Concentrate on the Last Run.


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Extra inquiries may be submitted to: meaningfuluse@healthland.com ... prescription or osteopathy; dental surgery or dental pharmaceutical; podiatric drug; ...
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Slide 1

Concentrate on the Final Rule

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Please present all inquiries through the WebEx Q&A capacity. Extra inquiries might be submitted to: meaningfuluse@healthland.com Focus on the Final Rule EHR Certification & Meaningful Use

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Final Rule Legal Restrictions & Guidance Daniel Gottlieb Partner, McDermott Will & Emery LLP

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Agenda Who is a qualified healing facility (EHs)? Medicare Incentives Medicaid Incentives Who is a qualified proficient (EP)? Medicare Incentives Medicaid Incentives Exclusion of inapplicable significant use (MU) destinations

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Agenda (cont\'d) Changes to Medicare and Medicaid motivating force counts Registration and confirmation procedure and timetables Certification of EHR Technology Stark Law EHR Donation Exception Independent doctors on Medical Staff Hospital-Owned Clinics

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Medicare Eligible Hospitals Medicare EHs: a healing facility situated in one of the 50 states or D.C. that takes an interest in the Medicare Inpatient Prospective Payment System (IPPS) and Maryland intense consideration healing centers CAHs are additionally qualified for motivators Multi-grounds doctor\'s facility with a solitary supplier number is a solitary doctor\'s facility

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Medicare Eligible Hospitals Excludes IPPS-barred clinics and doctor\'s facility units, for example, Psych hospital -Rehab doctor\'s facility Children\'s hospital -LTCHs Surgical and other claim to fame doctor\'s facilities partaking in IPPS are qualified for Medicare impetuses

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Medicare Eligible Professionals Medicare EPs incorporate specialists of: prescription or osteopathy; dental surgery or dental medication; podiatric solution; optometry or chiropractry Hospital-based doctors who give 90% or a greater amount of their secured administrations in a doctor\'s facility inpatient or ER setting are ineligible

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Medicaid Eligible Hospitals EHs incorporate "intense consideration doctor\'s facilities" and kids\' doctor\'s facilities An "intense consideration doctor\'s facility" is a doctor\'s facility where the ALOS is 25 days or less and a CCN that has the last four digits in the arrangement 0001-0879 (fleeting general doctor\'s facilities and 11 U.S. disease doctor\'s facilities) and now under the last control likewise 1300-1399 (CAHs)

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Medicaid Eligible Hospitals Acute consideration doctor\'s facility must have no less than 10 percent Medicaid Patient Volume taking into account quiet experiences Like other Medicaid EHs, CAHs may get both Medicare and Medicaid EHR impetus installments If an EH meets Medicare MU prerequisites, it will be esteemed to meet Medicaid MU necessities

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Medicaid Eligible Professionals Medicaid EPs are the accompanying experts (other than doctor\'s facility based experts): Physicians and dental specialists attendant experts ensured medical caretaker birthing specialists doctor collaborators rehearsing in FQHCs or RHCs that are driven by a doctor right hand

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Medicaid Eligible Professionals A PA leads a FQHC or RHC under any of the accompanying circumstances: when a PA is the essential supplier in a center (for instance, when there is low maintenance doctor and full-time PA when a PA is a clinical or restorative executive at a clinical webpage of practice PA is a proprietor of the RHC

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Medicaid Eligible Professionals Medicaid EP must fulfill one of three Patient Volume limits: Have ≥ 30% Patient Volume owing to Medicaid beneficiaries Have ≥ 20% Patient Volume owing to Medicaid beneficiaries and be a pediatrician hone prevalently in a FQHC or RHC and have ≥ 30% Patient Volume owing to Needy Individuals

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Medicaid Eligible Professionals Needy Individuals are people who: got therapeutic help from Medicaid or the Children\'s Health Insurance Program were outfitted uncompensated care or were outfitted administrations either at no expense or decreased cost in view of a sliding scale dictated by people\'s capacity to pay

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Inapplicable MU Objectives Some MU destinations don\'t make a difference to each supplier so supplier would not have any qualified patients or activities for the measure denominator In these cases, supplier may bar (i.e., not meet) the measure Exclusions don\'t include against the conceded measures the menu set

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Inapplicable MU Measures For instance, an EH or CAH that did not have demand for electronic duplicate of release directions may bar center MU Objective #12 and just agree to 13 of 14 targets An EH or CAH that is prohibited from a menu set goal should just meet 4 as opposed to 5 of 10 goals

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Medicaid Incentive Calculation CMS illuminated that business\' or FQHC\'s buy of EHR for use by utilized EPs is not an installment CMS did not address whether installments from different sources could incorporate EHR gift to free doctor hone under Stark EHR gift exemption

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Registration To partake in motivating force programs, qualified supplier must enlist on motivator program site at http://www.cms.gov/EHrIncentivePrograms/Medicaid projects will interface with system enrollment site Registration starts in January 2011

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Registration necessities include: Name, National Provider Identifier, place of work and telephone number Taxpayer distinguishing proof number Hospital\'s CCN EPs must choose Medicare or Medicaid suppliers must choose one state

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Attestation for Medicare FFS Eligible suppliers show MU to CMS through validation in 2011 and authentication and electronic reporting of clinical quality data in 2012 Providers may submit confirmations as ahead of schedule as April 2011 to CMS Payment starts as ahead of schedule as May 2011 after authentication

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Attestation for Medicare FFS CMS will give an online device to confirmation CMS has not discharged authentication instrument CMS is building up a review technique to check verifications and forestall extortion and misuse Providers ought to create consistence and archive maintenance methods

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Attestation to States must recognize confirmation and/or electronic reporting component in their State Medicaid HIT Plans, subject to CMS endorsement States must create review and check strategies

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Attestation and Reporting FY 2011: EH or CAH must bear witness to that amid the EHR reporting period, it: Used affirmed EHR innovation and indicate innovation Satisfied required MU destinations and measures Must indicate the EHR reporting period and give the aftereffect of each material measure for inpatients and ER patients amid the reporting time frame

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Attestation and Reporting FY 2012 and after: EH or CAH must verify that amid the EHR reporting period, it: Used guaranteed EHR innovation and determine EHR Satisfied required MU destinations and measures aside from clinical quality reporting Must indicate the EHR reporting period and give the consequence of each appropriate measure EH or CAH should electronically report clinical quality measures through an entrance (or, if possible HIE or registry)

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EP\'s Attestation and Reporting For CY 2011: EP must validate that amid the EHR reporting period, EP: Used ensured EHR innovation and indicate innovation Satisfied required MU targets and measures Must indicate the EHR reporting period and give the aftereffect of each relevant measure

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EP\'s Attestation and Reporting For CY 2012 and after: EP must authenticate that amid the EHR reporting period, EP: Used confirmed EHR innovation and indicate EHR Satisfied required MU targets and measures with the exception of clinical quality reporting Must determine the EHR reporting period and give the aftereffect of each pertinent measure EP should electronically report clinical quality measures through an entry (or, if plausible HIE or registry)

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Medicare EH Payment Process Single installment contractual worker pays an EH or CAH a preparatory, assessed EHR motivation installment in light of most as of late recorded 12-month cost report as ahead of schedule as May 2011 after fruitful MU confirmation Final installment decided at time of settling cost report that starts on or after begin of installment year

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Medicare EP Payment Process Single installment contractual worker makes yearly motivation installment to an EP when EP exhibits MU and acquires the greatest yearly motivation installment Payments start as right on time as May 2011 after effective show of MU on validation

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EHR Certification ONC distributed the transitory EHR accreditation program last run on 6/24/2010, which sets up : determination process for testing and affirmation bodies (ONC-ATCBs) parameters under which the ONC-ATCBs will test and affirm that EHR meets the EHR certificate necessities ONC will make a Certified EHR list accessible this Fall

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Review of Medicare\'s Timeline Fall 2011 : Certified EHR innovation on EHR motivator program site January 2011 : Registration starts on motivating force program site April 2011 : Attestation of MU starts through web apparatus May 2011 : Medicare motivator installments start

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Stark EHR Donation Exception Stark Law gives an exemption to sponsorships for EHR things and administrations Exception applies to endowments for EHRs utilized as a part of private doctor hone workplaces Hospital may buy inpatient or mobile EHR for use in doctor\'s facility offices to serve doctor\'s facility patients without meeting special case

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Other Resources Comprehensive McDermott White Paper in regards to last EHR confirmation and important use directions to be issued in the blink of an eye Healthcare Informatics article in regards to Stark EHR gift special case

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Daniel F. Gottlieb Partner, McDermott Will & Emery LLP dgottlieb@mwe.com 312-984-6471

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Final Rule Accounting Requirements & Incentive Guidelines Ralph Llewellyn Partner, Eide Bailly

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Reimbursement Topics Medicare Share PPS Hospitals Critical Access Hospitals Eligible Professionals Medicaid Same

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Medicare Share Based on inpatient volume Numerator Medicare days + Medicare Advantage quiet days IP, forte care Psych and Rehab incorporated into proposed standard, yet e

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