EHR Incentive Program

PROGRAM NEWS

August 25, 2017 – EHR Incentive Program Changes in the Fiscal Year (FY) 2018 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Acute Care Hospital (LTCH) Prospective Payment System Final Rule (FY2018 IPPS). On August 2, 2017, CMS published the FY2018 IPPS final rule. This final rule included changes and updates that impact the Medicare and Medicaid EHR Incentive Programs for CY2017 and CY2018 attestations of eligible professionals (EP) and eligible hospitals (EH).

Changes to Clinical Quality Measures (CQMs) for EH

For CY2017:

Reporting period: For EH reporting CQMs electronically that demonstrate meaningful use for the first time in 2017 or that have demonstrated meaningful use in any year prior to 2017, the reporting period will be one self‑selected quarter (or 90 days in the Medicaid EHR Incentive Program) of CQM data in CY2017.

CQMs: If an EH is only participating in the EHR Incentive Program or is participating in both the EHR Incentive Program and the Hospital IQR Program, the eligible hospital or CAH will report on at least four (self-selected) of the available CQMs electronically.

For CY2018:

Reporting period: For EH reporting CQMs electronically that demonstrate meaningful use for the first time in 2018 or that have demonstrated meaningful use in any year prior to 2018, the reporting period will be one self-selected quarter (or 90 days in the Medicaid EHR Incentive Program) of CQM data in CY 2018. For the Medicare EHR Incentive Program only, the submission period for reporting CQMs electronically will be the two months following the close of the calendar year, ending February 28, 2019.

CQMs: For EH participating only in the EHR Incentive Program or is participating in both the EHR Incentive Program and the Hospital IQR Program, the EH will report on at least four (self-selected) of the available CQMs electronically.

For CY2017 and CY2018, EHs that report CQMs by attestation under the Medicare EHR Incentive Program as a result of electronic reporting not being feasible and for EHs that report CQMs by attestation (manual data entry) under their State’s Medicaid EHR Incentive Program, they are required to report on all 16 available CQMs for the full CY (consisting of four quarterly data reporting periods). CMS also established an exception to this full-year reporting period for EHs demonstrating meaningful use for the first time under the State’s Medicaid EHR Incentive Program. Under this exception, the CQM reporting period is any continuous 90-day period within the CY.

Changes to Clinical Quality Measures (CQMs) for EP

For CY2017:

Reporting Periods: For 2017, CMS is modifying the CQM reporting period for EPs in the Medicaid EHR Incentive Program to be a minimum of a continuous 90-day period during CY2017.

CQMs: For 2017, EPs are no longer required to report CQMs based on 3 National Quality Domains (NQS). EPs may report any 6 (self-selected) CQMs from the list of 53 available CQMs. CMS is aligning the specific CQMs available to EPs participating in the Medicaid EHR Incentive Program with those available to professionals participating in the Merit-based Incentive Payment System removing 11 CQMs (see table below) from the list of 64 CQMs. 

Measure

Title

CMS61v6

Preventive Care and Screening: Cholesterol - Fasting Low Density Lipoprotein (LDL-C) Test Performed

CMS62v5

HIV/AIDS: Medical Visit

CMS64v6

Preventive Care and Screening: Risk-Stratified Cholesterol -Fasting Low Density Lipoprotein (LDL-C)

CMS77v5

HIV/AIDS: RNA Control for Patients with HIV

CMS126v5

Use of Appropriate Medications for Asthma

CMS140v5

Breast Cancer: Hormonal Therapy for Stage I (T1b)-IIIC Estrogen Receptor/Progesterone Receptor (ER/PR) Positive Breast Cancer

CMS141v6

Colon Cancer: Chemotherapy for AJCC Stage III Colon Cancer Patients

CMS148v5

Hemoglobin A1c Test for Pediatric Patients

CMS163v5

Diabetes: Low Density Lipoprotein (LDL-C) Control (< 100 mg/dL)

CMS179v5

ADE Prevention and Monitoring: Warfarin Time in Therapeutic Range

CMS182v6

Ischemic Vascular Disease (IVD): Complete Lipid Profile and LDL-C Control (<100 mg/dL)

Additional Changes to the Medicare and Medicaid EHR Incentive Programs

For 2018, CMS is finalizing the modification to the EHR reporting periods for new and returning participants attesting to CMS or their state Medicaid agency from the full year to a minimum of any continuous 90-day period during the calendar year.

CMS is finalizing the addition of a new exception from the Medicare payment adjustments for EPs, eligible hospitals, and CAHs that demonstrate through an application process that compliance with the requirement for being a meaningful EHR user is not possible because their certified EHR technology has been decertified under ONC’s Health IT Certification Program.

CMS is also finalizing an exception to the 2017 and 2018 Medicare payment adjustments for ambulatory surgical center (ASC)-based EPs and defining ACS-based EPs as those who furnishes 75 percent or more of their covered professional services in an ASC, using Place of Service (POS) code 24 to identify services furnished in an ASC.

CMS is adopting final policies to allow healthcare providers to use either 2014 Edition CEHRT, 2015 Edition CEHRT, or a combination of 2014 Edition and 2015 Edition CEHRT, for an EHR reporting period in 2018. This policy is based on the ongoing monitoring of progress on the deployment and implementation status of EHR technology certified to the 2015 Edition, as well as feedback by stakeholders expressing the need for more time and resources are needed for the transition process. All new and returning participants attesting to CMS or their State Medicaid agency have the option to attest to the Modified Stage 2 objectives and measures for the EHR reporting period in 2018 using 2014 Edition CEHRT, 2015 Edition CEHRT, or a combination of 2014 and 2015 Edition CEHRT, as long as the EHR Technology they possess can support the objectives and measures to which they plan to attest. Similarly, all new and returning participants attesting to CMS or their State Medicaid agency have the option to attest to the Stage 3 objectives and measures for the EHR reporting period in 2018 using 2015 Edition CEHRT or a combination of 2014 and 2015 Edition CEHRT, as long as their EHR technology can support the functionalities, objectives and measures for Stage 3.

Please review the final rule for detailed information.

June 29, 2017 – Hardship exemption information for Medicare Eligible Professionals (EP) and Eligible Hospitals (EH). To avoid a Medicare payment adjustment, EPs and EHs who are eligible to participate in the Medicare EHR Incentive Program, must successfully demonstrate meaningful use in either the Medicare EHR Incentive Program or in the Medicaid EHR Incentive Program, Medicaid EP who do not furnish covered professional services under Medicare are not subject to these payment adjustments. The deadline for Eligible Professionals (EPs) to submit Hardship forms for the 2018 payment adjustment, based on the 2016 EHR reporting period is July 01, 2017.

To be considered for an exception (to avoid a payment adjustment) providers must complete a Hardship Exception application and provide proof of the hardship. If approved, the hardship exception is valid for only one payment year. Providers need to submit a new application for subsequent years and in no case may a provider be granted an exception for more than 5 years.

For additional information on Hardship Exception, please visit the CMS Website.

April 26, 2017 - Review 2017 Program Requirements in the FY2017 Outpatient Prospective Payment System (OPPS) / Ambulatory Surgical Center (ASC) Final Rule on the EHR Incentive Programs Website. Providers who have not demonstrated meaningful use successfully in a prior year and are seeking to demonstrate meaningful use for the first time in 2017 to avoid the 2018 payment adjustment must attest to Modified Stage 2 objectives and measures. Providers who have demonstrated meaningful use successfully in a previous year may attest to Stage 3 objectives and measures starting in 2017.

CMS encourages eligible hospitals, CAHs, and dual-eligible hospitals to visit the EHR Incentive Programs website for more details about the 2017 program requirements outlined below.

OPPS/ASC Final Rule with Comment Period:

  • Eliminated the Clinical Decision Support (CDS), and the Computerized Provider Order Entry (CPOE) objectives and measures beginning in 2017;
  • Reduced the threshold for the View, Download or Transmit (VDT) measure of the Patient Electronic Access Objective to at least one unique patient (or patient-authorized representative) for Modified Stage 2;
  • Reduced the thresholds for a subset of Patient Electronic Access to Health Information, Coordination of Care through Patient Engagement, Health Information Exchange, and Public Health Reporting and Clinical Data Registry measures for Stage 3;
  • Added new naming conventions for measures; and
  • Requires that actions occur within the EHR reporting period, or the calendar year in which the EHR reporting period occurs, in order to be included in the numerators for specific measures.

April 24, 2017 - The Centers for Medicare & Medicaid Services (CMS) issued the proposed rule for FY2018 Inpatient Prospective Payment System (IPPS) and Long Term Acute Care Hospital (LTCH) rule on April 14, 2017. The proposed rule includes a number of changes to the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs summarized below:

  • For CY 2018, modifying the EHR reporting period from the full calendar year to a minimum of any continuous 90-day period for new and returning participants in the Medicare and Medicaid EHR Incentive programs.
  • Adding a new exception from the Medicare payment adjustments for Eligible Professionals (EPs), Eligible Hospitals, and Critical Access Hospitals (CAHs) that demonstrate through an application process that complying with the requirement for being a meaningful EHR user is not possible because their certified EHR technology has been decertified under ONC’s Health IT Certification Program.
  • Implementing a policy in which no payment adjustments will be made for EPs who furnish “substantially all” of their covered professional services in an ambulatory surgical center (ASC); applicable for the 2017 and 2018 Medicare payment adjustments.
  • Using Place of Service (POS) code 24 to identify services furnished in an ASC as well as requesting public comment on whether other POS codes or mechanisms should be used to identify sites of service in addition to or in lieu of POS code 24.

 Formal comments may be submitted by June 13, 2017. To learn more, review the proposed rule and visit the CMS website.

Program Year 2016 is the last year that Eligible Professionals (EPs) may begin participation in the Medicaid EHR Incentive Program. Participation information may be obtained by contacting the New Jersey Medicaid EHR Incentive Program Helpdesk at (800-767-145 option 7) or the Medicaid Provider Program of the NJ-HITEC, the State’s Regional Extension Center. The deadline date for CY2016 attestations is March 31, 2017.

February 7, 2017 - Alternate Medicare MU Attestations available to Medicaid EPs for PY 2016 during the CMS Reporting Period (January-March 13, 2017).  Medicaid Eligible Providers (EPs) who do not qualify to attest to Meaningful Use (MU) with Medicaid for Program Year or Calendar Year 2016 may attest to MU with Medicare in order to avoid Payment Adjustments in 2017 (if they are 1st-time MU attesters in PY 2016) or in 2018 (if they are returning MU attesters in PY 2016).

The Alternate Medicare MU attestation will now be available to Medicaid EPs who have registered for PY 2016 at the CMS Registration & Attestation UI (CMS RNA), and whose registration had been confirmed by New Jersey Medicaid at the CMS RNA between January 3rd, 2017 and March 13th, 2017.

Note that the end date for the CMS Medicare PY 2016 Reporting period has been extended from February 28, 2017 to March 13, 2017.

PLEASE NOTE: Although the Alternate Medicare MU attestation is done by the Medicaid EP with CMS (through CMS RNA), the registration of the Medicaid EP with the New Jersey Medicaid EHR Incentive Program has to be confirmed before the Medicaid EP can proceed with submitting the MU attestation in CMS RNA. In other words, even though a Medicaid EP has registered at the CMS RNA for PY 2016, the Medicaid EP cannot proceed with the Alternate Medicare MU attestation at the CMS RNA – the MU attestation menus do not become available – until New Jersey Medicaid EHR Incentive Program confirms the Medicaid EP’s registration. To do this, after the EP had registered in the CMS RNA, New Jersey Medicaid must confirm eligibility and send a response to CMS/NLR before the EP can proceed with the Medicare MU attestation. New Jersey Medicaid recommends that the EP must allow at least 24 hours for this process to be completed.

There is no incentive payment for successfully completing the Alternate Medicare MU attestation. It is for avoiding Medicare payment adjustments only.  EPs encountering difficulties at the CMS RNA attempting the Alternate Medicare MU attestation after New Jersey Medicaid has confirmed the EP’s registration may contact the CMS Help Desk/EHR Information Center for assistance: (888) 734-6433/ TTY: (888) 734-6563 and select option 1. Hours are from Monday to Friday between 8:30 a.m. and 7:30 p.m. EST.

February 6, 2017 - CMS Extends Meaningful Use Attestation Deadline for Medicare EHR Incentive Program.  The Centers for Medicare & Medicaid Services (CMS) has extended the attestation deadline for providers participating in the Medicare EHR Incentive Program to Monday, March 13, 2017, at 11:59 p.m. PT.  Providers participating in the Medicare EHR Incentive Program must attest to the 2016 program requirements by March 13, 2017 to avoid a 2018 payment adjustment.  Providers participating in the New Jersey Medicaid EHR Incentive Program have until March 31, 2017 to attest and demonstrate meaningful use of EHR technology.

January 17, 2017 - eCQM Submission Deadline Extended to March 13, 2017 for Calendar Year 2016 Reporting Period. The Centers for Medicare & Medicaid Services (CMS) is notifying eligible hospitals and critical access hospitals participating in the Hospital Inpatient Quality Reporting (IQR) and/or the Medicare Electronic Health Record (EHR) Incentive Programs of a deadline extension. The extension is for the submission of electronic Clinical Quality Measure (eCQM) data for the Calendar Year (CY) 2016 reporting period, pertaining to the Fiscal Year (FY) 2018 payment determination. The deadline has been changed from Tuesday, February 28, 2017, to Monday, March 13, 2017, at 11:59 p.m. PT. This extension is being granted to provide hospitals additional time to submit eCQM data.

December 9, 2016 – 90-day EHR Reporting Period for 2016 in the New Jersey EHR Incentive Program Attestation Application. In compliance with the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs provision included in the Final Rule for Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System for calendar year (CY) 2017, New Jersey completed all the necessary revisions to the attestation application or Provider Incentive Payment (PIP) system to allow eligible providers to attest using a 90-day EHR reporting period for CY2016.

November 1, 2016 – The Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System for calendar year (CY) 2017. The Final Rule for the OPPS and ASC was released, this rule includes a number of proposed changes that would affect the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs, including:

  • Eliminating the Clinical Decision Support (CDS) and Computerized Provider Order Entry (CPOE) objectives and measures beginning in 2017 for eligible hospitals and CAHs attesting to CMS, including:
    • Reducing a subset of thresholds for the remaining objectives and measures for Modified Stage 2 in 2017 and Stage 3 in 2017 and 2018.
    • Adding new naming conventions to measures for Modified Stage 2 and Stage 3 for Eligible Hospitals, critical access hospitals, and dual-eligible hospitals attesting to CMS.
  • Allowing all returning participants in the EHR Incentive Programs to report on a 90-day EHR reporting period in 2016 and 2017.
  • Implementing an application process for a one-time significant hardship exception to the Medicare EHR Incentive Program for certain eligible professionals in 2017 who are also transitioning to the Merit-based Incentive Payment System (MIPS).

A CMS fact sheet was published to provide additional information.

September 9, 2016 – Total Medicaid Encounter Calculation Using 90-Day Period in the 12-Months Preceding the Attestation (Volume “Look-Back” Period). New Jersey, with approval from CMS, will now allow the option for new eligible professionals (EPs) intending to attest for their first Medicaid EHR Incentive Program payment, to use a continuous 90-day period in the 12-months preceding the attestation to establish their Medicaid patient volume. New participating providers may select this option in place of the current preceding calendar year reporting period. This change was approved by CMS with the following provisions:

  1. In order to verify Medicaid volume eligibility, the State will conduct pre-payment inspections for all attestations that utilized the 12-month volume “look-back” period.
  2. If the 12-month volume look-back period falls under the preceding calendar year of attestation, the attestation will undergo the currently established volume reporting attestation process.
  3. The 12-month volume look-back period option will only be made available in calendar year 2016 and only for EPs attesting for their first Medicaid EHR Incentive Program payment.
  4. For practices with new EPs and other EPs that previously participated in the EHR Incentive Program, new EPs will attest utilizing a group proxy with a 12-month look-back volume reporting period and returning EPs will use group proxy with the previous calendar year volume reporting period.
  5. Returning EPs that reported a 90-day patient volume using the 12-month look-back period in CY2016 will be instructed to report a 90-day patient volume using the preceding calendar year in their subsequent attestation years.

Please contact Molina Provider Services for additional information.

June 28, 2016 – Medicare Eligible Professionals: Take Action by July 1 to Avoid 2017 Medicare Payment Adjustment. The Medicare EHR Incentive Program 2017 hardship exception instructions and application for EPs and eligible hospitals are available on the Payment Adjustments & Hardship Information webpage of the EHR Incentive Programs website. As a reminder, the application must be submitted electronically or postmarked no later than 11:59 p.m. ET on July 1, 2016 to be considered.

In addition, providers who are not considered eligible professionals under the Medicare program are not subject to payment adjustments and do not need to submit an application. Those types of providers include:

  • Medicaid only
  • No claims to Medicare
  • Hospital-based

Additional information regarding payment adjustments & hardship exception for Medicare eligible professionals is available from the CMS EHR Incentive Program website.

June 22, 2016 – Changes and Downtime for the ONC CHPL. The Office of the National Coordinator for Health IT (ONC) is implementing revisions to the Certified Health IT Products List (CHPL) webpage. ONC will be launching the CMS EHR Certification ID widget on the new CHPL site after July 1, 2016. As part of this process, the ONC CHPL website will not be available from June 28 to July 1, 2016.

June 1, 2016 – Deadline Extension for CMS NLR Registration for First-time Medicaid EHR Incentive Program Participants for Program Year 2016. CMS plans to extend the current registration deadline of December 31, 2016 to March 31, 2017. This welcome change allows first-time participants to register up to the New Jersey attestation deadline for Program Year 2016. New Jersey recommends that providers register at least one week before the March 31 deadline to allow registration information to be transmitted from the federal site to the state attestation application.

April 19, 2016 - Resources for Participation in the Medicare & Medicaid EHR Incentive Programs in 2016. To help eligible professionals, eligible hospitals, and critical access hospitals (CAHs) successfully participate in the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs in 2016, CMS posted new resources on the CMS EHR Incentive Programs website.

February 17, 2016 – Attestation Deadline for Eligible Hospitals and Eligible Professionals for Calendar Year 2015. The last day to attest for CY2015 in the New Jersey Medicaid EHR Incentive Program for eligible hospitals and eligible professionals is March 31, 2016.

February 17, 2016 – Attestation Update: Clinical Quality Measure Reporting Periods. Eligible providers demonstrating meaningful use for the first time are allowed to submit a CQM 90-day reporting period that is different than the 90-day meaningful use/EHR reporting period within the calendar year.

February 17, 2016 – Attestation Update: Reporting Measures Extracted From Patient Records Maintained Using Certified Electronic Health Record Technology (CEHRT) or All Patient Records. For the objectives, such as CPOE or ePrescription, where the provider is permitted, but not required, to limit the measures of the objectives to patients whose records are maintained using CEHRT, providers are required, as customary, to maintain auditable supporting documents.  In the audit process, the State’s auditors will perform additional testing procedures to determine accuracy of reported data.

February 3, 2016 – Modification to Meaningful Use in 2015-2017 Attestations in the New Jersey EHR Incentive Program Approved by CMS. The New Jersey EHR Incentive Program have received final approval from CMS for the Modifications to Meaningful Use 2015-2017 changes and will start accepting and processing all submitted attestations after all additional screen revisions are applied. We appreciate the patience of all our providers waiting to attest for CY2015 and we look forward to assisting providers and practices in their attestations.

December 15, 2015 – New Jersey EHR Incentive Program Attestations with Modification to Meaningful Use in 2015-2017 Specifications.  In compliance with the Modifications to Meaningful Use in 2015-2017 final rule, New Jersey completed all the necessary revisions to the attestation application to allow eligible professional attestations for CY2015 with the modified meaningful use specifications. We are currently awaiting final approval from CMS to start prepayment processing of the submitted attestations.

November 30, 2015 – Enhancement of Attestation System’s Supporting Document Upload Functionality. The supporting document upload functionality in the New Jersey EHR Incentive Program attestation application was recently enhanced. This enhancement, in the “Add Document” section of the attestation, will allow attesting providers to designate document categories to the documents that are being uploaded during attestation. The category choices are “Patient Volume”, “Certified EHR Technology”, “Meaningful Use Report/Dashboard (Only)”, “Meaningful Use (Other Documentation)” and “General”. The system was also improved where providers attesting for Meaningful Use will be required to upload their Meaningful Use report/dashboard and select the corresponding document category of “Meaningful Use Report/Dashboard (Only)” prior to submitting the completed attestation. The State expects that the new document category system enhancement will assist providers in supporting document management and streamline the attestation appeal process, while the MU dashboard requirement will reduce adverse audit findings.  

November 18, 2015 – Modification to Meaningful Use in 2015-2017 Effective Date on December 15, 2015.  The New Jersey EHR Incentive Program staff has been receiving calls on when eligible providers may attest for CY2015 with the Modifications to MU specifications. Based on the effective date of the new regulation, New Jersey plans to enable the attestation application with the Modifications to MU changes on December 15, 2015, pending CMS approval on the State submission of the required changes. Also, after December 15, 2015, the State will no longer accept MU attestations for any objective or measure which was removed and considered redundant, duplicative or topped out as defined in the final rule for Stage 3 of Meaningful Use and Modification to Meaningful Use in 2015-2017.

October 6, 2015 – CMS and ONC Release the Final Rules for the EHR Incentive Program, Stage 3 of Meaningful Use and Modification to Meaningful Use in 2015-2017 and the 2015 Edition CEHRT.  The Centers for Medicare & Medicaid Services (CMS) and Office of the National Coordinator for Health Information Technology (ONC) today released the final rules with comment period for the Medicare and Medicaid Electronic Health Records (EHRs) Incentive Programs - Stage 3 and Modifications to Meaningful Use in 2015-2017 and the final rules for 2015 Edition Health IT Certification Criteria (2015 Edition). Below are links and fact sheets to the final rules.

CMS Stage 3 and Modification to Meaningful Use in 2015-2017 – Final Rule
ONC 2015 Edition CEHRT Certification Criteria – Final Rule

CMS Stage 3 and Modification to Meaningful Use in 2015-2017 – Fact Sheet
ONC Stage 3 and 2015 Edition CEHRT – Fact Sheet

October 2, 2015 – New Jersey Medicaid EHR Incentive Program Attestation Website Scheduled Maintenance.  The Medicaid EHR Incentive Program website will undergo a scheduled system maintenance on October 8, Thursday, from 8:00pm to 12:00am.  We apologize for any inconvenience and we expect normal attestation process to resume after the scheduled maintenance is completed.

September 24, 2015 – CMS’ New Webpage for Past Program Requirements and Resources. CMS has created a new webpage on the EHR Incentive Programs website that contains all the program requirements and resources for previous years of the EHR Incentive Programs. Along with FAQs, the webpage is organized in a manner that allows users to readily retrieve specific information. Please select the link above to access the webpage.

September 10, 2015 – Celebrating the 10th Anniversary of National Health IT Week on October 5 thru 9, 2015. NHIT Week is a collaborative forum and virtual awareness week that assembles key healthcare constituents dedicated to working together to elevate the necessity of advancing health through the best use of information technology.

In celebration of NHIT Week, NJ-HITEC is conducting the 3rd Annual Medicaid Provider Meaningful Use event, "Road to Health IT Quality and Value" on October 7, Wednesday, at the NJIT campus in Newark. NJ-HITEC understands the importance of education, and will provide attendees with pertinent Health IT information that is necessary for successful participation in the Medicaid EHR Incentive Payment Program and Meaningful Use attestation. For additional information and to register for this event, please select this link.

July 1, 2015 – Updated Stage 2 Summary of Care FAQ Provides Guidance on Measure #3. CMS released a new FAQ with changes related to measure 3 of the Summary of Care objective in MU Stage 2 effective July 1, 2015. The change is associated with the discontinuation of the National Institute of Standards and Technology (NIST) EHR-Randomizer application, which is one of the options in meeting measure 3.

In summary, providers will be allowed to meet measure 3 either by, (1) transmission of summary care record to a recipient who has a different EHR vendor, within the calendar year but not beyond the EHR reporting period or attestation date or (2) attest “Yes” if the provider do not normally exchange summary of care records as common practice as long as the provider provides documentation of such circumstance and is using an EHR that is certified to send the summary of care document.

June 16, 2015 – Medicare Eligible Professionals: Take Action by July 1 to Avoid 2016 Medicare Payment Adjustment. Payment adjustments for eligible professionals that did not successfully participate in the Medicare EHR Incentive Program in 2014 will begin on January 1, 2016. Medicare eligible professionals can avoid the 2016 payment adjustment by taking action by July 1 and applying for a 2016 hardship exception. As a reminder, the application must be submitted electronically or postmarked no later than 11:59 p.m. ET on July 1, 2015 to be considered.

In addition, providers who are not considered eligible professionals under the Medicare program are not subject to payment adjustments and do not need to submit an application. Those types of providers include:

  • Medicaid only
  • No claims to Medicare
  • Hospital-based

Additional information regarding payment adjustments & hardship exception for Medicare eligible professionals is available from the CMS EHR Incentive Program website.

May 15, 2015 – ONC CHPL 4.0 Released. The Office of the National Coordinator for Health IT (ONC) Certified Health IT Product List (CHPL) was recently updated to version 4.0. The new release includes a completely refined user interface with improved search functions, better filtering options and new product selection processes.

Below are links to the new site as well as additional information

May 12, 2015 – CMS and ONC NPRMs Now Available for Comment. CMS and ONC invite the public to submit comments on the recently released notices of proposed rulemaking (NPRMs) announced in the program news item below dated April 15, 2015. Below are the due dates and links for comments to the proposed rules.

Comments due May 29

Comments due June 15

The New Jersey Regional Extension Center, NJ-HITEC, is also providing a Meaningful Use Proposed Rules: Stakeholder Webinar on May 18, 2015, 2:00pm-3:30pm. They will be providing a brief on the Meaningful Use Stage 3 and 2015-2017 Modifications NPRMs. The webinar will provide a forum for NJ stakeholders to provide their comments and NJ-HITEC will submit on their behalf. Select this link to register.

April 15, 2015 – CMS Releases Two Proposed Rules for the EHR Incentive Program, Stage 3 of Meaningful Use and Modification to Meaningful Use in 2015-2017. On March 23, 2015, CMS released a notice of proposed rulemaking (NPRM) for Stage 3 of Meaningful Use, the next step in the implementation of the Medicare and Medicaid Electronic Health Record Program. Concurrently, ONC also announced the proposed 2015 Edition certification criteria for health IT products. The CMS NPRM specifies the Stage 3 requirements for eligible professionals, eligible hospitals, and critical access hospitals to qualify for Medicaid EHR incentive payments and avoid Medicare payment adjustments in 2018 and beyond. ONC’s proposed rule outlines the certification and standards to help providers meet the proposed Stage 3 requirements with a 2015 Edition Certified Electronic Health Record Technology (CEHRT). On April 10, 2015, CMS issued a new proposed rule to align Stage 1 and Stage 2 objectives and measures with the long-term proposals for Stage 3, to build progress toward program milestones, to reduce complexity, and to simplify providers’ reporting. These modifications to meaningful use, intended to take effect in the 2015-2017 attestations, would allow providers to focus more closely on the advanced use of certified EHR technology to support health information exchange and quality improvement. Below are links and fact sheets to the proposed rules.

CMS EHR Incentive Program Stage 3 – Proposed Rule
ONC 2015 Edition CEHRT Certification Criteria – Proposed Rule
CMS Modification to Meaningful Use in 2015-2017 – Proposed Rule

CMS EHR Incentive Program Stage 3 – Press Release
ONC Stage 3 and 2015 Edition CEHRT – Fact Sheet
CMS Modification to Meaningful Use in 2015-2017 – Fact Sheet

March 11, 2015 – CY2014 Attestation Deadline for Eligible Professionals in the New Jersey Medicaid EHR Incentive Program.  Eligible Professionals have until 11:59 pm ET on March 31, 2015 to submit their CY2014 attestation for the New Jersey EHR Incentive Program. After this date, on April 1, 2015, the provider incentive payment system will start to accept CY2015 attestations.

March 2, 2015 – CMS Extends Deadline for Eligible Professionals (EP) to Switch EHR Incentive Program (from Medicare to Medicaid, or vice versa) and for Medicare Eligible Professionals to Attest to Meaningful Use.  CMS released a notice on February 25, 2015 announcing that EPs, who have not already used their one “switch”, to switch programs (from Medicare to Medicaid, or vice versa) for the 2014 payment year will have until 11:59 pm ET on March 20, 2015 to make the program switch.  After that time, EPs will no longer be able to switch programs.  The previous deadline date to allow the program switch was February 28, 2015. Additionally, the Medicare attestation deadline for CY2014 was also extended to March 20, 2015, from the previous deadline of February 28, 2015. Please note that this deadline date does not apply to the New Jersey Medicaid EHR Incentive Program, the deadline for EPs to submit the attestation for a CY2014 New Jersey Medicaid EHR Incentive Program payment remains March 31, 2015.

February 24, 2015 – Deadline to Register Intent for a Public Health Measure is March 1, 2015 for Eligible Professionals (EP) Attesting to Stage 2 of Meaningful Use.  CMS just released a reminder announcing the deadline date for all Stage 2 EPs planning to meet the public health measures. All Stage 2 EPs by rule at this time, are currently required to attest to a full-year meaningful use in CY2015 and would have already started their reporting period in January 1, 2015. These providers will have up to March 1, 2015 to meet the 60 day deadline date to submit “intent to initiate ongoing submission to public health registries”. Please refer to the CMS Stage 2 Eligible Professional Specification Sheet for more information. Please note that on January 29, 2015, CMS announced its intent to engage in rulemaking that is considering shortening the CY2015 meaningful use reporting period to 90 days. If this is adopted, then the 60 day deadline date will adjust corresponding to the start of the EP’s selected 90 day reporting period. However, based on the current rule, it is recommended that all Stage 2 EPs that need to register their intent for a public health objective must do so by the March 1, 2015 deadline to meet the measure.

February 12, 2015 – Last Year for Eligible Hospitals to Begin Participation and Receive Payments in the Medicaid and Medicare EHR Incentive Program.  CMS released an announcement on February 11, 2015 for eligible hospitals who have not started participation in the EHR Incentive Programs. For the Medicare EHR Incentive Program, the last year to begin and still earn incentive payments is FY2015. For the Medicaid EHR Incentive Program, the last year to begin and still earn incentive payments is FY2016. Medicaid eligible hospitals must receive an incentive in FY2016 to receive an incentive in FY2017 and later years. Starting in FY2016, incentive payments must be made every year in order to continue participation in the program.

January 28, 2015 - Hospital Attestation Deadline for 2014 Reporting Period in the Medicaid EHR Incentive Program.  Eligible hospitals who have not completed the attestation for fiscal year 2014 have until Saturday, January 31, 2015, to submit their attestations in the New Jersey Medicaid EHR Incentive Program.

December 31, 2014 – New Jersey Medicaid EHR Incentive Program Payments. As of today’s date, more than $156.8 million in incentive payments had been distributed to eligible hospitals ($102.1 million) and eligible providers ($54.7 million).

December 31, 2014 – 2014 Meaningful Use Reporting Period Ends for Eligible Professionals on December 31, 2014.  Today marks the end of the meaningful use reporting period for all calendar year 2014 attestations for eligible professionals participating in the EHR Incentive Program. Participating providers in the New Jersey Medicaid EHR Incentive Program have until March 31, 2015 to submit and attest that they are demonstrating meaningful use during the EHR reporting period for the 2014 calendar year.

December 8, 2014 – Hospital Attestation Deadline Extension for 2014 Reporting Period in the Medicare and Medicaid EHR Incentive Program.  CMS recently announced a one month extension for eligible hospitals to attest to meaningful use for the Medicare EHR Incentive Program reporting period 2014 to December 31, 2014. According to CMS, the extension will allow more time for hospitals to submit their meaningful use attestation data for incentive payments and avoid the 2016 Medicare payment adjustments. This information is now reflected on the CMS EHR Incentive Programs website (https://www.cms.gov/regulations-and-guidance/legislation/ehrincentiveprograms/basics.html).

Based on the revised Medicare attestation deadline, the New Jersey Medicaid EHR Incentive Program extended hospital attestations in reporting period 2014 to January 31, 2015. The corresponding extension in the Medicaid program will allow for the completed Medicare meaningful use attestation data to be sent to Medicaid and, subsequently, allow dually eligible hospitals to complete their Medicaid attestations.

For eligible professionals in reporting period 2014, the attestation deadline date of March 31, 2015 in the New Jersey Medicaid EHR Incentive Program remains unchanged. The attestation deadline for eligible professionals in the Medicare EHR Incentive Program is February 28, 2015.

November 24, 2014 – Hardship Exception Applications to Avoid the 2015 Medicare Payment Adjustment Due November 30, 2014. CMS released an announcement reminding eligible professionals and eligible hospitals that the reopened submission period for hardship exception application to avoid the 2015 Medicare payment adjustments for not demonstrating meaningful use is ending at 11:59 PM EST on November 30, 2014.

IMPORTANT NOTE: The New Jersey Division of Medical Assistance and Health Services is NOT responsible for administering the Medicare payment adjustment and cannot grant exemptions from the payment adjustment.  All requests for additional information on the payment adjustment should be directed to CMS.

Additional details as well as application instructions regarding this update may be obtained from the Payment Adjustments and Hardship Exceptions webpage.

November 5, 2014 – New Jersey Medicaid EHR Incentive Program Attestation Website Scheduled Maintenance.  The Medicaid EHR Incentive Program website will undergo a scheduled system maintenance from November 10, Monday, at 4:00pm through November 12, Wednesday, at 6:00pm.  Although the website will remain up, Medicaid patient volume data entry functionality will not be available prohibiting attestations to proceed.  We apologize for any inconvenience and we expect normal attestation process to resume after the scheduled maintenance is completed.

October 20, 2014 – New CMS FAQ on "How can a provider meet the Protect Electronic Health Information core objective...?” CMS released this FAQ to provide updated guidance on meeting this objective. The FAQ states that the steps required to conduct or review security risk analysis may be completed outside or the EHR reporting period timeframe but must take place no earlier than the start of the reporting year and end of the reporting year. Additional details may be obtained from the CMS FAQ10754.

October 8, 2014 - Hardship Exception Applications to Avoid the 2015 Medicare Payment Adjustment Extended for Eligible Providers and Eligible Hospitals.  CMS released an announcement Tuesday, October 7, that they are reopening the submission period for hardship exemption applications for eligible professionals and eligible hospitals to avoid the 2015 Medicare payment adjustments for not demonstrating meaningful use of certified electronic health record technology.  The new deadline will be 11:59 PM EST November 30, 2014.  The extension is only for eligible professionals and eligible hospitals who have been unable to fully implement 2014 Edition CEHRT due to delays in 2014 Edition CEHRT availability AND for eligible professionals who were unable to attest by October 1, 2014 and eligible hospitals that were unable to attest by July 1, 2014 using the flexibility options provided in the CMS 2014 CEHRT Flexibility Rule.  Additional details as well as application instructions regarding this update may be obtained from the CMS Payment Adjustments & Hardship Exceptions website.

August 20, 2014 - New CMS rule allows flexibility in certified EHR technology for 2014. The Department of Health and Human Services (HHS) published a final rule that allows health care providers more flexibility in how they use certified electronic health record (EHR) technology (CEHRT) to meet meaningful use for an EHR Incentive Program reporting period for 2014. Additional details on this Final Rule may be obtained from the EHR Incentive Programs 2014 CEHRT Rule: Quick Guide provided through the CMS.gov webpage.

June 25, 2014 - Eligible Professionals looking for information on the Medicare payment adjustments that will be applied in 2015 for Medicare providers that have not attested to meaningful use through either the Medicare or Medicaid EHR Incentive Programs should access the CMS Payment Adjustments & Hardship Exemptions website and review the CMS Payment Adjustments & Hardship Exceptions Tipsheet for Eligible Professionals.

This tip sheet provides an overview of the payment adjustment, including background information on the adjustment, deadlines for EPs to complete attestations in order to avoid being subject to the adjustment, and instructions for applying for hardship exemptions. 

IMPORTANT NOTE: The New Jersey Division of Medical Assistance and Health Services is NOT responsible for administering the Medicare payment adjustment and cannot grant exemptions from the payment adjustment.  All requests for additional information on the payment adjustment should be directed to CMS.

Frequently Asked Questions related to the New Jersey Medicaid EHR Incentive Program can be found below.

     New Jersey Medicaid FAQs
     CMS Medicaid and Medicare Incentive Program FAQs

Medicaid Eligible Professionals: To register for the Medicaid EHR Incentive Program, eligible professionals must register with the CMS National Level Repository (NLR) and elect to enroll in the New Jersey Medicaid EHR Incentive Program. Upon successfully registering with the NLR, providers will receive an e-mail from the State informing them that the State has received their registration information and will be able to begin the attestation process once the State's attestation system is available.

Note: Eligible professionals will have until March 31, 2016 to register and attest for a Medicaid EHR Incentive Program payment related to calendar year 2015.

Additional information about the registration and attestation processes can be found below:

Introduction to the Medicaid EHR Incentive Program for Eligible Professionals
NLR Registration User Guide for Medicaid Eligible Professionals
New Jersey Medicaid EHR Incentive Program Attestation Workbook for Eligible Professionals
New Jersey Medicaid EHR Incentive Program Attestation Application Manual for Eligible Professionals

Hospitals: Hospitals that have registered with the National Level Repository (NLR) for both the Medicare and Medicaid EHR Incentive Payment Programs should choose New Jersey as the state from which they will receive their Medicaid EHR Incentive Payment.  Hospitals that have not registered for a Medicare incentive payment are able to register for both the Medicare and Medicaid programs and choose New Jersey as their Medicaid state.  Hospitals can begin the registration process here. Upon successfully registering with the NLR and choosing New Jersey as their Medicaid state, hospitals will receive an e-mail from the State informing them that their registration information has been received and that they will be able to begin the attestation process once the State's attestation system is available.

Additional information about the registration and attestation processes can be found below:

NLR Registration Guide for Hospitals (covers both the Medicare and Medicaid Incentive Payment Programs)
New Jersey Medicaid EHR Incentive Payment Program Attestation Worksheet for Eligible Hospitals
New Jersey Medicaid EHR Incentive Payment Program Attestation User Guide for Eligible Hospitals

Medicare Eligible Professionals: New Jersey Medicare health care practitioners who are eligible for incentive payments for adopting and implementing an electronic health records system, and becoming a meaningful EHR user, can now register for the program via the Centers for Medicare and Medicaid Services website.

Click here for detailed instructions about the CMS NLR registration process for Medicare Eligible Professionals.

Last Reviewed: 8/28/2017