VIOUS AGE SAVE AND CONTINUE E Figure 95 Menu Measures Question 5 Additional Information Entry Screen Confidential and Proprietary Page 149 of 192 Department de Hon BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 6 of 6 Red asterisk indicates a required field Report Specific Cases Objective Capability to identify and report specific cases to a specialized registry other than a cancer registry except where prohibited and in accordance with applicable law and practice Measure Successful ongoing submission of specific case information from CEHRT to a specialized registry for the entire EHR reporting period EXCLUSION Any EP that meets at least 1 of the following criteria may be excluded from this objective Please select the exclusion option that applies to you The EP does not diagnose or directly treat any disease associated with a specialized C registry sponsored by a national specialty society for which the EP is eligible or the public h
169. ng the COM data to the NJ state agency CMS provided the following guidance for the CQMs CMS has also published a recommended core set of COMs for eligible professionals that focus on high priority health conditions and best practices for care delivery 9 COMs for adult populations that meet all of the program requirements 9 COMs for pediatric populations that meet all of the program requirements These recommended core sets focus on conditions that contribute to the morbidity and mortality of most Medicare and Medicaid beneficiaries and also focus on areas that represent national public health priorities or disproportionately drive health care costs If one of these sets is applicable to your patient population CMS recommends choosing these 9 COMs http www cms gov Regulations and Guidance Legislation EHRIncentivePrograms Downloads Stage2 Guid e Eps 9 23 13 pdf 1 1 Eligible Professionals EP Attestation for Year 2 and beyond is not solely concentrated on meeting Meaningful Use and reporting on CQMs You are still required to be eligible for the incentive program for WV Medicaid The Center for Medicare amp Medicaid Services CMS has defined eligible professionals for the Electronic Health Record Incentive program for Medicaid as follows e An actively enrolled Medicaid Provider with the State Medicaid program with one of the below provider types Physician primarily doctors of medicine and doctors of osteopathy Nurse practi
170. nical Quality Measure Page Numerator Denominator Exceptions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE EJ Figure 126 COM Question 29 Diabetic Retinopathy Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy Confidential and Proprietary Page 169 of 192 Health Hunian BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 30 of 64 Red asterisk indicates a required field CMS142v2 NQF 0089 Title Diabetic Retinopathy Communication with the Physician Managing Ongoing Diabetes Care Description Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed with documented communication to the physician who manages the ongoing care of the patient with diabetes mellitus regarding the findings of the macular or fundus exam at least once within 12 months For field descriptions and additional information Clinical Quality Measure Page Numerator Denominator Exceptions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 127 COM Question 30 Diabetic Retinopathy Communication with the Physician Managing
171. nline serving West Virginia Medicaid Figure 12 WV Welcome Screen Confidential and Proprietary mI Healt Hu Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Welcome to the Provider Incentive Payment System for the Medicaid EHR Incentive Program About This Site The Medicaid Electronic Health Records EHR Incentive Program provide incentive payments to eligible professionals and eligible haspitals as they demonstrate adoption implementation upgrading or meaningful use af certified EHR technology These incentive programs are designed to support providers in this period of Health IT transition and instill the use of EHRs in meaningful ways to help our nation to improve the quality safety and efficiency of patient health cara The Provider Incentive Payment PIP system 15 for the Medicaid EHR Incentive Program Those wanting to take part in the program will use this system to participate in the program Additional Resources For User Guides to Registration and Attestation that will show you how ta complete these modules a list of EHR technology that is certified for this program specification sheets with additional information on each Meaningful Use objective and other general resources that will help you complete registration and attestation please visit CMS website i5 Eligible to Participate There are two types of groups who can
172. nounters you conducted at each location 50 or more of your patient encounters during the EHR reporting period must be at a practice location or practices locations equipped with certihed EHR technology Add Location Total Practice Narne Location Address Encounters at thes location Edit My First Practice 123 1st Street Charleston WV 12345 Yes Edit My Second Practice 345 2nd street Charleston WV 12345 No p Total Encounters All Practices Locations Percentage with Certified EHR Technology G PREVIOUS PAGE SAVE AND CONTINUE Figure 38 Attestation Tab Certified EHR Technology Page Page 64 of 192 Confidential and Proprietary BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 1 Enter the EHR Certification number 2 Select the option of Meaningful Use 3 The EHR period that displays 1s based on your payment as outlined below 90 day selection date range controls display for the following conditions I AIU which is the first year payment 2 1 year of Meaningful Use second year of payment 3 2014 regardless of payment year Otherwise one year date range is required according to your payment schedule 4 Respond to the 80 of patients records are in an EHR question If answered No attestation progress is not allowed 5 Respond to the Multiple Locations Practices question If you did not practice at m
173. ns on how to start the WV EHR Incentive Solution application and logging into the system to use the application Please obtain authorization from the registering provider to enter the data on their behalf Page 28 of 192 Confidential and Proprietary WEST VIRGINIA Department of Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 9 1 1 Starting WV EHR Incentive Program Application The application runs on the Internet Execute the following steps to start the application 1 Access the www wvmmis com main page As shown in the figure below gt B Home Bl Login Health PAS Online Registration Password Reset Site Requirements Suggestions Reference Contact V v MMIS Documents B rao Forms B Manuals B Hewsletters Pharmacy Provider Directory B user Guides powered by xjsERIES M Logon Name Password Only approved West Virginia Medicaid EDI Trading Partners are authorized to E Use web browser forms to submit Professional Institutional and Dental claim transactions Use a web browser form to submit Claim Status Request transactions Bb Use a web browser form to submit Eligibility Benefit Request transactions and B Upload and download files to and from West Virginia Medicaid To begin enter your logon name and password If vou have not selected logon name and password and
174. nts on relevant health information Measure A secure message was sent using the electronic messaging function of CEHRT by more than 5 percent of unique patients or their authorized representatives seen by the EP during the EHR reporting period Complete the following information All information entered may be subject to audit that could result in payment recoupment Numerator The number of patients or patient authonzed representatives in the denominator who send a secure electronic message to the EP that is received using the electronic messaging function of CEHRT during the EHR reporting penod Denominator Number of unique patients seen by the EP during the EHR reporting period Numerator Denominator For additional information CMS Specification Sheet Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 86 MU Core Question 17 Numerator amp Denominator Entry question Page 140 of 192 Confidential and Proprietary Department de unn BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 26 Meaningful Use Menu Measures Screen Shots CMS requires that a minimum of three menu set questions are selected All six questions screen shots are displayed The application will only display the questions that are selected by the user Questionnair
175. ocess to proceed with submission For Year 1 providers do not have to demonstrate Meaningful Use Meaningful Use question responses will be recorded if completed but not scored for Year 1 The WV EHR Incentive Payment Solution will verify providers meet the above requirements by validating the provider s claims based data within the MMIS upon incentive payment registration and attestation In addition to validating the above criteria electronically the system will perform the following validations Q Providers must pass a systematic check of claims volume and place of service relative to the amount of Medicaid patient volume they claim to have seen during the attestation process they complete online Claims for providers for patients within a hospital setting will not be considered for their Medicaid patient volume since providers are supposed to by predominately office based Providers will not be paid if currently under review with the State of West Virginia or not actively enrolled with Medicaid The provider s Pay To providers indicated within the NLR registration must also be an active Medicaid provider to receive payment on behalf of the attesting provider 1 2 Registering with CMS The provider does not need to register with CMS from Year 2 and beyond However if the information reported to CMS needs to be updated the provider may log into the CMS registration website to do so If you review your CMS registration and no change
176. of age with diabetes who had hemoglobin Alc gt 9 0 during the measurement period For CQM field descriptions and additional information Numerator Denominator Exclusions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 115 COM Question 18 Diabetes Hemoglobin A1C Poor Control Questionnaire 19 of 64 Red asterisk indicates a required field CM5148v2 NQF 0060 Title Hemoglobin Alc Test for Pediatric Patients Description Percentage of patients 5 17 years of age with diabetes with an HbA1c test during the measurement period For CQM field descriptions and additional information Numerator Denominator Exclusions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed fg PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 116 COM Question 19 Hemoglobin A1C test for Pediatric Patients Confidential and Proprietary Page 163 of 192 Department de Hon BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 20 of 64 Red asterisk indicates a required field CMS134v2 0062 Title Diabetes Urine Protein Screening Description The percentage of patients 18 75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during th
177. ortal a Medicaid enrolled provider must visit https www wvmmis com TradingPartnerRegistration aspx or contact WV Medicaid Provider Services staff at 1 888 483 0793 or via email at wvmmis molinahealthcare com Confidential and Proprietary Page 17 of 192 Department of UM BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 5 Determine If Intend to Use Group Clinic Medicaid Volume to Meet Medicaid Volume Requirements Providers may elect to use group practice or clinic locations encounter to achieve the 30 Medicaid volume requirement for incentive payment If the provider elects to use the group or clinic total as the proxy for encounter volume all providers within that practice or location must also do so if they intend to attest for incentive payment and report their volume using the practice or clinic NPI accordingly EPs may use a clinic or group practice s patient volume as a proxy under three conditions l The clinic or group practice s patient volume is appropriate as a patient volume methodology calculation for the EP for example 1f an EP only sees Medicare commercial or self pay patients this 1s not an appropriate calculation There is an auditable data source to support the clinic s patient volume determination So long as the practice and EPs decide to use one methodology in each year in other Words clinics could not have some of
178. ou EPs who write fewer than 100 permissible prescriptions during the EHR reporting period would be excluded from this requirement EPs must enter the number of permissible prescriptions written during the EHR reporting period in the Exclusion box to attest to exclusion from this requirement Any EP who does not have a pharmacy within their organization and there are no pharmacies that accept electronic prescriptions within 10 miles of the EP s practice location at the start of his her EHR reporting period C None of the above exclusions apply to me Exclusion Box For additional information CMS Specification Sheet Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE Figure 51 MU Core Question 2 e Prescribing eRx Confidential and Proprietary Page 105 of 192 west VIRGINIA Healt Go Hun BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 2 of 17 Red asterisk indicates a required field e Prescribing eRx Objective Generate and transmit permissible prescriptions electronically eRx Measure More than 50 percent of all permissible prescriptions or all prescriptions written by the EP are queried for a drug formulary and transmitted electronically using CEHRT Complete the following information All information entered may be s
179. ources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 4 of 4 Red asterisk indicates a required field Needy Patient Volume at FOHC RHC EPs who practice predominantly at an or RHO must meet a certain needy patient volume threshold to be eligible for an incentive payment Select any 90 day period in the previous calendar year for your patient volume figures Start Date 10 3 2010 End Date 12 31 2010 Complete the follawing information Numerator Number of patient encounters at an FQHC or RHE in which the patient received medical assistance fram Medicaid the patient received medical assistance from CHIP patient was furnished uncompensated care the patient was furnished services at either no cost or reduced cost based on a sliding scale determined by the individual s ability ta pay Number of patient encounters at an FQHC or RHC in which the patient is a needy individual Denominator All patient encounters at an FQHC or RHC over the 90 day period FU UL Out of State Needy Patient Volume at FQHC RHC If you or your proxy provider saw patients who belong to another Medicaid payer out of State and wish ta count these patients towards your total Medicaid Patient volume for incentive qualification please record the numbers by clicking the Add State text below Please note that any out of state M
180. populations for which data is collected by their jurisdiction s immunization registry or immunization information system during the EHR reporting period The EP operates in a jurisdiction for which no immunization registry or immunization information system is capable of accepting the specific standards required for CEHRT at the start of their EHR reporting period The EP operates in a jurisdiction where no immunization registry or immunization information system provides information timely on capability to receive immunization data The EP operates in a jurisdiction for which no immunization registry or immunization information system that is capable of accepting the specific standards required by CEHRT at the start of their EHR reporting period can enroll additional EPs C None of the above exclusions apply to me For additional information CMS Specification Sheet Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed Figure 83 MU Core Question 16 Immunization Registries Data Submission Confidential and Proprietary Page 137 of 192 WEST VIRGINIA ment of coe Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 16 of 17 Red asterisk indicates a required field Immunization Registries Data Submission Objective Capability to submit electronic data to immunization r
181. purpose of the Attestation Eligibility section 1s to determine if the practice setting and Medicaid thresholds are met In order to be eligible for the Medicaid EHR Incentive Program eligible professionals EPs must meet eligible patient volume thresholds For most professionals this means a 30 eligible patient volume based on total patient encounters For most EPs eligible patient volume only includes Medicaid encounters however EPs that practice predominantly at a Federally Qualified Health Center FQHC or a Rural Health Clinic RHC have different criteria as described in the details below Pediatricians have special rules and are allowed to participate with a reduced eligible patient volume threshold 20 instead of 3096 If pediatricians have greater than 20 but less than a 30 eligible patient volume their annual incentive cap is reduced to 2 3 Pediatricians who achieve 30 eligible patient volume are eligible to receive the full incentive amount they quality for WV EHR Incentive Program defines an encounter as One or more claims for the same patient for the same rendering physician for the same date of service DOS This should be a count of unduplicated per patient per DOS Medicaid Claim Based Encounters in the 90 day period This includes all Medicaid paid encounters including inpatient outpatient and emergency room services The West Virginia EHR Incentive Payment solution will run a report from the MMIS system to validat
182. purposes of supporting Meaningful Use in Years 2 6 Meaningful Use Core There are 17 required core objectives that the user 1s required to answer Confidential and Proprietary Page 39 of 192 Department of Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Meaningful Use Menu Measures A minimun selection of three objectives is chosen from the list of six menu measures objectives Clinical Quality Measures minimum selection of nine from the list of 64 clinical quality measures To access the Attestation process select the Attestation Tab Back To WY MMIS Portal Help My PIP Account Home Registration 8 554107 Status Figure 23 Attestation Tab When selected the Attestation Instructions page displays This page displays the registration ID s that are assigned to the user The user does not need to complete the Attestation process in one sitting Each screen in the Attestation flow has a Save and Continue button This will save changes and allow the user to stop at any time without the loss of data that has been entered on that page The attestation process does not allow the user to skip forward to screens or jump past a screen without entering data The user may edit answers until the attestation 1s submitted To start the attestation process 1 Select the Attestation option on the row for the Registration
183. r Incentive Program MEANINGFUL USE Provider For additional information Clinical Quality Measure Specification Page amp 8 2 2 WV EHR Incentive Program Account Hyperlink Q Displays a screen with an email address box WV EHR Incentive Program will use this email address to send notifications regarding the attestations You may enter a new address or update an existing one Save changes by selecting the Update button Press the Cancel button and changes will not be saved Mq PDIP Account Update Account Red asterisk indicates a required field First Name lame Last Name LastName Email Address CANCEL UPDATE Figure 5 Update Account Screen 8 2 3 Back to WV MMIS Portal Q Displays the WV MMIS Portal Welcome screen Refer to Figure 12 WV Welcome Screen 8 24 Tab The Home tab displays the Home page Refer to Figure 6 Page 22 of 192 Confidential and Proprietary WEST VIRGINIA Department of Healt H Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Home Attestation Status First Successful Login Unsuccessful Login Attempts 0 Notifications Welcome to the Provider Incentive Payment System Medicaid EHR incentive program particpants can complete their attestation and receive incentive payments this system You will need to demonstrate adoption implementation up
184. r type in the NLR registration does not match WY Medicaid s provider type Provider has reported a payee NPI in CMS registration that is not a valid payee NPI within the Medicaid system Reason for rejection For more information on eligible providers for the EHR Provider Incentive Program please visit www wvymmis com and refer to the instructions and FAQ s If you need any other assistance regarding eligibility for the EHR s Provider Incentive Program please contact 888 483 0793 option 8 for the Provider Service EHR Provider Incentive Program help desk Thank you for using the PIP system Version 1 0 0 1 WEST VIRGINIA Depar Resources DINCAIL CAD MCNICAL CCDVIACC Page 90 of 192 Confidential and Proprietary WEST VIRGINIA Department of Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 16 Attestation Error Practice Predominately in a Hospital Setting Email Claims checks are part of the processing If it was found that the provider practiced predominately in a hospital the attestation 1s ineligible and the email 1s sent From PIP Administrator Date Monday February 13 2012 11 49 AM To Subject PIP Attestation rejected The provider whose details are listed below has been found to be not eligible for the payment incentive program due to the below reason NPI ID 191 Provider Name Provider Name Organiza
185. ram MEANINGFUL USE Provider 6 The system calculates the number of encounters for Needy Individuals encounters using the information entered in steps 1 5 7 Enter the Denominator DEFINITION This is the total number of patient encounters the FOHC RHC had for the specified time frame based on reports from the practice management system or EHR systems not add commas The system will format with commas after entry 8 Out of State Entry Optional The screen allows for entry of out of state entries The following is a sample of a screen to display the different options available to the user Each option s instructions are bulleted sections following this screen shot Out of State Needy Patient Volume at FQHC RHC If vou or your proxy provider saw patients who belong ta another Medicaid payer out of State and wish to count these patients towards your total Medicaid Patient volume for incentive qualification please record the numbers by clicking the Add State text below Please note that any out of state Medicaid patients that you add must be verified by a report from Medicaid State payer identified showing claims volume for the time frame specified and attached to this attestation You willbe asked to upload your supporting documents at the end of this attestation on the Submit Attestation page Add State State Total Needy Patient Encou nters Total FGHEIRHC Patient Encounters 100 310 Remove Figure 34 Out of
186. ratory orders during the EHR reporting period would be excluded from this requirement EPs must enter the number of laboratory orders recorded during the EHR reporting period in the Exclusion box to attest to exclusion from this requirement Does this exclusion apply to you C Yes C No Exclusion Box For additional information CMS Specification Sheet Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed B PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 49 MU Core 1C Question CPOE Medication Radiology and Laboratory Orders Confidential and Proprietary Page 103 of 192 west VIRGINIA Healt Go Hun BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Attestations gt Attest gt Meaningful Use Core Measures gt Core Measure Questionnaire 1C of 17 Red asterisk indicates a required field CPOE for Medication Radiology and Laboratory Orders Objective Use computerized provider order entry CPOE for medication radiology and laboratory orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state local and professional guidelines Measure More than 30 percent of laboratory orders created by the EP during the EHR reporting period are recorded using CPOE Complete the following information All information entered may be subject to audit
187. receives the summary of care record via exchange facilitated by an organization that is a NWHIN Exchange participant or in a manner that is consistent with the governance mechanism ONC establishes for the nationwide health information network The organization can be a third party or the sender s own organization Denominator Number of transitions of care and referrals during the EHR reporting penod for which the EP was the transferring or referring provider Numerator Denominator For additional information CMS Specification Sheet Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE 83 Figure 80 MU Core Question 15B Numerator amp Denominator Entry Screen Page 134 of 192 Confidential and Proprietary WEST VIRGINIA D rtment of Healt H Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 15C of 17 Red asterisk indicates a required field Summary of Care Objective The EP who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care should provide summary care record for each transition of care or referral Measure An EP must satisfy one of the following criteria Conducts one or more successful electronic exchanges of a summary of care document a part of
188. recording blood pressure 2 Believes that all 3 vital signs of height length weight and blood pressure have no relevance to their scope of practice is excluded from recording them 3 Believes that height length and weight are relevant to their scope of practice but blood pressure is not is excluded from recording blood pressure 4 Believes that blood pressure is relevant to their scope of practice but height length and weight are not is excluded from recording height length and weight Please select the exclusion option that applies to you Any EP who sees no patients 3 years or older is excluded from recording blood pressure Any EP who believes that all 3 vital signs of height length weight and blood pressure have no relevance to their scope of practice is excluded from recording them Any EP who believes that height length and weight are relevant to their scope of practice but blood pressure is not is excluded from recording blood pressure Any EP who believes that blood pressure is relevant to their scope of practice but height length and weight are not is excluded from recording height length and weight None of the above exclusions apply to me For additional information Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed Figure 54 MU Core Question 4 Record Vital Signs Page 108 of 192 Confidential and Proprietary WEST VIRGINIA t t of
189. riptions and additional information Clinica Population Criteria 1 Numerator 1 Denominator 1 Exclusions Exceptions Population Criteria 2 Numerator 2 Denominator 2 Exclusions Exceptions Population Criteria 3 Numerator 3 Denominator 3 Exclusions Exceptions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed GJ PREVIOUS PAGE SAVE AND CONTINUE Figure 152 CQM Question 55 Preventive Care and Screening Cholesterol Fasting LDL C Test Performed Confidential and Proprietary Page 187 of 192 Department de Hon BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 56 of 64 Red asterisk indicates a required field CMS64v3 Title Preventive Care and Screening Risk Stratified Cholesterol Fasting Low Density Lipoprotein LDL C Description Percentage of patients aged 20 through 79 years who had a fasting LDL C test performed and whose nsk stratified fasting LDL C is at or below the recommended LDL C goal For CQM field descriptions and additional information Clini Population Criteria 1 Numerator 1 Denominator 1 Exclusions Population Criteria 2 Numerator 2 Denominator 2 Exclusions Population Criteria 3 Numerator 3 Denominator 3 Exclusions Please select the PREVIOUS PAGE
190. rms are all PHI 45 CFR Parts 160 and 164 Standards for Privacy of Individually Identifiable Health Information Final Rule Page 2 of 192 Confidential and Proprietary Department of de Huron BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Revision History 01 29 2014 Joseph White Final QA Submission Confidential and Proprietary Page 3 of 192 Department of UM BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Table of Contents Mi 11 Costo RR RR RR RET ARR RS 12 1 1 E E A E E E AE E 13 1 2 BRS TAE E e PO E EEE T EEE AE E E A T 14 PEN clics Needed MM 15 2 Eligible Provider Attestation Workbook Overview sees 15 3 Required Supporting Documentation ccce eee e eee e eee ette eese es ssss asus 16 4 Obtaining an West Virginia WV Medicaid Management Information System WYM MISS EO JU 17 5 Determine If Intend to Use Group Clinic Medicaid Volume to Meet Medicaid Volume REQUIECDIOD S QU EEUU rU 18 6 Finding Certification Number eee e cecus eee ee eee eee eese esee esses esee eee eeessssssssos 19 XE LITT 20 ME
191. rs created by the EP during the EHR reporting period are recorded using CPOE EXCLUSION EPs who write fewer than 100 medication orders during the EHR reporting period would be excluded from this requirement EPs must enter the number of medication orders recorded dunng the EHR reporting period in the Exclusion box to attest to exclusion from this requirement Does this exclusion apply to you C Yes C No Exclusion Box For additional information CMS Specification Sheet Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE 83 Figure 46 MU Core Question 1A CPOE for Medication Radiology and Laboratory Page 100 of 192 Confidential and Proprietary WEST VIRGINIA tmen Healt Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Attestations gt Attest gt Meaningful Use Core Measures gt Core Measure Questionnaire 1B of 17 Red asterisk indicates a required field CPOE for Medication Radiology and Laboratory Orders Objective Use computerized provider order entry CPOE for medication radiology and laboratory orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state local and professional guidelines Measure More than 30 percent of radiology orders created by the EP during
192. rtified EHR Technology CEHRT as structured data Generate lists of patients by specific conditions to use for quality improvernent reduction of disparities research or outreach Use clinically relevant information to identify patients who should receive reminders for preventive follow up care and send these patients the reminders per patient preference Use clinically relevant information from Certified EHR Technology to identify patient specific education resources and provide those resources to the patient The EP who receives a patient from another setting of care or provider of care or believes an encounter is relevant should perform medication reconciliation The EP who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care should provide summary care record for each transition of care or referral Capability to submit electronic data to immunization registries or immunization prohibited and in accordance with applicable law and practice Use secure electronic messaging tc communicate with patients on relevant health information West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Measure 1 Implement five clinical decision support interventions related to four or more clinical quality measures at a relevant point in patient care for the entire EHR reporting period Absent four clinical quality meas
193. rting period The EP operates in a jurisdiction where no PHA provides information timely on capability to receive electronic cancer case information The EP operates in a jurisdiction for which no public health agency that is capable of receiving electronic cancer case information in the specific standards required for CEHRT at the beginning of their EHR reporting period can enroll additional EPs C None of the above exclusions apply to me For additional information CMS Specification Sheet Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE amp Figure 94 Menu Measures Question 5 Report Cancer Cases Page 148 of 192 Confidential and Proprietary WEST VIRGINIA rtment of Healt Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 5 of 6 Red asterisk indicates a required field Report Cancer Cases Objective Capability ta identify and report cancer cases to a public health central cancer registry except where prohibited and in accordance with applicable law and practice Measure Successful ongoing submission of cancer case information from CEHRT to a public health central cancer registry for the entire EHR reporting period Complete the following information EPs must attest YES to successful ongoing submission of
194. s Page 46 of 192 Confidential and Proprietary WEST VIRGINIA Department ot Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Back To WV MMIS Portal Help My PIP Account Mome Registration Attestation Status Eligibility stestations gt Astest gt Eligibility Questionnaire 1 of 4 Red asterisk indicates a required field Service Setting Hospital based eligible professionals are not eligible for incentive payments An elo ble professiona i considered hosptal based f 90 4 or more of his or her services are performed in a hospital inpatient Place Of Service code 21 or emergency room Place Of Service code 23 setting Complete the following information you perform 90 of your services in an inpatient hospital or emergency room hospital setting C Yes C No Plesce select the PREVIOUS PAGE button to go beck or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE a wv Medicaid Provider Services Box 2002 Charleston WY 25327 2002 Figure 27 Attestation Tab Service Setting 8 Select YES if hospital based then select Save and Continue button Eligibility Attestations Attest Eligibility Questionnaire I of 4 You are NOT currently eligible to receive an incentive payment under the Medicaid EHE Incentive Program CCS Red asterisk indicates a requ
195. s or 3 years after audits with any and all exceptions having been declared resalved by your state s Medicaid office or the LI 5 Department of Health and Human Services OHHS Attestation Sefection Identify the desired attestation and select the Action you vould like to perform Please note only one Action can be performed at a time on this page Provider Identifier HP Program Year Re Status Action 201 1 Provider Name i 1 07172010 Figure 8 Attestation Tab Confidential and Proprietary Page 25 of 192 Department of Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 8 2 7 The Standard Buttons There are certain buttons found below the fields of each functional window that enables certain actions The available actions depend on the purpose of the window The most common buttons associated with WV EHR Incentive Payment Program are the Previous Page and the Save and Continue buttons The Previous Page button displays the previous page in page sequence The Save and Continue button must be selected after information is entered If not any entries in the window are lost and must be re entered The Submit button is also an option and is used when the user 1s ready to submit the answers for review and possible payment Refer to Figure 9 Please select the PREVIOUS PAGE button to go back or the S
196. s and older with a diagnosis of Clinical r NQF 0565 uncomplicated cataract who had cataract surgery and no significant ocular conditions Process Effectiveness impacting the visual outcome of surgery and had best corrected visual acuity of 20 40 or better distance or near achieved within 90 days following the cataract surgery Title Pregnant Women That Had HBsAg Testing Patient Safety z Description This measure identifies pregnant women who had a HBsAg hepatitis B nM Lj NQF 0608 Process Effectiveness test during their pregnancy Title Depression Remission at Twelve Months CMS159v2 Description Adult patients age 18 and older with major depression or dysthymia and Clinical NQF 0710 an initial PHQ 9 score 9 who demonstrate remission at twelve months defined as wp PHQ 9 score less than 5 This measure applies to both patients with newly diagnosed and existing depression whose current PHQ 9 score indicates a need for treatment Title Depression Utilization of the PHQ 9 Tool CMS160v2 Description Adult patients age 18 and older with the diagnosis of major depression or Clinical r NQF 0712 dysthymia who have a PHQ 9 tool administered at least once during a 4 month period Process Effectiveness in which there was a qualifying visit Title Children Who Have Dental Decay or Cavities Clinical CMS75v Description Percentage of children age 0 20 years who have had tooth decay or SEE eee cavities during the measurement period
197. s are made you will still need to submit the registration If you do not this will stop the processing of your attestation Page 14 of 192 Confidential and Proprietary Department of Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 2 Information Needed Before a provider can begin to complete the EHR Incentive Program attestation process the provider or clinic practice will need to gather all of the information necessary to complete the attestation correctly The West Virginia EHR Incentive program has created a workbook to guide the provider or representative user through obtaining the appropriate data needed to complete an attestation successfully The workbook is available in PDF format This workbook is embedded within this User Manual in the immediate pages below as well as available on the www wvmmis com web portal The Provider Workbook provides the questions CMS requires and can be used to gather answers before logging into the WV EHR Incentive Payment online application The items below provide the minimum that 1s needed in order to use the Provider Incentive Program application in addition to the workbook 2 1 Eligible Provider Attestation Workbook Overview The workbook describes the eligibility requirements the Meaningful Use Core and Menu Measures and the Clinical Quality Measures for the professional provider and web requirements for uti
198. s of the macular or fundus exam at least once within 12 months Title Falls Screening for Future Fall Risk Description Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period Title Adult Major Depressive Disorder MDD Suicide Risk Assessment Description Percentage of patients aged 18 years and older with a diagnosis of major depressive disorder MDD with a suicide risk assessment completed during the visit in which a new diagnosis or recurrent episode was identified Title Anti depressant Medication Management Description Percentage of patients 18 years of age and older who were diagnosed with major depression and treated with antidepressant medication and who remained on antidepressant medication treatment Two rates are reported a Percentage of patients who remained on an antidepressant medication for at least 84 days 12 weeks b Percentage of patients who remained on an antidepressant medication for at least 180 days 6 months Clinical Process Effectiveness Clinical Process Effectiveness Clinical Process Effectiveness Clinical Process Effectiveness Clinical Process Effectiveness Patient Safety Clinical Process Effectiveness Clinical Process Effectiveness Confidential and Proprietary WEST VIRGINIA D t t of Healt H Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Pro
199. se Secure Electronic 139 Figure 86 MU Core Question 17 Numerator amp Denominator Entry question 140 Figure 87 Menu Measures Question 1 Syndromic Surveillance Data Submission 141 Figure 88 Menu Measure Question 1 Additional Information Entry Screen 142 Figure 89 Menu Measure Question 2 Electronic enn 143 Figure 90 Menu Measures Question 3 Imaging 144 Figure 91 Menu Measures Question 3 Numerator amp Denominator Entry Screen 145 Figure 92 Menu Measures Question 4 Family Health History 146 Figure 93 Menu Measures Question 4 Numerator amp Denominator Entry Screen 147 Figure 94 Menu Measures Question 5 Report Cancer 148 Figure 95 Menu Measures Question 5 Additional Information Entry Screen 149 Figure 96 Menu Measures Question 6 Report Specific Cases 150 Figure 97 Menu Measures Question 6 Additonal Information Entry Screen 151 Figure 98 COM Question 1 Appropriate Testing for Children with Pharyngitis 152 Figure 99 COM Question 2 Initiation and Engagement of Alcohol amp Other Drug D
200. se select the criteria that was met and enter the registry name Ongoing submission was already achieved for an EHR reporting period in a prior year and continues throughout the current EHR reporting period Registration with the PHA or other body to whom the information is being submitted of intent to initiate ongoing submission was made by the deadline within 60 days of the start of the EHR reporting period and ongoing submission was achieved Registration of intent to initiate ongoing submission was made by the deadline and the EP is still engaged in testing and validation of ongoing electronic submission Registration of intent to initiate ongoing submission was made by the deadline and the EP is awaiting invitation to begin testing and validation Registry Name For additional information CMS Specification Sheet Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed Figure 97 Menu Measures Question 6 Additional Information Entry Screen Confidential and Proprietary Page 151 of 192 WEST VIRGINIA Healt Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 27 Clinical Quality Measures Screen Shots Below are screen shots for the 64 CQMs that are available for selection Questionnaire 1 of 64 Red asterisk indicates a required field CMS146v2 NQF 0002 Title Appropriate Testin
201. sources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 15B of 17 Red asterisk indicates a required field Summary of Care Objective The EP who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care should provide summary care record for each transition of care or referral Measure The EP who transitions or refers their patient to another setting of care or provider of care provides a summary of care record for more than 10 percent of such transitions and referrals either a electronically transmitted using CEHRT to a recipient or b where the recipient receives the summary of care record via exchange facilitated by an organization that is a NwHIN Exchange participant or in a manner that is consistent with the governance mechanism ONC establishes for the NwHIM EXCLUSION EPs who transfer a patient to another setting or refer a patient to another provider less than 100 times during the EHR reporting period would be excluded from this requirement EPs must enter the number of transfers and referrals during the EHR reporting period in the Exclusion box to attest to exclusion from this requirement Does this exclusion apply to you For additional information CMS Specification Sheet Please select the PREVIOUS PAGE button to go back or the SAVE a
202. sources identified by Certified EHR Technology are provided to patients for more than 10 percent of all unique patients with office visits seen by the EP during the EHR reporting period EXCLUSION EPs who have no office visits during the EHR reporting period would be excluded from this requirement Does this exclusion apply to you C Yes C No For additional information CMS Specification Sheet Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE 2 Figure 73 MU Core Question 13 Patient Specific Education Resources Confidential and Proprietary Page 127 of 192 Health Hunian BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 13 of 17 Red asterisk indicates a required field Patient Specific Education Resources Objective Use clinically relevant information from Certified EHR Technology to identify patient specific education resources and provide those resources to the patient Measure Patent specific education resources identified by Certified EHR Technology are provided to patients for more than 10 percent of all unique patients with office visits seen by the EP during the EHR reporting period Complete the following information All information entered may be subject to audit that could result in payment recoupment Numerator Number of pa
203. t 888 463 0793 option 8 for the Provider Service EHR CMS and your state s Medicaid office recommends documentation are retained in case of audit Please rewiew your state s Medicaid requirements and applicable provider manuals for the specific service requirements retention periods and lists Providers must maintain records in accordance with Federal regulations for 4 period of 5 years or 3 Years after audits with any and all exceptions having been declared resolved by your state s Medicaid office or the U S Department of Health and Human Services DHHS The provider must make all records and documentation available upon request to your state s Medicaid office andor DHHS Such records and documentation must include but not be limited to o Financial Records o Practicing Provider Information credentials Identification of Service Sites Dates of Service for Each Service Component by Patient Patient Records Invoices lease agreement supporting Adopt Implementation Utilizationg o Reports supporting Meaningful Use attestation e FOR AIL evidence CMS and State recommends that a least one or more of the following documentation is retained o a signed contract o a8 user agreement o purchase order o purchase receipt ar o license agreement CMS and your state s Medicaid office recommends documentation are retained in case of audit Providers must maintain records in accordance with Federal regulations for a period of 5 year
204. t have been tested and certified under the Temporary Certification Program maintained by the Office of the National Coordinator for Health IT ONC Each Complete EHR and EHR Module listed below has been certified by an ONC Autharized Testing and Certification Body ONC ATCB and reported to ONC Only the product versions that are included on the CHPL are certified under the ONC Temporary Certification Program Please send suggestions and comments regarding the Certified Health IT Product List CHPL to ONC certification hhs goy with CHPL in the subject line Vendors or developers with questions about their product s listing should contact the ONC Authorized Testing and Certification Body ONC ATCB that certified their product USING THE CHPL WEBSITE To browse the CHPL and review the comprehensive listing of certified products follow the steps outlined below 1 Select your practice type by selecting the Ambulatory or Inpatient buttons below 2 Selectthe Browse button to view the list of CHPL products To obtain a CMS EHR Certification ID follow the steps outlined below Select your practice type by selecting the Ambulatory or Inpatient buttons below Search for EHR Products by browsing all products searching by product name or searching by criteria met 1 2 3 Add product s to your cart to determine if your product s meet 100 of the required criteria 4 Request a CMS EHR Certification ID for CMS registration or attestation from
205. t the CMS Website Diesre allow at least 24 hours for the State to receive and process your regstratio Once the State as received and processed your registration you ca add the registration to the hst below Registratons i this hst wil appears o t e Attestato tad and the Status tab Select one of the following acbo s to manage t e reg strabo s associated mth your Provider Payment System 212 uper eccount Add Registration Please select the ADD REGISTRATION button to assocate eg strato wth your user account for any of the following reasons e You are EP or eligible hospital and have completed the Medicaid Incentive Program regatrat o at the CMS Website You nent to sssociste t e registration wth your 210 account to Degen attestato e You are working o behalf of a EP or eligibile hospital and went to view the providers EHR incentive Program records and or attest o be alf of the provider View Registration Please select the View action next to the registration in the list to view the registration information that nas entered at the CMS Viebsete Remove Registration lease select the Remove actor next to the regutration i the bat to disassociate the registration from your PIP user account The registration and attestabon information sl not be lost You can e assoCate the registration by selecting the ADO AEGISTARATION Button Registration Selection identity the desired registration and se
206. tage of patients aged 18 years and older seen during the reporting penod who were screened for high blood pressure AND a recommended follow up plan is documented based on the current blood pressure BP reading as indicated For CQM field descriptions and additional information Numerator Denominator Exclusions Exceptions Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed G PREVIOUS PAGE SAVE AND CONTINUE Figure 161 COM Question 64 Preventive Care and Screening Screening for High Blood Pressure and Follow Up Documented Page 192 of 192 Confidential and Proprietary
207. the CMS website to edit the information Registration ID 10 Business Address Probie ame PO BOM 4 TIN XXX XX 1234 SSN Charleston WY 25364 4009 NPI 17 Phone 3012881288 Payee NPI 18 E Mail kcapihealtheare com Payee TIN 12346798 Incentive Program Medicaid Please select the Medicaid ID associated with NPI 17 Medicaid ID 0000000008 10 14 2010 12 31 2078 Please select the Medicaid ID associated with Payee NPI 18 Payee Medicaid ID 5000005000 10 1 2001 1231 2078 Does the attesting provider wish to use their group practice s patient volume as a proxy for their own for the purpose of meeting the 30 Medicaid volume required for meeting incentive payment requirements C Yes No If Yes then please enter the NPI of your practice organization you are electing to use as group practice s patient volume as a proxy for meeting the volume requirements Organization NPI Note The solution will validate all the claims wolume for the NPI of the organization you have identified where the organization is the pay to provider on the claim ws the claims submitted by the attesting provider as the attending rendenng provider Please make sure you are supplying the correct NPI for your organization Please select the PREVIOUS PAGE button to qo back or the SAVE amp CONTINUE button to praceed PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 26 Attestation Tab Verify Registration
208. the EHR reporting period are recorded using CPOE EXCLUSION EPs who write fewer than 100 radiology orders during the EHR reporting penod would be excluded from this requirement EPs must enter the number of radiology orders recorded during the EHR reporting period in the Exclusion box to attest to exclusion from this requirement Does this exclusion apply to you C Yes C No Exclusion Box For additional information CMS Specification Sheet Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 0 PREVIOUS PAGE SAVE AND CONTINUE 2 Figure 47 MU Core Question 1B CPOE for Medication Radiology and Laboratory Confidential and Proprietary Page 101 of 192 west VIRGINIA Healt de Hon BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Attestations gt Attest gt Meaningful Use Core Measures gt Core Measure Questionnaire 1B of 17 Red asterisk indicates a required field CPOE for Medication Radiology and Laboratory Orders Objective Use computerized provider order entry CPOE for medication radiology and laboratory orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state local and professional guidelines Measure More than 30 percent of radiology orders created by the EP during the EHR reporting period are recorded usin
209. the EPs using their individual patient volume for patients seen at the clinic while others use the clinic level data The clinic or practice must use the entire practice s patient volume and not limit it in any way EPs may attest to patient volume under the individual calculation or the group clinic proxy in any participation year Furthermore if the EP works in both the clinic and outside the clinic or with and outside a group practice then the clinic practice level determination includes only those encounters associated with the clinic practice Page 18 of 192 Confidential and Proprietary WEST VIRGINIA artment of Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 6 Finding EHR Certification Number The Office of the National Coordinator Authorized Testing and Certification Body ONC ATCB tests and certifies electronic medical record EHR systems If the EHR system is approved it is assigned a certification number The website below 1s the Certified Health IT Product List website to look up EHR certification number or even to register an EHR http onc chpl force com ehrcert i Certified Health IT Product List The Office of the National Coordinator for Health Information Technology HealthlT HHS Gov The Certified HIT Product List CHPL provides the authoritative comprehensive listing of Complete EHRs and EHR Modules tha
210. tients in the denominator who were provided patient specific education resources identified by the Certified EHR Technology Denominator Number of unique patients with office visits seen by the EP during the EHR reporting period Numerator Denominator For additional information CMS Specification Sheet G Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 9 PREVIOUS PAGE SAVE AND CONTINUE Figure 74 MU Core Question 13 Numerator amp Denominator Entry Screen Page 128 of 192 Confidential and Proprietary Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 14 of 17 Red asterisk indicates a required field Medication Reconciliation Objective The EP who receives a patient from another setting of care or provider of care or believes an encounter is relevant should perform medication reconciliation Measure The EP who performs medication reconciliation for more than 50 percent of transitions of care in which the patient is transitioned into the care of the EP EXCLUSION If an EP was not on the receiving end of any transition of care during the EHR reporting period they would be excluded from this requirement Does this exclusion apply to you C Yes No For additional information CMS Specification Sheet G Please select the PREVIOUS PAGE button to go
211. tion Name Reporting Period Name FY2011 Submitted Date 10 1 2011 10 55 12 AM Reason for rejection Attesting provider s claims data shows more than 9096 of services performed in an hospital setting For more information on eligible providers for the EHR Provider Incentive Program please visit www wymmis com and refer to the instructions and FAQ s If you need any other assistance regarding eligibility for the EHR s Provider Incentive Program please contact 888 483 0793 option 8 for the Provider Service EHR Provider Incentive Program help desk Thank you for using the PIP system Version 1 0 0 1 WEST VIRGINIA Healt Hu n Resources BUREAU FOR MEDICAL SERVICES Confidential and Proprietary Page 91 of 192 WEST VIRGINIA Healt Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 17 Attestation Error Medicaid Claims Count Failed Email The solution will check the provider s Medicaid claims that were submitted during the attestation period If there were no claims found for the attestation period the following email will be sent From PIP A amp cdministrator vsz Date Wednesday August 10 2011 1 40 PM To Av test org sunil matteg molinaheatthcare com Subject PIP Attestation rejected The provider whose details are listed below has been found to be not eligible for the payment incentive program due to the below reason
212. tioners Certified nurse midwife Dentist A Physician Assistant who furnishes services in a Federally Qualified Health Center or Rural Health Clinic that 1s led by a physician assistant where 1 PA is the primary provider in a clinic 2 15 clinical or medical director at a clinical site of practice or 3 PA 1s an owner of an RHC Confidential and Proprietary Page 13 of 192 Department of UM BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider e To be eligible for the incentive payment professional providers meeting the provider type requirement above must also meet one of the following Medicaid patient volume criteria O Havea minimum 30 Medicaid patient volume Havea minimum 20 Medicaid patient volume and also be enrolled as a practicing physician with a specialty of pediatrician with WV Medicaid Q Practice predominantly in a Federally Qualified Health Center or Rural Health Center and have a minimum 30 patient volume attributable to needy individuals e provider must also not practice predominately in a hospital setting Providers who see more than 90 of their Medicaid patients in a hospital inpatient or emergency room setting are considered to be practicing predominately in a hospital setting e Providers must indicate if they are adopting upgrading or implementing a certified EHR solution during their attestation pr
213. to the EP Measure More than SO percent of all unique patients seen by the EP during the EHR reporting period are provided timely available to the patient within 4 business days after the information is available to the EP online access to their health information Complete the following information All information entered may be subject to audit that could result in payment recoupment Numerator The number of patients in the denominator who have timely within 4 business days after the information is available to the EP online access to their health information Denominator Number of unique patients seen by the EP during the EHR reporting period Numerator Denominator Briefly describe how the EP provided the required access For additional information CMS Specification Sheet Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 62 MU Core Question 7A Numerator amp Denominator Entry Screen Page 116 of 192 Confidential and Proprietary WEST VIRGINIA D rtment of Healt es unn Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 7B of 17 Red asterisk indicates a required field Patient Electronic Access Objective Provide patients the ability to view online download and transmit their health inform
214. to use Provider Proxy Please enter the election to use the provider proxy usage for Medicaid Volume Please remember that the following criteria must be met The clinic or group practice s patient volume is appropriate as a patient volume methodology calculation for the EP for example if an EP only sees Medicare commercial or self pay patients this is not an appropriate calculation There is an auditable data source to support the clinic s patient volume determination 44 of 192 Confidential and Proprietary BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider The practice and EPs decide to use one methodology in each year in other words clinics could not have some of the EPs using their individual patient volume for patients seen at the clinic while others use the clinic level data The clinic or practice must use the entire practice s patient volume and not limit itin any way EPs may attest to patient volume under the individual calculation or the group clinic proxy in any participation year Furthermore if the EP works both in the clinic and outside the clinic or with and outside a group practice the clinic practice level determination includes only those encounters associated with the clinic practice l Select Yes or No 2 If selected Yes enter organization s NPI number 3 Select Save and Continue button 9 3 1 Attestation Eligibility The
215. topic is completed when the required answers are entered and saved Topics become available as prerequisite topics are completed 4 Select the Start Attestation button to start the attestation process or to continue to add and modify data already entered 5 Select the Submit amp Attest button when satisfied with the data that is entered This submits the responses to determine eligibility for payment processing The responses are also available to be reviewed by the State Submit amp Attest button is disabled on the initial selection of a registration ID Submit amp Attest button is disabled if the Eligibility check was set to Ineligible Page 42 of 192 Confidential and Proprietary Healt H Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 6 Select the Previous page button to display the Attestation Instructions page 7 On selection of the Start Attestation button the Registration Information will display Eligibility Attestations gt Attest gt Verify Registration Verify Registration Information Red asterisk indicates a required field Please review the registration summary below to ensure this is the correct registration information If the information below is correct select the SAVE AND CONTINUE button to proceed with attestation If the information is incorrect then please retum to
216. tor Denominator For additional information CMS Specification Sheet Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 0 PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 69 MU Core Question 10 Numerator amp Denominator Entry Screen Confidential and Proprietary Page 123 of 192 Department de Hurtin BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 11 of 17 Red asterisk indicates a required field Patient Lists Objective Generate lists of patients by specific conditions to use for quality improvement reduction of disparities research or outreach Measure Generate at least one report listing patients of the EP with a specific condition Complete the following information Eligible professionals EPs must attest YES to having generated at least one report listing patients of the EP with a specific condition to meet this measure C Yes No Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 0 PREVIOUS PAGE SAVE AND CONTINUE Figure 70 MU Core Question 11 Patient Lists Page 124 of 192 Confidential and Proprietary WEST VIRGINIA rtment of Healt Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire
217. ubject to audit that could result in payment recoupment Numerator The number of prescriptions in the denominator generated queried for a drug formulary and transmitted electronically using CEHRT Denominator Number of prescriptions written for drugs requiring a prescription in order to be dispensed other than controlled substances during the EHR reporting period or Number of prescriptions written for drugs requiring a prescription in order to be dispensed during the EHR reporting period Numerator Denominator o For additional information CMS Specification Sheet Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 0 PREVIOUS PAGE SAVE AND CONTINUE 2 Figure 52 MU Core Question 2 Numerator amp Denominator Entry Screen Page 106 of 192 Confidential and Proprietary WEST VIRGINIA D tment of Healt H Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 3 of 17 Red asterisk indicates a required field Record Demographics Objective Record the following demographics preferred language sex race ethnicity date of birth Measure More than 80 percent of all unique patients seen by the EP have demographics recorded as structured data Complete the following information All information entered may be subject to audit that could result in payment recoupment
218. uld be excluded from this requirement Does this exclusion apply to you C Yes No For additional information Please select the PREVIOUS PAGE button to qo back or the SAVE amp CONTINUE button to proceed E PREVIOUS PAGE SAVE AND CONTINUE EJ Figure 68 MU Core Question 10 Clinical Lab Test Results Page 122 of 192 Confidential and Proprietary WEST VIRGINIA Healt Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 10 of 17 Red asterisk indicates a required field Clinical Lab Test Results Objective Incorporate clinical lab test results into Certified EHR Technology CEHRT as structured data Measure More than 55 percent of all clinical lab tests results ordered by the EP during the EHR reporting period whose results are either in a positive negative or numerical format are incorporated in Certified EHR Technology as structured data Complete the following information All information entered may be subject to audit that could result in payment recoupment Numerator Number of lab test results which are expressed in a positive or negative affirmation or as a numeric result which are incorporated in CEHRT as structured data Denominator Number of lab tests ordered during the EHR reporting period by the EP whose results are expressed in a positive or negative affirmation or as a number Numera
219. ultiple locations practices during the Meaningful Use period select No You have addressed the multiple locations practices question If you did practice at multiple locations practices during the Meaningful Use period select Yes You will need to add the location practice information and the total number of encounters for each location The Location Practice table allows you to edit or delete the locations practices 1f needed Per CMS at least 50 of the encounters must be at locations practices with a certified EHR Add Location Instructions 1 Select the Add Location icon on the upper left hand corner of the table 2 Enter the Practice Name 3 Enter the Practice location 4 Enter the number of encounters 5 Repeat for each location The system will calculate the percentage Confidential and Proprietary Page 65 of 192 Department of UM BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Edit Location Instructions 1 Select the Edit hyperlink 2 The row is open for your edits The system will calculate the percentage Delete Location Instructions 1 Select the Delete hyperlink 2 The row is deleted e The system will calculate the percentage 6 Select Save and Continue 7 The system validates if all fields have data entered Error message displays if the user did not supply EHR Certification number supply
220. unters will suspend until supporting documentation has been uploaded and validated Supporting documentation is defined as Certification on official letter head from the state Medicaid agency to the provider declaring the information provided was derived from their MMIS and is accurate An accompanying report generated by the state Medicaid agency which identifies the total encounters and the reporting period used in the development of the report Mote The reporting period for OOS encounters must match the reporting period indicated during registration Addpacurnert Date and Time Fil Mame Tile Description This document cantains 02 1 3 201212 33 Sample jpg Tithe of Uploaded Doc Remove Reason s Submission You are an Eligible Professional attesting for a payment year in the incentive program You have decided to resubmit your attestation information PREVIOUS PAGE SUBMIT E3 Figure 42 Attestation Tab Submit Attestation Check Email Address Confidential and Proprietary Page 81 of 192 WEST VIRGINIA Depar ent of Heal H Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Enter an email address 1f the one listed 1n the Email field 1s 1ncorrect 9 8 Supporting Documentation Documents may be in the form of PDF Jpeg Excel or Word files four megabytes or smaller Sectio
221. ures related to an EP s scope of practice or patient population the clinical decision support interventions must be related to high priority health conditions Measure 2 The EP has enabled and implemented the functionality for drug drug and drug allergy interaction checks for the entire EHR reporting period Measure 1 More than 50 percent of all unique patients seen by the EP during the EHR reporting period are provided timely available to the patient within 4 business days after the information is available to the EP online access to their health information Measure 2 More than 5 percent of all unique patients seen by the EP during the EHR reporting period or their authorized representatives view download or transmit to a third party their health information Clinical summaries provided to patients or patient authorized representatives within one business day for more than 50 percent of office visits Conduct or review a security risk analysis in accordance with the requirements under 45 CFR 164 308 2 1 including addressing the encryption security of data stored in CEHRT in accordance with requirements under 45 CFR 164 312 a 2 rv and 45 CFR 164 306 d 3 and implement security updates as necessary and correct identified security deficiencies as part of the provider s risk management process for EPs More than 55 percent of all clinical lab tests results ordered by the EP during the EHR reporting period whose results are eit
222. used to determine if the EP practiced predominantly in an FQHC Do not add commas System will format with commas after entry 4 Select Save and Continue The system validates if all fields have data entered If any field does not contain an entry an error message will display Please enter the appropriate data If all fields contain responses the next action depends on the data entered If the EP meets the 50 patient volume threshold needed to be considered to be practicing predominantly in an FQHC or RHC the EP will proceed to Volume Screen 4 If the EP does not meet the 50 patient volume threshold needed to be considered to be practicing predominantly in an FQHC or RHC then the EP will not be allowed to continue their attestation If the EP has questions or needs assistance please call the WV Medicaid Provider Services Help Desk at 1 888 483 0793 option 8 for questions and assistance 9 3 1 3 3 Volume Screen 4 Needy Patient Volume Providers who predominately practice in a FOHC or RHC are allowed to use criteria more inclusive Needy Individual patient volume measure to establish their eligibility for the EHR Incentive Program An EP practices predominantly at an FQHC or an RHC when the clinical location for over 50 of his her total patient encounters over a period of six months occur at an FQHC or RHC Providers who practice in an FQHC or RHC but do not meet the predominantly practicing t
223. user ID The Registration Information window displays with the registration information that was entered Refer to Figure 19 Page 36 of 192 Confidential and Proprietary Department Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 11 The Previous Page button returns to the Registration home page Back To WY MMIS Portal My PIP Account Attestation Status Registrations Registration Information Please review the registration summary below to ensure this is the correct registration information If any information is incorrect please update the information at the CMS Website Registration ID Business Address Name TIN NPI Phone Payee NPI E Mail Payee TIN Incentive Program Medicaid Department of Health amp Human Services IC Bureau for Medical Services IE Web Policies amp Important Links IC Accessibility amp Figure 19 Registration Tab Registration Information Window If invalid an error message displays The Add Registration page continues to display until the information is entered correctly or a navigation option is selected Registrations Add Registration Registration 0495idk not found Red asterisk indicates a required field Add a registration to your registrations list so that you can attest for the associated provider or simply view the attest
224. uture CMS will continue to expand on the current baseline and continue to develop through future rule making The Stage 2 requirements ONLY are addressed in this manual and summarized below According to the guidelines for the EHR Incentive Program for 2014 all Meaningful Use reporting periods are 90 days regardless of the reporting period used in prior years After 2014 all Meaningful Use providers will need to meet the standards for their particular payment year EHRs must meet the new 2014 standards and certification criteria If additional information is needed please visit ONC s new 2014 Certification Programs and Policy page http www healthit gov policy researchers implementers certification and ehr incentives Along with meeting the 2014 EHR criteria the Stage 2 Meaningful Use requirements are summarized as follows e There are a total of 23 Meaningful Use objectives To qualify for an incentive payment 20 of these 23 objectives must be met In addition responses to Clinical Quality Measures COM questions are required o There are 17 required core objectives o There are six menu measure objectives and three menu measures must be selected Page 12 of 192 Confidential and Proprietary BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider o Eligible Providers must also report on nine of the 64 total clinical quality measures by submitti
225. ve Program please visit www wymmis com and refer to the instructions and FAQ s If you need any other assistance regarding eligibility for the EHR s Provider Incentive Program please contact 888 483 0793 option 8 for the Provider Service EHR Provider Incentive Program help desk Thank you for using the PIP system Version 1 0 0 1 WEST VIRGINIA Healt Human Resources BUREAU FOR MEDICAL SERVICES Page 98 of 192 Confidential and Proprietary m Healt Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 24 Attestation Failed Meaningful Use After the provider attestation passes the volume check and payment checks the application will validate that the Meaningful Use Core and Menu Measures responses meant or exceed the required response If the user failed one or more questions the following email will be sent to notify that Meaningful Use failed From EHR Administrator Sent Fri 12 10 5 To Cc Subject EHR Incentive Program Attestation rejected The provider whose details are listed below has been found to be not eligible for the EHR Incentive Program due to the below reason NPI ID i Provider Name Organization Name Reporting Period Name CY2012 Submitted Date 3 2 2012 10 38 39 AM Reason for rejection Failed Meaningful Use For more information on gible prcouherz for the Eravider Incentive Pro
226. ventive Care and Screening Risk Stratified Cholesterol Fasting Low Density Clinical 964 3 Description Percentage of patients aged 20 through 79 years who had a fasting LDL Process Effecti C test performed and whose risk stratified fasting LDL C is at or below the recommended LDL C goal CMS61v3 Title Dementia Cognitive Assessment Description Percentage of patients regardless of age with a diagnosis of dementia Clinical for whom an assessment of cognition is performed and the results reviewed at least Process Effectiveness once within a 12 month period Title Hypertension Improvement in Blood Pressure Clinical CMS65v3 Description Percentage of patients aged 18 85 years of age with a diagnosis of SERS Lj hypertension whose blood pressure improved during the measurement period Title Closing the Referral Loop Receipt of Specialist Report Description Percentage of patients with referrals regardless of age for which the referring provider receives a report from the provider to whom the patient was referred Title Functional Status Assessment for Knee Replacement Description Percentage of patients aged 18 years and older with primarytotal knee Patient and Family CMS149v2 CMS50 2 Care Coordination a arthroplasty TKA who completed baseline and follow up patient reported Engagement functional status assessments Title Functional Status Assessment for Hip Replacement CMSS6v2
227. vider declaring the information provided was derived from their MIS and is accurate e An accompanying report generated by the state Medicaid agency which identifies the total encounters and the reporting period used the development of the report Mate The reporting period for QOS encounters must match the reporting period indicated during registration state Select Numerator Number of patient encounters at an FaHC or RHG in which the patientis a needy individual Denominator All patient encounters at an FQHC or RHE over the 90 day period Please selectthe ADD button to add out of state patient volume to the list Figure 35 Out of state Needy Patient Volume Entry Edit Screen Page 60 of 192 Confidential and Proprietary BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider e Enter in each value Definitions of each field may be found in the Needy Patient volume section above e Select Add To Edit Select Edit next to the state 2 The Out of State Patient Volume Entry screen displays with your entries 3 Modify the entries 4 Select Update To Delete 1 Select Delete on the desired state 2 Respond appropriately to the Are you sure question 9 Select Save and Continue to save all changes 10 The system validates if all fields have data entered An error message displays if the user did not supply dates numerator and a D
228. which is counted in measure 2 for EPs the measure at 8495 6 j 14 I B with a recipient who has EHR technology that was developed or designed by a different EHR technology developer than the sender s EHR technology certified to 45 CFR 170 314 b 2 Conducts one or more successful tests with the CMS designated test EHR during the EHR reporting period EXCLUSION EPs who transfer a patent to another setting or refer a patient to another provider less than 100 times during the EHR reporting period would be excluded from this requirement EPs must enter the number of transfers and referrals during the EHR reporting period in the Exclusion box to attest to exclusion from this requirement Does this exclusion apply to you C Yes No Exclusion Box sid For additional information CMS Specification Sheet Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed PREVIOUS PAGE SAVE AND CONTINUE 3 Figure 81 MU Core Question 15C Summary of Care Confidential and Proprietary Page 135 of 192 WEST VIRGINIA t of Healt Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 15C of 17 Red asterisk indicates a required field Summary of Care Objective The EP who transitions their patient to another setting of care or provider of care or refers the
229. who have had 2 or more office visits with the EP within the 24 months before the beginning of the EHR reporting period were sent a reminder per patient preference when available Complete the following information All information entered may be subject to audit that could result in payment recoupment Numerator Number of patients in the denominator who were sent a reminder per patient preference when available during the EHR reporting period Denominator Number of unique patients who have had two or more office visits with the EP in the 24 months prior to the beginning of the EHR reporting period Numerator fs Denominator For additional information CMS Specification Sheet Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed 0 PREVIOUS PAGE SAVE AND CONTINUE 23 Figure 72 MU Core Question 12 Numerator amp Denominator Entry Screen Page 126 of 192 Confidential and Proprietary WEST VIRGINIA D rtment of Healt H Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 13 of 17 Red asterisk indicates a required field Patient Specific Education Resources Objective Use clinically relevant information from Certified EHR Technology to identify patient specific education resources and provide those resources to the patient Measure Patient specific education re
230. y a different EHR technology developer than the sender s EHR technology Recipient Name il Exchange Date MM DD YY Successful test with the CMS designated test EHR during the EHR reporting period Test Date MM DD YY For additional information CMS Specification Sheet C Please select the PREVIOUS PAGE button to go back or the SAVE amp CONTINUE button to proceed Ima samara BANE __ QANE aun presen PEt ac s nf rn Figure 82 MU Core Question 15C Additional Information Entry Screen Page 136 of 192 Confidential and Proprietary WEST VIRGINIA D tment of Healt s Huan BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider Questionnaire 16 of 17 Red asterisk indicates a required field Immunization Registries Data Submission Objective Capability to submit electronic data to immunization registnes or immunization information systems except where prohibited and in accordance with applicable law and practice Measure Successful ongoing submission of electronic immunization data from CEHRT to an immunization registry or immunization information system for the entire EHR reporting period EXCLUSION Any EP that meets one or more of the following criteria may be excluded from this objective Please select the exclusion option that applies to you The EP does not administer any of the immunizations to any of the
231. you wish ta use this functionality select the Mew Trading Partner Registration menu option on the lett You must complete a Trading Partner Agreement before access js granted to this ste TRAs are available for download in the forms section Contact the Molina EDI Helpdesk for more information at 855 483 0733 prompt 6 or by email at edihelpdesk molinahealthcare com The Molina EDI Technical Support Helpdesk is staffed Monday thru Friday fram 8 00 am to 5 00 EST Figure 11 WV Login Screen 2 Prepare to Logon by entering in Logon Name and Password in the appropriate entry boxes and select Submit e Enter Provider Web portal user ID e Enter Provider Web portal password e Select Submit button 3 On the Welcome window select the WV EHR Incentive Program option to display the Provider Incentive Program About This Site window Refer to Figure 13 Confidential and Proprietary Page 29 of 192 VET VIRGINIA Healt Hu Resources BUREAU FOR MEDICAL SERVICES Page 30 of 192 West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider B Alerts Home B Logout Password Reset view Trading Partner Information Site Requirements Suggestions Reference Contact W MMIS Documents B rao B Forms Manuals Pharmacy B Newsletters Provider Directory User Guides WV EHR Incentive Program powered by XjSERIES Welcome to Health PAS O
232. your cart page STEP 1 SELECT YOUR PRACTICE TYPE ONC HIT Website Privacy Policy Last Modified Date 12 23 2010 The information on this page is currently hosted by the HITRC and its Partners under contract with the Office of the National Coordinator for Health Information Technology Figure 2 Certified Health IT Product List window Confidential and Proprietary Page 19 of 192 Department of UM BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 7 System Requirements To successfully use all features of the Provider Incentive Program WV EHR Incentive Program ensure that the computer system meets the following minimum requirements PChasareliable internet connection Q Web browser The latest version of Microsoft Internet Explorer is recommended IE7 0 and higher As versions of Internet Explorer become available it is recommended that these versions are used O Adobe Acrobat Reader Page 20 of 192 Confidential and Proprietary Department of Resources BUREAU FOR MEDICAL SERVICES West Virginia Electronic Health Record Provider Incentive Program MEANINGFUL USE Provider 8 Navigation This section describes all of the different navigation options that are available throughout the application 8 1 Breadcrumbs When a hyperlink is clicked the appropriate web page is displayed to the right of the navigation bar The breadcru

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