1. health and fitness

Minnesota EHR Incentive Program (MEIP)
Guidance Manual
for Eligible Professionals and Hospitals
Released October 18, 2012
MEIP Guidance for Eligible Professionals and Hospitals
Released October 18, 2012
Table of Contents
Section 1: Guidance for Eligible Professionals (EP)
Page
1.1 Prerequisites Part I: Preparation and Registration with CMS ............…………………………………..3
1.2 Prerequisites Part II: Preparing, Enrolling & Attesting for MEIP …………………………………………..6
1.3 Medicaid Patient Volume (MPV) Calculation for Eligible Professionals (EP) ……………..…………8
1.4 Attesting for Medicaid Patient Volume (MPV) Using Group Volumes ……………………………….13
Section 2: Guidance for Eligible Hospitals (EH)
2.1 Prerequisites Part I: Preparation and Registration with CMS …………………….………………………16
2.2 Prerequisites Part II: Preparing, Enrolling & Attesting for MEIP ……………………….……………….19
2.3 Medicaid Patient Volume (MPV) Calculation for Eligible Hospitals (EH) …………………………….23
Section 3: Appendices
3.1 Appendix A – Supporting Documentation for Eligible Professionals and Hospitals .............27
3.2 Appendix B – Sample Group Volume Consent Form ………………………………….………………………29
3.3 Appendix C – Sample Hospital Calculation worksheet ……………………………………………………...30
3.4 Appendix D – Hospital First Enrollment and Attestation Month …………….…………………………31
3.5 Appendix E – Hospital Fiscal Year Start ………………………….…………...……………………………………32
Minnesota EHR Incentive Program (MEIP)
Page 2 of 26
MEIP Guidance for Eligible Professionals and Hospitals
Released October 18, 2012
Section 1: Guidance for Eligible Professionals (EPs)
1.1
Prerequisites for EPs Part I: Preparation and Registration with CMS
Prior to registration in the Minnesota EHR Incentive Program (MEIP) at the Centers for Medicare and
Medicaid Services (CMS) website, a provider should first determine if they have the information
necessary to complete the initial registration and eventual enrollment in the MEIP.
1. Determine if you are potentially eligible to participate in the MEIP. The CMS Eligibility Tool can
help you determine whether you may be eligible.
2. Confirm you have an individual National Provider ID (NPI) valid for participation in the Centers
for Medicare and Medicaid Services (CMS) Medicare and Minnesota EHR Incentive Programs.
Note: The NPI will need to be an active Individual NPI, not a group NPI.
3. Confirm you are enrolled in Minnesota Health Care Programs (MHCP). The enrollment linked to
your NPI must be active and in good standing. If you are not enrolled in MHCP, or you are not
in good standing in MHCP, you will not be allowed by rule to participate in the program.
Q: What can I do if I am not currently enrolled in Minnesota Health Care Programs or
have questions about my enrollment standing?
A: You will need to complete your Minnesota Medicaid enrollment first, prior to
participating in the MEIP. Contact MHCP Provider Enrollment at (651) 431-2700; Tollfree line at (800) 366-5411; Fax at (651) 431-7462.
4. Confirm your NPI is enrolled in the MHCP system as an Eligible Provider Type
According to the CMS Final Rule for the Medicaid EHR Incentive Program and the Minnesota
State Medicaid HIT Plan, Eligible Provider Types for the Medicaid EHR Incentive Program are:
• Physicians
• Dentists
• Certified Nurse-Midwifes
• Nurse Practitioners. This includes Clinical Nurse Specialists who meet the
federal and MN state plan definition of Nurse Practitioners.
• Physician Assistants practicing in Federally Qualified Health Centers
(FQHCs), Rural Health Centers (RHCs) or Indian Health Services (IHSs) which
Minnesota EHR Incentive Program (MEIP)
Page 3 of 26
MEIP Guidance for Eligible Professionals and Hospitals
Released October 18, 2012
is led by a Physician Assistant
Q: What can I do if I am not currently enrolled as an eligible provider type in MHCP?
A: You will need to complete a full enrollment with MHCP. This process includes
validation of current certifications and licenses. Contact MHCP Provider Enrollment at
(651) 431-2700; Toll-free line at (800) 366-5411; Fax at (651) 431-7462.
5. Confirm your Electronic Health Records system is certified by the Offices of the National
Coordinator (ONC) for Health Information Technology (HIT). If you are currently adopting,
implementing, upgrading, or using an electronic health records system you can determine if
your system is certified by ONC by performing a search on this site: ONC EHR Certification
Search
Q: What if I do not have my EHR Certification Number at this time?
A: You may register with CMS for program participation prior to receiving the EHR
Certification Number; however you will be required to enter this number in MEIP portal
during your enrollment and attestation in order to meet program eligibility
requirements and achieve payment.
6. Confirm your Payment Assignment
By rule, a provider may assign payment to himself/herself, or to another entity such as a facility
or group. In order to assign payment for MEIP, the following is required:
a. The Payee NPI and Payee TIN/SSN identified by the Provider at the time of CMS EHR
Incentive Program registration must be enrolled in MHCP. The Payee NPI and
Payee TIN/SSN must match exactly to the MHCP Enrollment data.
Note: When assigning a payee during CMS registration enter a TIN and NPI for the
clinic or a TIN/SSN and NPI for the EP, do not enter a clinic TIN and an EP’s NPI. If
this occurs no payee will appear in MEIP.
b. The enrollment linked to your chosen payee must be active and in good standing. If
the Payee NPI and Payee TIN/SSN do not match an enrollment with MHCP, or the
Payee NPI and Payee TIN/SSN matches an enrollment with MHCP which is not in
good standing, the payee selection will not be allowed for MEIP.
Q: What can I do if my Payee NPI and TIN combination is not known to MHCP?
Minnesota EHR Incentive Program (MEIP)
Page 4 of 26
MEIP Guidance for Eligible Professionals and Hospitals
Released October 18, 2012
A: The Provider may: (1) Choose a new payee NPI and payee TIN/SSN combination
which is currently enrolled in MHCP; or (2) Request the Payee associated with the
Payee NPI and Payee TIN/SSN combination complete a full enrollment in MHCP.
Contact MHCP Provider Enrollment at (651) 431-2700; Toll-free line at (800) 3665411; Fax at (651) 431-7462.
Q: What can I do if my Payee NPI and Payee TIN/SSN combination is currently
enrolled in MHCP, but is not in an active status or good standing?
A: The Provider may choose a new payee NPI and payee TIN/SSN combination
which is currently enrolled and in good standing in Minnesota Medicaid. The Payee
may contact MHCP to discuss the standing of their enrollment. If you are currently
enrolled, but have questions about your enrollment standing, Contact MHCP
Provider Enrollment at (651) 431-2700; Toll-free line at (800) 366-5411; Fax at (651)
431-7462.
Note: A provider may register with CMS for program participation prior to finalizing
MHCP Payee Enrollment; however, the provider will not be able to complete the
MEIP attestation process required to achieve payment until this information is
finalized.
7. Register for participation in the MEIP at CMS’ EHR Incentive Program registration website: CMS
EHR Incentive Registration. Your registration, if accepted, will be sent to the Minnesota EHR
Incentive Program the next day. Registrations are processed by CMS and Minnesota 7 days a
week.
Minnesota EHR Incentive Program (MEIP)
Page 5 of 26
MEIP Guidance for Eligible Professionals and Hospitals
Released October 18, 2012
1.2
Prerequisites for EPs Part II: Preparing, Enrolling & Attesting for MEIP
1. Upon receipt of your CMS registration, Minnesota EHR Incentive Program will send you an email
including instructions on to start your MEIP attestation, if the MHCP enrollment matching your
registration NPI is: (1) Found in the MHCP system; (2) In good standing/not sanctioned in the
MHCP system; and (3) A provider type eligible to participate in the MEIP.
Q: How do I seek assistance if an issue is found with my program MHCP enrollment?
A: For assistance with your MHCP enrollment, contact MHCP Provider Enrollment at
(651) 431-2700; Toll-free line at (800) 366-5411; Fax at (651) 431-7462.
Q: How do I seek assistance for questions related to MEIP enrollment?
A: For assistance with MEIP enrollment, contact the MEIP help desk at
[email protected] or call 1-855-676-0366.
2. Gather and prepare documentation that will be needed during the MEIP enrollment and
attestation process. Appendix A: MEIP Guidance on Supporting Documentation provides the list
of documentation options that will appear in the drop down menu as you are uploading
documentation in support of your enrollment and attestation.
Note: There are multiple options for documentation in each of the primary categories. Some
categories are required, while others would be situational. Under no circumstances should a
provider upload any documentation containing personal health information (PHI).
3. Complete your attestation in the MEIP. Providers will be required to enter and attest to the
following types of data:
a. Attesting as a pediatrician
b. Attesting as part of an FQHC/RHC/IHS
c. Attesting as part of a group. MHCP requires hospitals and clinic providers to review their
provider affiliations with individual providers per MHCP Provider Update – Provider
Affiliations
d. Confirmation of the Payee selection
e. Volume Attestation by Encounter Method
f. Validation of the EHR Certification number
g. Attestation to Meaningful Use criteria (Participation year 2 through 6)
h. Signing of a Legal Notice confirming attested data
Minnesota EHR Incentive Program (MEIP)
Page 6 of 26
MEIP Guidance for Eligible Professionals and Hospitals
Released October 18, 2012
i.
j.
Confirming and Submitting your attestation as complete
Upload of Certified EHR system ownership documentation
4. Pre-Payment Review
Based on DHS Minnesota EHR Incentive Program policy, providers will be processed through
automated, and in some cases, manual pre-payment verification procedures. If selected,
providers may be required to upload additional information to support the data entered at the
time of attestation.
5.
If determined eligible, payment will be received following the completion of the attestation in
the MEIP within 45 days of the final attestation “Confirm and Submit”. Payments will be
disbursed by DHS on a bi-weekly basis and will appear as a gross adjustment on your remittance
advice.
Minnesota EHR Incentive Program (MEIP)
Page 7 of 26
MEIP Guidance for Eligible Professionals and Hospitals
Released October 18, 2012
1.3
Medicaid Patient Volume (MPV) Calculation for EPs
DHS has received several requests for clarification language contained in the State Medicaid HIT Plan
(SMHP) related to which participants may be counted toward their Medicaid Patient Volume (MPV) for
purposes of the Minnesota Medicaid EHR Incentive Program (MEIP). This resource is intended to
provide clarification on the process used by MHCP to calculate MPV based on the Minnesota Health
Care Programs (MHCP) that meet the definitions for eligible encounters in the federal regulations.
Minnesota’s approved SMHP indicated the following for EP:
Minnesota EPs use Option 1: Patient Encounter, as described in the rule, for calculating their Medicaid
patient encounters and can:
•
Choose the 90-day period;
•
Count out-of-state encounters;
•
Calculate volume using the group clinic/proxy methodology; and
•
Count participants in:
o
o
o
o
o
o
o
o
•
MA (Medicaid)
EH (Medicaid coverage of certain noncitizens for medical conditions)
FF (federally funded demonstration; MinnesotaCare for parents and adult caretakers)
LL (federally funded demonstration; MinnesotaCare for pregnant women and children)
FP (Family Planning services; family planning services only)
QM (Medicare Part A & B premiums, and cost sharing)
SL (Medicare Part B premiums)
WD (Medicare Part A premium only)
EPs practicing predominantly in FQHC/RHC and Physician Assistants also include:
o
o
NM with eligibility type PC (CHIP program)
Services provided on a sliding scale or that were uncompensated
MA, or Medical Assistance, is Minnesota’s Medicaid program. It is jointly funded with state and federal
funds. The Minnesota Department of Human Services oversees the program statewide. The federal
Centers for Medicare and Medicaid Services oversees Medicaid nationally. All Medical Assistance subcategories/products (see below) are countable for purposes of determining Medicaid Patient Volume
Minnesota EHR Incentive Program (MEIP)
Page 8 of 26
MEIP Guidance for Eligible Professionals and Hospitals
Released October 18, 2012
under the Minnesota Electronic Health Record Incentive Program. MA is administered through both feefor-service and managed care. Additional details on the managed care products for MA are provided
below.
Relevant language from CMS Response and Analysis on Comments in the Final Rule:
In establishing the Medicaid patient volume thresholds for EPs and acute care hospitals, section
1902(t)(2) of the Act requires that individuals enrolled in a Medicaid managed care plan be included. We
interpret this to mean that individuals enrolled in MCOs, prepaid inpatient health plans (PIHPs), or
prepaid ambulatory health plans (PAHPs), under 42CFR Part 438 be included in the calculation.
Clarification on DHS Programs Administered Through Managed Care Organizations:
In an effort to assist Minnesota providers with identifying encounters that can be included, the following
overview provides additional details on the DHS programs administered through Managed Care
Organizations. MCO’s were asked to provide the group numbers that correspond to the program codes
that are eligible for inclusion in the Medicaid Patient Volume calculation under the Minnesota Medicaid
Electronic Health Record Incentive Program.
Medical Assistance with Federal Financial Participation (FFP):
Sub-categories identified under DHS Major Program Code MA include:
MA12 – Prepaid Medical Assistance Program
MA20 – Prepaid Medical Assistance Program
MA17 – Special Needs Basic Care (SNBC Integrated Medicare)
MA19 – Special Needs Basic Care (SNBC PIN Non-integrated Medicare)
MA37 – Special Needs Basic Care (SNBC Non-integrated Medicare)
MA30 – Minnesota Senior Care Plus (MSC+)
MA35 – Minnesota Senior Care Plus (MSC+)
MA02 – Minnesota Senior Health Options (MSHO)
Minnesota EHR Incentive Program (MEIP)
Page 9 of 26
MEIP Guidance for Eligible Professionals and Hospitals
Released October 18, 2012
Other Programs Administered by Managed Care Organizations with Federal Financial Participation:
MinnesotaCare
MinnesotaCare is a publicly subsidized program for Minnesota residents who do not have access to
affordable health care coverage. This program is also administered by managed care organizations, and
is funded by a state tax on Minnesota hospitals and health care providers, as well as federal Medicaid
matching funds (in some cases), and enrollee premiums.
The MinnesotaCare Products that are eligible for FFP and countable for purposes of determining
Medicaid Patient Volume under the Minnesota Medicaid Electronic Health Record Incentive Program
(MEIP) include:
•
•
•
•
MinnesotaCare Basic Plus Two (parents & adult caretakers with income ≤275% FPL)
MinnesotaCare Basic Plus ( parents and adult caretakers with income ≤275% FPL)
MinnesotaCare Expanded (MinnesotaCare for children under age 21 and pregnant women)
MinnesotaCare Expanded (MinnesotaCare for adults without children up to 250% FPL)
The MinnesotaCare programs that are not eligible for FFP and are exclusively funded by the state that
are not countable for purposes of determining Medicaid Patient Volume under MEIP include:
•
•
MinnesotaCare for noncitizen parents/caretakers with income ≤275%FPL
MinnesotaCare for noncitizen children under 21 and pregnant women
Children’s Health Insurance Program (CHIP)
The Children’s Health Insurance Program (CHIP) is a federal program that provides health coverage to
children in families with incomes too high to qualify for Medicaid, but that can’t afford private coverage.
Signed into law in 1997, CHIP provides federal matching funds to states to provide this coverage. Under
the Medicaid EHR Incentive Program, CHIP enrollees are included in the definition of “needy individuals”
who may be counted toward Medicaid patient volume, but only for eligible professionals practicing
predominantly in a Federally Qualified Health Center (FQHC), Rural Health Clinic (RHC) or Indian Health
Services clinic (IHS). Individuals in the CHIP program are identified under the following code:
•
CHIP for unborn children of noncitizen mothers ineligible for federally funded MA
Minnesota EHR Incentive Program (MEIP)
Page 10 of 26
MEIP Guidance for Eligible Professionals and Hospitals
Released October 18, 2012
Additional Rules for Counting Encounters for EPs
MHCP will filter EP-Specific claim queries in accordance with the following rules:
•
•
•
•
Identify and separate MHCP encounters from private health plan encounters
Multiple visits by an individual to the same rendering provider on one day will count as one
encounter
EP services provided within a hospital or Emergency Department (ED) setting with Place of
Service 21 – Inpatient Hospital or 23 – Emergency Department Hospital are included in the EP
patient volumes
Claim lines paid for through State-only funded programs will be removed
If you are attesting as an individual:
1.
2.
3.
4.
5.
Determine Source of Patient Volume
Determine your reporting period
Calculate Medicaid Patient Encounters
Calculate Total Patient Encounters
Divide Medicaid Patient Encounters by the Total Patient Encounters
Determine your reporting period. The reporting period is any 90-day consecutive period in the previous
calendar year
To calculate encounters, use the following calculation:
Medicaid encounters divided by Total patient encounters times 100:
Your Medicaid Patient Encounters * X 100
Your Total Patient Encounters **
* Use all Medicaid encounters from all places where you practice.
** Use all patient encounters from all places where you practice.
Minnesota EHR Incentive Program (MEIP)
Page 11 of 26
MEIP Guidance for Eligible Professionals and Hospitals
Released October 18, 2012
EXAMPLE A
Provider #9 also has his own practice in addition to providing services at Group A clinic and will attest as
an individual EP:
• Chooses to attest to solo practice patient volume
• Chooses to attest from March 1, 2011 through May 31, 2011
• Attests to 75 Medicaid patients and 180 total patients seen during this period for a 41%
total.
Table 1. Provider #9 Patient Volume
Provider Medicaid Patients Total Patients
1
75
180
Totals
75
Provider #9 Patient Volume
180
41%
Minnesota EHR Incentive Program (MEIP)
Page 12 of 26
MEIP Guidance for Eligible Professionals and Hospitals
Released October 18, 2012
1.4
Attesting for Medicaid Patient Volume (MPV) Using Group Volumes
If you are attesting as part of a group or clinic, the following should be considered:
1. Group as defined under MEIP is a unique pair of Federal Tax Identification Number (TIN) and
National Provider Identifier (NPI). Appendix B MEIP Group Consent Form provides a template for
providers to account for all professionals employed by the group.
2. All Medicaid encounters performed as part of the group are included for every practitioner in
the group/clinic (numerator and denominator), regardless of whether the practitioner is eligible
for the incentive program. Do not include encounters from outside the attestation group or the
clinic.
3. If an eligible professional (EP) chooses not to participate in the group/clinic, the encounters
generated by that EP may still be used in the calculation (numerator and denominator) for that
particular group/clinic. The EP cannot use those encounters for calculating volumes for another
practice or individually if the group/clinic has already included them in their volume calculation.
4. For Group Attestations:
a. The first person attesting will enter the reporting period, the number of members in the
group, the group name, and the group volume (numerator and denominator). Each
subsequent person in the group to attest will select the group they are attesting with,
attest to information provided by the first person in the group, and provide other
required information pertaining to their attestation. See “Determining your Group’s
Patient Volume” below for information on how to calculate your group’s volume.
5. For Clinic Attestations:
a. Each Eligible Professional attesting as part of an FQHC/RHC/IHS will be required to
indicate the clinic or individual volume at the time of attestation.
Note: Attesting as part of a Clinic may only be done by those Eligible Professionals choosing to
attest as part of an FQHC/RHC/IHS. Clinics are not considered Groups in the Minnesota EHR
Incentive Program (MEIP). Selection of ‘no’ when prompted with the question “Are you
attesting as a group?” directs an EP to the FQHC/RHC/IHS volume attestation screen. The
FQHC/RHC/IHS screen provides individual or clinic volume attestation of Needy Patient
Encounters.
Minnesota EHR Incentive Program (MEIP)
Page 13 of 26
MEIP Guidance for Eligible Professionals and Hospitals
Released October 18, 2012
Determining your Group’s or Clinic’s Patient Volume
To correctly determine the patient volume for a Group:
a.
b.
c.
d.
e.
Determine number of EPs attesting
Determine your reporting period
Calculate Medicaid Patient Encounters
Calculate Total Patient Encounters
Divide Medicaid Patient Encounters by the Total Patient Encounters
Determine your reporting period. The reporting period is a 90-day consecutive period in the previous
calendar year.
To calculate encounters , use the following calculation:
Medicaid encounters divided by Total patient encounters times 100:
Your Medicaid Patient Encounters *, *** X 100
Your Total Patient Encounters **, ***
* Use all Medicaid encounters from all practitioners in the group, even those who are not eligible for
incentives and those who chose not to participate.
** Use all patient encounters from all practitioners in the group, even those who are not eligible for
incentives and those who chose not to participate.
*** Providers attesting as part of a Clinic (FQHC/RHC/IHS) include the Needy Patient Volume in the
numerator and denominator.
EXAMPLE B
Group A has a total of 10 Professionals working in their clinic. Of the 10 professionals:
• 5 EPs will attest to their patient volume as part of Group A
• 3 EPs have elected to attest to their patient volume as an individual using volume from
other clinics
• 2 professionals are not eligible for MEIP
Minnesota EHR Incentive Program (MEIP)
Page 14 of 26
MEIP Guidance for Eligible Professionals and Hospitals
Released October 18, 2012
•
•
Group A will add Medicaid and Total patient volume from all 10 professionals
Group A has chosen to attest to March 1, 2011 to May 31, 2011 for their 90-day period
Table 2. Group A Patient Volume
Provider Medicaid Patients Total Patients
1
25
100
2
37
102
3
10
30
4
12
25
5
5
16
6
14
22
7
25
97
8
45
57
9
3
7
10
2
9
Totals
178
Group Patient Volume
465
38%
Minnesota EHR Incentive Program (MEIP)
Page 15 of 26
MEIP Guidance for Eligible Professionals and Hospitals
Released October 18, 2012
Section 2: Guidance for Eligible Hospitals (EHs)
2.1
Prerequisites Part I: Preparation and Registration with CMS
Prior to registration in the Minnesota EHR Incentive Program (MEIP) at the Centers for Medicare and
Medicaid Services (CMS) website, a provider should first determine if they have the information
necessary to complete the initial registration and eventual enrollment in the MEIP.
1. Determine if the Eligible Hospital (EH) is potentially eligible to participate in the MEIP. The CMS
Eligibility Tool can help you determine whether you may be eligible.
2. Confirm the EH has an individual National Provider ID (NPI) valid for participation in the Centers
for Medicare and Medicaid Services (CMS) Medicare and Minnesota EHR Incentive Programs.
3. Confirm the EH is enrolled in Minnesota Health Care Programs (MHCP). The enrollment linked
to the EH’s NPI must be active and in good standing. If the EH is not enrolled in MHCP, or the
EH is not in good standing in MHCP, the EH will not be allowed by rule to participate in the
program.
Q: What can I do if the EH is not currently enrolled in Minnesota Health Care Programs
or have questions about my enrollment standing?
A: You will need to complete your Minnesota Medicaid enrollment first, prior to
participating in the MEIP. Contact MHCP Provider Enrollment at (651) 431-2700; Tollfree line at (800) 366-5411; Fax at (651) 431-7462.
4. Confirm your NPI is enrolled in the MHCP system as an Eligible Provider Type
According to the CMS Final Rule for the Medicaid EHR Incentive Program and the Minnesota
State Medicaid HIT Plan, EHs for MEIP are those whose last four digits of their CMS Certification
Number (CCN) fall into one of the following ranges:
• 0001-0879 for acute care hospitals
• 1300-1399 for critical access hospitals
• 3300-3399 for children’s hospitals
Q: What can I do if I am not currently enrolled as an eligible provider type in MHCP?
A: You will need to complete a full enrollment with MHCP. This process includes
validation of current certifications and licenses. Contact MHCP Provider Enrollment at
(651) 431-2700; Toll-free line at (800) 366-5411; Fax at (651) 431-7462.
Minnesota EHR Incentive Program (MEIP)
Page 16 of 26
MEIP Guidance for Eligible Professionals and Hospitals
Released October 18, 2012
5. Confirm your Electronic Health Records system is certified by the Offices of the National
Coordinator (ONC) for Health Information Technology (HIT). If you are currently adopting,
implementing, upgrading, or using an electronic health records system you can determine if
your system is certified by ONC by performing a search on this site: ONC EHR Certification
Search
Q: What if I do not have my EHR Certification Number at this time?
A: You may register with CMS for program participation prior to receiving the EHR
Certification Number; however you will be required to enter this number in MEIP portal
during your enrollment and attestation in order to meet program eligibility
requirements and achieve payment.
6. Confirm your Payment Assignment
By rule, a provider assigns payment to the EH. In order to assign payment for MEIP, the
following is required:
c. The Payee NPI and Payee TIN identified by the Provider at the time of CMS EHR
Incentive Program registration must be enrolled in MHCP. The Payee NPI and
Payee TIN must match exactly to the MHCP Enrollment data.
d. The enrollment linked to your payee must be active and in good standing. If the
Payee NPI and Payee TIN do not match an enrollment with MHCP, or the Payee NPI
and Payee TIN matches an enrollment with MHCP which is not in good standing, the
payee selection will not be allowed for MEIP.
Q: What can I do if my Payee NPI and TIN combination is not known to MHCP?
A: The Provider may: Request the Payee associated with the Payee NPI and Payee
TIN combination complete a full enrollment in MHCP. Contact MHCP Provider
Enrollment at (651) 431-2700; Toll-free line at (800) 366-5411; Fax at (651) 4317462.
Q: What can I do if my Payee NPI and Payee TIN combination is currently enrolled in
MHCP, but is not in an active status or good standing?
A: The Payee may contact MHCP to discuss the standing of their enrollment. If you
are currently enrolled, but have questions about your enrollment standing,
Contact MHCP Provider Enrollment at (651) 431-2700; Toll-free line at (800) 3665411; Fax at (651) 431-7462.
Minnesota EHR Incentive Program (MEIP)
Page 17 of 26
MEIP Guidance for Eligible Professionals and Hospitals
Released October 18, 2012
Note: A provider may register with CMS for program participation prior to finalizing
MHCP Payee Enrollment; however, the provider will not be able to complete the
MEIP attestation process required to achieve payment until this information is
finalized.
7. Register for participation in the MEIP at CMS’ EHR Incentive Program registration website: CMS
EHR Incentive Registration. Your registration, if accepted, will be sent to the Minnesota EHR
Incentive Program the next day. Registrations are processed by CMS and Minnesota 7 days a
week.
Minnesota EHR Incentive Program (MEIP)
Page 18 of 26
MEIP Guidance for Eligible Professionals and Hospitals
Released October 18, 2012
2.2
Prerequisites Part II: Preparing, Enrolling & Attesting for MEIP
The following process will need to be followed in order to participate in the Minnesota EHR Incentive
Program (MEIP):
1. Upon receipt of your CMS registration, Minnesota EHR Incentive Program will send you an email
including instructions on to start your MEIP attestation, if the MHCP enrollment matching your
registration NPI is: (1) Found in the MHCP system; (2) In good standing/not sanctioned in the
MHCP system; and (3) A provider type eligible to participate in the MEIP.
Q: How do I seek assistance if an issue is found with my program MHCP enrollment?
A: For assistance with your MHCP enrollment, contact MHCP Provider Enrollment at
(651) 431-2700; Toll-free line at (800) 366-5411; Fax at (651) 431-7462.
Q: How do I seek assistance for questions related to MEIP enrollment?
A: For assistance with MEIP enrollment, contact the MEIP help desk at
[email protected] or call 1-855-676-0366.
2. Gather and prepare documentation that will be needed during the MEIP enrollment and
attestation process. Appendix A: MEIP Guidance on Supporting Documentation provides the list
of documentation options that will appear in the drop down menu as you are up-loading
documentation in support of your enrollment and attestation.
Note: There are multiple options for documentation in each of the primary categories. Some
categories are required, while others would be situational. Under no circumstances should a
provider upload any documentation containing personal health information (PHI).
3. Complete Payee designation. As part of the CMS EHR Registration process, the Hospital Payee is
defaulted to the Hospital NPI and Hospital Tax Identification Number (TIN) used at the time of
registration. Unlike Eligible Professionals, hospitals may not designate their payments to other
Medicaid professionals or entities. Payments will be made to the Medicaid Hospital Enrollment
which matches the Hospital’s registration NPI and TIN.
The MEIP will require the attesting hospital to:
a) Confirm the Payee NPI and TIN as part of the attestation process. This will help ensure
the appropriate Medicaid payee receives the EHR Incentive payment, if the hospital is
determined eligible for an EHR Incentive payment.
Minnesota EHR Incentive Program (MEIP)
Page 19 of 26
MEIP Guidance for Eligible Professionals and Hospitals
Released October 18, 2012
4. Attest to Patient Discharge Volume. The CMS EHR Incentive Program Final Rule requires
hospitals to meet a 10% Medicaid Discharge volume in order to participate in the program.*
*Children’s Hospitals are not required to meet a Medicaid Discharge volume percentage in
order to participate.
The MEIP will require attesting hospitals (non-children’s hospitals) to:
a) Select the volume reporting period. The reporting period is any 90-day consecutive
period in the previous federal fiscal year.
b) Input the numerator counting discharges where Medicaid paid part or all of the
inpatient discharge and emergency room services on any one day.
c) Input the denominator for total discharges and ED encounters (Medicaid Paid and nonMedicaid Paid).
d) Derive the numerator and denominator from the same continuous three-month period
in the preceding Fiscal year. The calculation appears as follows:
Medicaid Discharges + Medicaid ED Encounter
Total Discharges + ED Encounters
X100
5. Confirm EHR Certification Number. The MEIP requires hospitals to input their Certified EHR
Number during the attestation process. The number is then validated real-time against the
Office of the National Coordinator (ONC) Certification database.
The (MEIP) will require attesting hospitals to Enter the CMS EHR certification identification
number on the AIU attestation page. Attestation cannot continue without the entry of your
EHR solution’s Certification Number.
a. You can determine if your EHR solution is certified by the ONC or obtain an EHR
Certification number by visiting this site: ONC EHR Certification website
6. Payment Calculation Attestation . The CMS EHR Incentive Program Final Rule documents the
payment calculation to be used by Medicaid states. MEIP payments are to made to hospitals
which have been determined eligible to participate in the program. The EH can reference the
following tips on how to prepare for attestation:
Minnesota EHR Incentive Program (MEIP)
Page 20 of 26
MEIP Guidance for Eligible Professionals and Hospitals
Released October 18, 2012
•
•
•
•
•
•
A multi-site hospital with one CCN is considered one hospital for purposes of attestation
and payment.
It is suggested the hospital use an auditable data source, such as the latest Medicare
cost report and HAR to complete the EHR Incentive Payment Calculation attestation.
Hospitals are to use their MN Hospital Annual Report (HAR) when necessary.
If the EH has only one year of data the EH would use the first year data and enter zeroes
for the other years then as the years progress the EH would update the worksheet from
year to year.
The EH is required to review the worksheet amounts every year, attest the amounts are
still correct and adjust them if they have changed due to an audit.
If an EH has experienced a merge of two facilities and has had to submit cost reports in
six month increments during this period of change which cost report should the EH use
on the worksheet, the EH must go back to the first full 12-month report for year one.
To estimate your hospital payment, access and download the MEIP Hospital Calculation
worksheet link found on the MEIP Eligible Hospitals page. The worksheet identifies the
Medicare Cost Report data and HAR fields used to verify hospital payment attestation data.
The MEIP Hospital Calculation Sample provides EHs with an example of a completed estimated
EHR incentive payment. Appendix C Sample MEIP Hospital Calculation provides an example of a
completed MEIP Hospital Calculation worksheet.
7. Select enrollment year. Eligible hospitals can choose to enroll for 2013 as the Year 1 EHR
incentive payment. The following tables can assist the decision:
a) Appendix D: MEIP First Enrollment and Attestation Month provides the Payment Year
options based on when the EH has submitted the CMS R&A registration and the month
they are performing their attestation in MEIP.
b) Appendix E: MEIP Hospital Fiscal Year Start provides the time period to be used for
discharge volumes, charges and inpatient days in the MEIP incentive payment
calculation based on the desired first payment year.
If the EH is enrolling for the 2012 payment year, the EH should review when the EH calendar
year ends. The EH must use the cost report year that overlaps the most recent federal fiscal
year. If the EH calendar year ends on August 31 for the 2012 payment year then the EH would
use the 2010 cost report.
To determine the discharge-related amount for the three subsequent payment years that are
included in determining the overall EHR amount, the number of discharges will be based on the
Minnesota EHR Incentive Program (MEIP)
Page 21 of 26
MEIP Guidance for Eligible Professionals and Hospitals
Released October 18, 2012
average annual growth rate for the hospital over the most recent three years of available data.
Per a CMS.gov outreach document, “For the first payment year, data on hospital discharges
from the hospital fiscal year that ends during the federal fiscal year prior to the hospital fiscal
year that serves as the first payment year will be used as the basis for determining the
discharge-related amount.”
8. Pre-Payment Review
Based on DHS Minnesota EHR Incentive Program policy, providers will be processed through
automated, and in some cases, manual pre-payment verification procedures. If selected,
providers may be required to upload additional information to support the data entered at the
time of attestation. Following the completion of the attestation process, a Pre-Payment Review
may be conducted.
9. If determined eligible, payment will be received following the completion of the attestation in
the MEIP within 45 days of the final attestation “Confirm and Submit”. Payments will be
disbursed by DHS on a bi-weekly basis and will appear as a gross adjustment on your remittance
advice.
Minnesota EHR Incentive Program (MEIP)
Page 22 of 26
MEIP Guidance for Eligible Professionals and Hospitals
Released October 18, 2012
2.3
Medicaid Patient Volume (MPV) Calculation for EHs
DHS has received several requests for clarification language contained in the State Medicaid HIT Plan
(SMHP) related to which participants may be counted toward their Medicaid Patient Volume (MPV) for
purposes of the Minnesota Medicaid EHR Incentive Program (MEIP). This resource is intended to
provide clarification on the process used by MHCP to calculate MPV based on which Minnesota Health
Care Programs (MHCP) meet the definitions for eligible encounters in the federal regulations.
Minnesota’s approved SMHP indicated the following:
Eligible Hospitals
The SMA follows the definition in federal regulations for EH Medicaid patient encounters where an “EH
Medicaid patient-encounter,” is defined as services rendered to an individual per inpatient discharge or
on any one day in the emergency room where Title XIX Medicaid or another state’s Medicaid program
paid for part or all of the service, their premiums, co-payments, and/or cost-sharing. Per federal
regulations, children’s hospitals are not required to meet any Medicaid patient-volume percentage, and
do not provide information on patient encounters. Minnesota has created a hospital incentive calculation
template which is available on our EHR Incentive website.
Minnesota EHs use Inpatient Discharges and Emergency Department (ED) visits, as described in the rule,
for calculating their Medicaid patient encounters and EHs can:
•
Choose the 90-day period;
•
Count out-of-state encounters;
•
Calculate volume using the group clinic/proxy methodology; and
•
Count participants in:
o
MA (Medicaid)
o
EH (Medicaid coverage of certain noncitizens for medical conditions)
o
FF (federally funded demonstration; MinnesotaCare for parents and adult caretakers)
o
LL (federally funded demonstration; MinnesotaCare for pregnant women and children)
o
FP (Family Planning services; family planning services only)
Minnesota EHR Incentive Program (MEIP)
Page 23 of 26
MEIP Guidance for Eligible Professionals and Hospitals
Released October 18, 2012
•
o
QM (Medicare Part A & B premiums, and cost sharing)
o
SL (Medicare Part B premiums)
o
WD (Medicare Part A premium only)
EPs practicing predominantly in FQHC/RHC and Physician Assistants also include:
o
NM with eligibility type PC (CHIP program)
o
Services provided on a sliding scale or that were uncompensated
MA, or Medical Assistance, is Minnesota’s Medicaid program. It is jointly funded with state and federal
funds. The Minnesota Department of Human Services oversees the program statewide. The federal
Centers for Medicare and Medicaid Services oversees Medicaid nationally. All Medical Assistance subcategories/products (see below) are countable for purposes of determining Medicaid Patient Volume
under the Minnesota Electronic Health Record Incentive Program. MA is administered through both feefor-service and managed care. Additional details on the managed care products for MA are provided
below.
Relevant language from CMS Response and Analysis on Comments in the Final Rule:
In establishing the Medicaid patient volume thresholds for EPs and acute care hospitals, section
1902(t)(2) of the Act requires that individuals enrolled in a Medicaid managed care plan be included. We
interpret this to mean that individuals enrolled in MCOs, prepaid inpatient health plans (PIHPs), or
prepaid ambulatory health plans (PAHPs), under 42CFR Part 438 be included in the calculation.
Clarification on DHS Programs Administered Through Managed Care Organizations:
In an effort to assist Minnesota providers with identifying encounters that can be included, the following
overview provides additional details on the DHS programs administered through Managed Care
Organizations. MCO’s were asked to provide the group numbers that correspond to the program codes
that are eligible for inclusion in the Medicaid Patient Volume calculation under the Minnesota Medicaid
Electronic Health Record Incentive Program.
Medical Assistance with Federal Financial Participation (FFP):
Sub-categories identified under DHS Major Program Code MA include:
MA12 – Prepaid Medical Assistance Program
Minnesota EHR Incentive Program (MEIP)
Page 24 of 26
MEIP Guidance for Eligible Professionals and Hospitals
Released October 18, 2012
MA20 – Prepaid Medical Assistance Program
MA17 – Special Needs Basic Care (SNBC Integrated Medicare)
MA19 – Special Needs Basic Care (SNBC PIN Non-integrated Medicare)
MA37 – Special Needs Basic Care (SNBC Non-integrated Medicare)
MA30 – Minnesota Senior Care Plus (MSC+)
MA35 – Minnesota Senior Care Plus (MSC+)
MA02 – Minnesota Senior Health Options (MSHO)
Other Programs Administered by Managed Care Organizations with Federal Financial Participation:
MinnesotaCare
MinnesotaCare is a publicly subsidized program for Minnesota residents who do not have access to
affordable health care coverage. This program is also administered by managed care organizations, and
is funded by a state tax on Minnesota hospitals and health care providers, as well as federal Medicaid
matching funds (in some cases), and enrollee premiums.
The MinnesotaCare Products that are eligible for FFP and countable for purposes of determining
Medicaid Patient Volume under the Minnesota Medicaid Electronic Health Record Incentive Program
(MEIP) include:
•
MinnesotaCare Basic Plus Two (parents & adult caretakers with income ≤275% FPL)
•
MinnesotaCare Basic Plus ( parents and adult caretakers with income ≤275% FPL)
•
MinnesotaCare Expanded (MinnesotaCare for children under age 21 and pregnant women)
•
MinnesotaCare Expanded (MinnesotaCare for adults without children up to 250% FPL)
The MinnesotaCare programs that are not eligible for FFP and are exclusively funded by the state that
are not countable for purposes of determining Medicaid Patient Volume under MEIP include:
•
MinnesotaCare for noncitizen parents/caretakers with income ≤275%FPL
•
MinnesotaCare for noncitizen children under 21 and pregnant women
Minnesota EHR Incentive Program (MEIP)
Page 25 of 26
MEIP Guidance for Eligible Professionals and Hospitals
Released October 18, 2012
Children’s Health Insurance Program (CHIP)
The Children’s Health Insurance Program (CHIP) is a federal program that provides health coverage to
children in families with incomes too high to qualify for Medicaid, but that can’t afford private coverage.
Signed into law in 1997, CHIP provides federal matching funds to states to provide this coverage. Under
the Medicaid EHR Incentive Program, CHIP enrollees are included in the definition of “needy individuals”
who may be counted toward Medicaid patient volume, but only for eligible professionals practicing
predominantly in a Federally Qualified Health Center (FQHC), Rural Health Clinic (RHC) or Indian Health
Service Clinic (IHS). Individuals in the CHIP program are identified under the following code:
•
CHIP for unborn children of noncitizen mothers ineligible for federally funded MA
Additional Rules for Counting Medicaid Encounters for EHs
MHCP will filter EH-Specific claim queries in accordance with the following rules:
•
•
•
•
•
•
If a person has an Emergency Department (ED) visit and no inpatient stay on a given day, the ED
is one encounter
If a person has an inpatient stay but no ED visit, the inpatient discharge is one encounter
If a person goes to an ED and is admitted to an inpatient stay where the DISCHARGE from that
inpatient stay is any day FOLLOWING the ED visit is TWO encounters
If a person has an inpatient stay and is discharged and goes to the ED on the same day as the
discharge to the same provider, that will be counted as ONE encounter
Contiguous inpatient stays from the same provider are merged and counted as ONE encounter
The measurement span includes one month prior and one month after the actual measurement
year to evaluate inpatient discharge dates
o Inpatient discharge must occur between the start and end dates of the measurement
span to be included as an encounter
Minnesota EHR Incentive Program (MEIP)
Page 26 of 26
Appendix A - MEIP Guidance on Supporting Documentation
Category
Document Options
AIU Other
Adopt, Implement, Upgrade
Contract
Purchase Order/Invoice/Receipt
Reconsideration
Reconsideration Request –
Supporting Documentation
Appeal
MEIP Appeal Form
Pre-Payment Audit
Pre-Payment Audit
Documentation
Post-Payment Audit
Post-Payment Audit
Documentation
EHR Solution
EHR Contract
EHR Other
EHR Purchase Order
EHR Software License
Group
Group Attestation Document
Group Members Consent
Documentation
Group Other
Group Volumes Supporting
Documentation
Required/Situational
Required – first year only. In the first year, providers will be required to upload at
least one form of AIU documentation. This documentation must clearly show the
relationship between the certified EHR vendor, the entity that adopted, implemented
or upgraded to the system, and the licensed user.
Situational. This documentation type would only be used if a provider is requesting a
reconsideration of an initial payment decision.
Situational. This documentation type would only be used if a provider is filing a
formal appeal of a payment decision.
Situational. This documentation type would only be used if a provider has been
asked for additional documentation during a pre-payment desk audit.
Situational. This documentation type would only be used if a provider has been
asked for additional documentation during a post-payment audit.
Required – second year and beyond. Providers will be required to upload at least
one form of EHR solution documentation in year 2 and beyond. This documentation
must clearly show the relationship between the certified EHR vendor, the entity
using the system, and the licensed user.
Situational. Providers attesting using a group Medicaid Patient Volume (MPV), will
be required to upload documentation listing the EPs, whether they intend to attest
as part of the group, and documenting their consent to include their patient volume
included in the group. The MEIP Group Consent Form available on the MEIP
Reference Material website provides a template for providers to account for all
professionals employed by the group.
Category
Document Options
Disagreed with Legal Notice
Legal Notice
Signed & Affirmed Legal Notice
Meaningful Use
MU Other
Patient Volume
Hospital Based
Patient Encounter
Patient Volumes Other
Out of State Volume
Payment
Pediatrician Attestation
FQHC/RHC/IHS Attestation
Required/Situational
Situational. This document is automatically generated and uploaded to the
provider’s file if the provider indicates that they disagree with the legal notice.
Required. This document is automatically generated and uploaded to the provider’s
file when they electronically sign the legal notice. Providers are offered the
opportunity to print a copy of this document for their records upon attestation.
Situational. If a provider is attesting for meaningful use, they may use this option to
upload any related documentation in support of their MU attestation.
Situational. Providers may upload documentation in support of their Medicaid
patient volume. This is required in situations where providers are including out-ofstate encounters in their MPV attestation. Documentation of out-of-state
encounters should specify the number and state in which the encounters occurred.
EH Average Length of Stay
EH Charity Expenses Supporting
Documentation
EH Discharge Documentation
EH Schedule Adjustment
EH Medicaid Share
EH Cost Report and/or HAR
EP Adjustment
Payment Other
Situational. Hospitals will be required to submit documentation relevant to their
payment calculation. Categories are also available in the event that an EP would
need to upload any payment related documentation.
Pediatrician Certification
Situational. Providers may upload documentation in support of their pediatrician
attestation. Per MN Statute, (f) "Pediatrician" means a physician who is certified by
either the American Board of Pediatrics or the American Osteopathic Board of
Pediatrics.
PA So-Led Documentation
Situational. Providers may upload documentation in support of their PA-So-Led
attestation. Page 44483 of the Final Rule clarifies the CMS definition of Physician
Assistant (PA) ‘so-led’. The MEIP PA So-Led Form is available on the MEIP Reference
Material website for providers to attest to being employed in a so-led facility.
Appendix B. MEIP EP Individual and Group Volume Worksheet
From Date (m/d/yy)
Medicaid Provider Name
NPI
To Date (m/d/yy)
Group NPI
Total Medicaid EP
Encounters
Total Encounters
PV Numerator
PV Denominator
Attesting with
Group (Y/N)
Consent to include
your patient
volume in the
group (Y/N)
Signature of Consent to attest
with the group
1
2
3
4
5
6
7
8
9
10
11
12
13
14
Note: The Medicaid patient volume will be calculated based on any continuous three month reporting period in the previous calendar year starting the first day of the month.
Appendix C. MEIP Hospital Calculation Sample
MEIP Hospital Incentive Payment Calculation Worksheet Version 1.0
Step 1: Calculate growth rate
Total
Discharges
Previous
Year
(Source1: CMS-2552-10 Medicare Cost Report
Worksheet S-3, Part I, col. 15, line 14) OR (Source2:
CMS-2552-96 Medicare Cost Report Worksheet S-3,
Part I, Col. 15, Line 12)
Year 1
(Federal
Fiscal (FF) Year
prior to payment
year))
Year 2
(1st Previous
FF Year)
Year 3
(2nd Previous
FF Year)
Year 4
(3rd Previous
FF Year)
18,131 =
-0.006397882
18,131 -
17,297 =
834 ÷
17,297 =
0.048216454
17,297 -
16,773 =
16,773
Average
Growth Rate
+
+
+
+
18,015
18,015
18,454
18,903
(Source1: CMS-2552-10 Medicare Cost Report
Worksheet C, Part I, col. 8, line 200) OR (Source2: CMS2552-96 Medicare Cost Report Worksheet C, Part I,
Col. 8, Line 101)
Charity
Care
Charges*
Step 4: Calculate aggregate amount
Overall EHR Amount
Step 5: Apply MN hospital incentive payout schedule
Aggregate EHR Amount
$4,292,535 ×
$4,292,535 ×
$4,292,535 ×
18,015
18,454
18,903
19,363
Allowed
Discharges
Medicaid
Share
31.44%
Payout
Percentage
50%
40%
10%
=
$939,854,524 =
Aggregate EHR
Amount
16,865
17,304
17,753
18,213
0.031240684
Years
of Data
0.073 ÷
Discharges
Rate
×
×
×
×
3
Average Growth Rate
=
Discharge
Cost
=
=
=
=
$200
$200
$200
$200
$3,373,000
$3,460,744
$3,550,625
$3,642,695
% of
Noncharity
Charges
0.95 ×
Total Inpatient
Days
(Source1: CMS-2552-10 Medicare Cost Report Worksheet S3 part I, col. 8, line 1, 2 + lines 8-12) OR (Source2: CMS2552-96 Medicare Cost Report Worksheet S-3, Part I, Col. 6,
Line 1, 2 +lines 6-10)
97,530 =
Adjusted
Inpatient
Days
92,879
2.44%
Base
Amount
+
+
+
+
Note: There is no dischange allowance for discharges less than 1,150 and more than 23,000 (23,000 - 1,150
= 21,850).
Total
Charges
$44,821,846.00 ÷
16,773 =
(max=21,850)
(Source1: CMS-2552-10 Medicare Cost Report Worksheet S10, col. 3, line 20 minus HAR 0621) OR (Source2: CMS-255296 Medicare Cost Report Worksheet S-10, Line 30 minus
HAR 0621) OR (Source3: HAR line 0762)
$939,854,524.00 -
$13,654,544 ×
524 ÷
Adjusted
Discharges
=
=
=
=
0
2.44%
2.44%
2.44%
Total
Charges
Year 1
Year 2
Year 3
Percent
Change
(116) ÷
Step 3: Calculate Medicaid share
Current Yr
Previous
Year
18,131 =
Total
Discharges
Current Yr
Difference
18,015 -
Step 2: Calculate initial payments
Year 1
Year 2
Year 3
Year 4
Last updated: 09/26/2012
Transition Factor
×
×
×
×
$2,000,000
$2,000,000
$2,000,000
$2,000,000
Initial EHR
Payment
1
=
0.75
=
0.50
=
0.25
=
Overall EHR Amount:
Medicaid Inpatient Days
FFS**
Medicaid Inpatient Days
MC***
(Source1: CMS-2552-10 Medicare Cost Report Worksheet S3 part I, col. 7, line 1 + lines 8-12) OR (Source2: CMS-255296 Medicare Cost Report Worksheet S-3, Part I, Col. 5, Line
1 + lines 6-10)
(Source1: CMS-2552-10 Medicare Cost Report
Worksheet S-3 part I, col. 7, line 2) OR (Source2:
CMS-2552-96 Medicare Cost Report Worksheet S-3,
Part I, Col. 5, Line 2)
8,889
+
$5,373,000
$4,095,558
$2,775,313
$1,410,674
$13,654,544.48
20,309 ÷
MEIP Hospital Calculation Worksheet footnotes
$4,292,534.96
* Charity Care Charges - Charges amount on CMS-2552-10 Medicare Cost Report Worksheet S-10, col. 3, line 20 and CMS-2552-96 Medicare Cost Report Worksheet S-10, Line 30 is
an Uncompensated amount and not exclusive to Charity Care. To calculate Charity Care when using 2552-10 or 2552-96, Bad Debt must be located on HAR Report 0621 then
=
=
=
Annual Incentive
Payment
$2,146,267.48
$1,717,013.98
$429,253.50
$4,292,534.96
Subtracted from the Uncompensated amount.
** Medicaid Inpatient Days FFS - To calculate net value, SUBTRACT Managed Care (MC) patient days, Medicaid eligible days for which no payment was received and nursery days
after discharge from CMS-2552-10 Medicare Cost Report Worksheet S-3 part I, col. 7, line 1 + lines 8-12 or CMS-2552-96 Medicare Cost Report Worksheet S-3, Part I, Col. 5,
line 1 +lines 6-10.
*** Medicaid Inpatient Days MC – To calculate net value, SUBTRACT Medicaid Fee-For-Service (FFS) secondary payer patient days, Medicaid eligible days for which no payment
was received and nursery days after discharge from CMS-2552-10 Medicare Cost Report Worksheet S-3 part I, col. 7, line 2 or CMS-2552-96 Medicare Cost Report Worksheet S-3,
Part I, Col. 5, Line 2.
Requirement: Hospitals are required to use their CMS approved cost report. If a CMS approved cost report is not used then supporting documentation will be required. Hospitals
are to use their MN Hospital Annual Report (HAR) when necessary.
Adjusted
Inpatient
Days
92,879
Medicaid
Share
=
31.44%
Appendix D. MEIP First Enrollment and Attestation Month
OCT 2012 NOV 2012 DEC 2012 JAN 2013 FEB 2013 MAR 2013 APR 2013 MAY 2013 JUN 2013 JUL 2013 AUG 2013 SEP 2013 OCT 2013 NOV 2013 DEC 2013 JAN 2014
SEPT 2012 2012 or
or earlier
2013
OCT 2012
CMS R & A Registration Date
NOV 2012
DEC 2012
JAN 2013
FEB 2013
MAR 2013
APR 2013
MAY 2013
JUN 2013
JUL 2013
AUG 2013
SEP 2013
OCT 2013
NOV 2013
DEC 2013
JAN 2013
2013
2012 or
2013
2012 or
2013
2012 or
2013
2013
2013
2013
2013
2013
2013
2013
2013
2013 or
2014
2013 or
2014
2013 or
2014
2014
2013
2013
2013
2013
2013
2013
2013
2013
2013
2013
2013
2013 or
2014
2013 or
2014
2013 or
2014
2014
2013
2013
2013
2013
2013
2013
2013
2013
2013
2013
2013
2013 or
2014
2013 or
2014
2013 or
2014
2014
2013
2013
2013
2013
2013
2013
2013
2013
2013
2013
2013 or
2014
2013 or
2014
2013 or
2014
2014
2013
2013
2013
2013
2013
2013
2013
2013
2013
2013 or
2014
2013 or
2014
2013 or
2014
2014
2013
2013
2013
2013
2013
2013
2013
2013
2013 or
2014
2013 or
2014
2013 or
2014
2014
2013
2013
2013
2013
2013
2013
2013
2013 or
2014
2013 or
2014
2013 or
2014
2014
2013
2013
2013
2013
2013
2013
2013 or
2014
2013 or
2014
2013 or
2014
2014
2013
2013
2013
2013
2013
2013 or
2014
2013 or
2014
2013 or
2014
2014
2013
2013
2013
2013
2013 or
2014
2013 or
2014
2013 or
2014
2014
2013
2013
2013
2013 or
2014
2013 or
2014
2013 or
2014
2014
2013
2013
2013 or
2014
2013 or
2014
2013 or
2014
2014
2013
2013 or
2014
2013 or
2014
2013 or
2014
2014
2014
2014
2014
2014
2014
2014
2014
2014
2014
2014
Appendix E - MEIP Hospital Fiscal Year Start
Hospital
Fiscal Year
Start
2012 Payment Year1
2013 Payment Year2
January
January 1, 2010 - December 31, 2010
January 1, 2011 - December 31, 2011
February
February 1, 2010 - January 31, 2011
February 1, 2011 - January 31, 2012
March
March 1, 2010 - February 28, 2011
March 1, 2011 - February 28, 2012
April
April 1, 2010 - March 31, 2011
April 1, 2011 - March 31, 2012
May
May 1, 2010 - April 30, 2011
May 1, 2011 - April 30, 2012
June
June 1, 2010 - May 31, 2011
June 1, 2011 - May 31, 2012
July
July 1, 2010 - June 30, 2011
July 1, 2011 - June 30, 2012
August
August 1, 2010 - July 31, 2011
August 1, 2011 - July 31, 2012
September
September 1, 2010 - August 31, 2011
September 1, 2011 - August 31, 2012
October
October 1, 2010 - September 30, 2011
October 1, 2011 - September 30, 2012
November
November 1, 2009 - October 31, 2010
November 1, 2010 - October 31, 2011
December
December 1, 2009 - November 30, 2010 December 1, 2010 - November 30, 2011
1
2
– EH must have registered with CMS Registration and Attestation (R&A) prior to September 30, 2012
– During the “120 day grace period” from October 1, 2012 – January 31, 2013, EHs that have
completed the CMS R&A registration per footnote 1, have the choice of selecting payment year 2012 or
2013.