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Eligible Hospital User Manual - Connecticut Medical Assistance

1. Measure Number Clinical Quality Measure Domain Screen Example CMS55 v3 Clinical Quality Measure 1 Screen 1 CMS111 v3 Clinical Quality Measure 2 Screen 1 Patient and Family CMS107 v3 Clinical Quality Measure 8 Engagement Screen 3 CMS110 v3 Clinical Quality Measure 14 Screen 5 CMS26 v2 Clinical Quality Measure 26 Screen 5 CMS104 v3 Clinical Quality Measure 3 Screen 2 CMS71 v4 Clinical Quality Measure 4 Screen 2 CMS91 v4 Clinical Quality Measure 5 Screen 3 CMS72 v3 Clinical Quality Measure 6 Screen 2 CMS105 v3 Clinical Quality Measure 7 Screen 2 CMS73 v3 Clinical Quality Measure 12 Screen 3 CMS109 v3 Clinical Quality Measure 13 Clinical Screen 3 Process Effectiveness CMS100 v3 Clinical Quality Measure 16 Screen 2 CMS113 v3 Clinical Quality Measure 17 Screen 3 CMS60 v3 Clinical Quality Measure 18 Screen 2 CMS53 v3 Clinical Quality Measure 19 Screen 3 CMS30 v4 Clinical Quality Measure 20 Screen 2 CMS9 v3 Clinical Quality Measure 27 Screen 3 CMS31 v3 Clinical Quality Measure 29 Screen 3 CMS102 v3 Clinical Quality Measure 9 Screen 3 Care Coordination CMS32 v4 Clinical Quality Measure 25 Screen 1 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide Measure Number Clinical Quality Measure Domain Screen Example CMS108 v3 Clinical Quality Measure 10 Screen 3 CMS190 v3 Clinica
2. Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide PATIENT VOLUMES cont Review the numbers you entered Click Save amp Continue to continue or click Previous to go back Print ContactUs Exit Connecticut DEPARTMENT oF Socia SERVICES Tuesday 03 12 2013 2 07 59 PM EDT Casing far Canmeclioat MAPIR HOSPITAL NPI 2011062207 ccm 070098 Hospital TIN Payment Year 1 Program Year 2013 Please review your hospital cost report data below When ready click the Save amp Continue button to continue or click Previous to go back Red asterisk indicates a required field De Pn Tan Total Se Total Charges All Total Charges Discharges Charity Care 10 01 2010 09 30 20112 10 01 2008 09 30 2009 um Click link to proceed to complete Patient Volume Cost Data on page 49 52 February 2015 Change Hospital Cost Data When you have applied since the start of the program in the same state and your payment year is 2 or higher MAPIR allows you to revise previously entered hospital cost data The Hospital Cost Data screen will display the data from the previously paid application The revised hospital cost data that you enter will be referenced when MAPIR calculates your total EHR incentive amount overriding any amount for previous years When viewing any previous applications MAPIR will continue to display the cost data that was entered originally for referenc
3. Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide Validation Messages The following is an example of the validation message You have entered an invalid CMS EHR Certification ID Check and reenter your CMS EHR Certification ID The Validation Messages Table lists validation messages you may receive while using MAPIR Payment Year Program Year MAPIR Memorial Hospital Applicant NPI Status If you are attesting to a Meaningful Use option that is different from what you were scheduled for you will be required to supply one or more delay reasons on the next screen Note If you are attesting to Adopt Implement or Upgrade you must be adopting implementing or upgrading to a 2014 certified edition If you are attesting to Meaningful Use please enter the certification number you had during your EHR reporting period The EHR Incentive Payment Program requires the use of technology certified for this program Please enter the CMS EHR Certification ID that you have obtained from the ONC Certified Health IT Product List CHPL website Click here to access the CHPL website You must enter a valid certification number Click the Exit button to terminate your session When ready click the Next button to continue Click Reset to restore this panel to the starting point Red asterisk indicates a required field Please enter the 15 character CMS EHR Certification ID for the Complete EHR Syst
4. The patient volumes selections you entered are depicted below Please review the current information to verify what you have entered is correct When ready click the Save amp Continue button to continue or click Previous to go back 2011062207 008020870 MAPIR HOSPITAL 195 SCOTT SWAMP ROAD In State Medicaid 883 FARMINGTON CT 06032 ear eerie e Total Discha 8600 New Location 123 Main Street In State Medicaid 200 Anytown AL 12345 6789 Other Medicaid 500 Total Discharges 1000 48 February 2015 PATIENT VOLUMES cont Part 3 of 3 Patient Volume Cost Data The following screens will request Patient Volume Cost Data This information will be used to calculate your hospital incentive payment amount when completing the hospital s first year attestation The total hospital incentive payment is calculated in your first payment year and distributed over three years by Connecticut Medical Assistance program To receive subsequent year payments you must only attest to the eligibility requirements patient volume requirements except Children s hospitals and meaningful use each year Enter the Start Date of the hospital fiscal year that ends during the prior Federal fiscal year to the fiscal year that serves as the first payment year or select one from the calendar icon located to the right of the Start Date field Click Save amp Continue to review your selection or click Previous to go back Click Reset to restore this panel
5. You are capturing meaningful use measures using a certified EHR technology Connecticut Medicaid Electronic Health Record Incentive Program ATTESTATION cont Implementation Phase Part 2 of 3 Select your Implementation Activity by selecting the Planned or Complete button Click Other to add any additional Implementation Activities you would like to supply Eligible Hospital User Guide Click Save amp Continue to proceed or click Previous or Reset to clear unsaved data and move to the screen where the last data was saved Click Clear All to remove activity selections and clear the fields on this page Connecticut DEPARTMENT oF Socia SERVICES Caring har Cammeclioul MAPIR HOSPITAL CCN 070098 Payment Year 1 Attestation Phase Please select the activities where you have Planned to include In Progress or completed an implementation It is important to know that the information you select about your Planned to include In Progress and completed implementation tasks is optional and will not impact your ability to receive an incentive payment This information is helpful to the State Medicaid Program Office in understanding the implementation process If there are no applicable activities to select or list please select the Other Click to Add button and enter none When ready click the Save amp Continue button to review your selection or click Previous to go back Click Reset to
6. Discharge Payment 2010 26 900 21 851 200 4 370 200 2011 28 137 21 851 4 370 200 2012 29 432 21 851 200 4 370 200 2013 30 786 21 851 4 370 200 Step 4 Add the Base Year Amount of 2 000 000 per payment year to the eligible discharge payment Total Fiscal Base Year Eligible Discharge Eligible Discharge Year Amount Payment Payment 2010 2 000 000 4 370 200 6 370 200 2011 2 000 000 4 370 200 6 370 200 2012 2 000 000 4 370 200 6 370 200 2013 2 000 000 4 370 200 6 370 200 Step 5 Multiply the Medicaid Transition Factor to the Eligible Discharge Payment to arrive at the Overall EHR Amount The transition factor equals 1 for year 1 3 4 for year 2 for year 3 and for year 4 All four years are then added together Total Eligible Medicaid Discharge Transition Overall EHR Fiscal Year Payment Factor Amount p ene l 2011 6 370 200 0 75 4 777 650 2012 6 370 200 a fr 3 185 100 Total EHR Amount 15 925 500 12 February 2015 Step 6 Calculate the Medicaid Share The next step requires that the Medicaid Share be applied to the total EHR amount The Medicaid Share is the percentage of inpatient bed days Medicaid MLIA and HUSKY A managed care divided by the estimated total inpatient bed days adjusted for charity care Note All bed day totals should exclude nursery psych and rehab days To calculate the
7. Print ContactUs Exit Connecticut DEPARTMENT oF Socia Services Tuesday 03 12 2013 3 03 42 PM EDT Caring far Canmcclioal MAPIR HOSPITAL NPI 2011062207 Hospital TIN mm Program Year 2013 Please select the activities where you have Planned to include In Progress or completed an upgrade It is important to know that the information you select about your Planned to include In Progress and completed upgrade tasks is optional and will not impact your ability to receive an incentive payment This information is helpful to the State Medicaid Program Office in understanding the upgrade process If there are no applicable activities to select or list please select the Other Click to Add button and enter none When ready click the Save amp Continue button to review your selection or click Previous to go back Click Reset to restore this panel to the starting point After saving click the Clear All button to remove standard activity selections Red asterisk indicates a required field i Upgrade Activity Upgrading Software Version Upgrading Hardware or Peripherals Clinical Decision Support Electronic Prescribing Computerized Provider Order Entry Adding Functionality Modules personal health record mental health dental _ _ aoa o y eo Other Reviewed EHR Certification Information 4 C oteti eee o errr m Heston Rest lem ANC 7 sea scents J gt Connecticut
8. When ready click the Save amp Continue button to review your selection or click Previous to go back Click Reset to restore this panel back to the starting point Red asterisk indicates a required field Primary Contact First Name Hospital Last Name Provider Phone 899 999 9999 Phone Extension Email Address hospital preparer com Verify Email hospital preparer com Department EHR Dept Address Line 1 8888 Street Address Line 2 City City State Connecticut Zip Code 06000 Alternate 777 777 7777 any email emai com Reset KTT Save amp Continue je Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide HOSPITAL R amp A AND CONTACT INFORMATION cont This screen confirms you successfully completed the R amp A Contact Info section Note the check box located in the R amp A Contact Info tab You can return to this section to update the Contact Information at any time prior to submitting your application Click Continue to proceed to the Eligibility section Print Contact Us Exit CONNECTICUT DEPARTMENT oF SociAL SERVICES Tuesday 03 12 2013 1 30 24 PM EDT Caring far Canncelieal MAPIR HOSPITAL NPI 2011062207 CCN 070098 Hospital TIN Eeee Payment Year 1 Program Year 2013 Get Started R amp A Contact Info 7 Eligibility Patient Volumes Attestation f Review Submit You have now completed the R amp A Contact Information section of
9. 3 Numerator 5 76 Denominator 5 100 Performance Rate 5 78 0 Exclusion 5 4 Numerator 6 56 Denominator 6 100 Performance Rate 6 45 0 Exclusion 6 5 Numerator 7 123 Denominator 7 200 Performance Rate 7 67 0 Exclusion 7 6 Numerator 8 79 Denominator 8 100 Performance Rate 8 78 0 Exclusion 8 7 Numerator 45 Denominator 78 Performance Rate 79 0 Exclusion 3 Exception 2 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide Proceed to the Attestation Phase Part 3 of 3 on page 157 Stages 1 and 2 Meaningful Use Clinical Quality Measures This initial screen provides information about the Clinical Quality Measures Click Begin to continue to the Meaningful Use Clinical Quality Selection screen Print ContactUs Exit Connecticut DEPARTMENT OF SOCIAL SERVICES Monday 01 06 2014 11 48 18 AM EST Caring far Canmeclieal ROCKVILLE GENERAL HOSPITAL NPI 1871536227 CCN 700015 Hospital TIN S Payment Year 2 Program Year 2014 Get Started RB amp A Contact Info Eligibility Patient Volumes Attestation 7 Submit fg MEANINGFUL USE CLINICAL QUALITY MEASURES As part of the Meaningful Use Attestation Eligible Hospitals must report on 16 of 29 Clinical Quality Measures irrespective of the stage of Meaningful Use Selected CQMs must cover at least 3 of the National Quality Strategy domains The data for these measures must be obt
10. Clinical Quality Measures Note When all topics are marked as completed select the Save amp Continue button to complete the attestation process Previous Save amp Continue Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Stage 1 Meaningful Use Core Measures The screen on the following page summarizes the requirements for the Meaningful Use Core Measures Please read this as it provides details that will make it easier to complete the application Please note that Meaningful Use Core Measures 9 11 and 13 are no longer available for attestation NOTE Eligible Hospitals are required to complete all 12 Core Measures even if you meet the exclusion requirements Click Begin to start the Core Measure List Table If you are in Meaningful Use Stage 1 proceed to the next page If you are in Meaningful Use Stage 2 proceed to page 110 Thursday 10 02 2014 4 58 18 PM EDT Name MAPIR HOSPITAL NPI 2011062207 CCN oe Hospital TIN ee Payment Year Program Year 2014 Get Started RBA Contact Info Patient Volumes py Attestation ig Submit MEANINGF REM R ti As part of the meaningful use attestation Eligible Hospitals are required to complete 12 Core Measures in Stage 1 Some Meaningful Use Objectives may not apply to the EH e g if the hospital does not have any eligible patients or actions for the measure denominator In these cases the EH would
11. MAPIR HOSPITAL NPI 2011062207 CCN 070098 Hospital TIN 060220678 Payment Year 1 Program Year 2013 When ready click the Save amp Continue button to review your selection or click Previous to go back Click Reset to restore this panel to the starting point You are installing certified EHR Technology Upgrade You are expanding functionality of certified EHR Technology ee a oo D a og Meaningful Use You are capturing meaningful use measures using a certified EHR technology OF pa t For Adoption continue to the next page of this guide For Implementation turn to page 61 of this guide For Upgrade turn to page 65 of this guide For Meaningful Use turn to page 71 of this guide Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Adoption Phase For Adoption select the Adoption button Click Save amp Continue to review your selection or click Previous to go back Click Reset to restore this panel to the starting point Print Contact Us Exit Connecticut DEPARTMENT oF SociaL SERVICES Tuesday 03 12 2013 2 18 08 PM EDT Caring far Canncclioal MAPIR HOSPITAL NPI 2011062207 CCN 070098 Hospital TIN ee Payment Year Program Year 2013 Attestation Phase Part i of 3 Please select the appropriate EHR System Adoption Phase When ready click the Save amp Continue button to review your selection or click Previous to go
12. Total discharges are the sum of all inpatient discharges excluding nursery psych and rehab discharges which are not considered acute care Average Total Annual Fiscal Year Dis Calculating Annual Growth rate Growth Rate 2010 26 900 25 800 25 800 4 3 2009 25 800 25 800 24 700 24 700 4 5 2008 i 24 700 23 500 23 500 5 1 2008 2007 2007 growth rate Average Annual Growth Rate 4 6 Step 2 Apply the Average Annual Growth Rate to the Base Number of Discharges projected out over the next 3 years The number of discharges for the Base Year of Fiscal Year 2010 is multiplied by the average annual growth rate of 4 6 Projected Inpatient Discharges Fiscal Year 2010 Fiscal Year 2011 Fiscal Year 2012 Fiscal Year 2013 wa Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide Step 3 Determine the number of eligible discharges and multiply by the appropriate discharge payment amount 1 For the first through the 1 149th discharge 0 2 For the 1 150th through the 23 000th discharge 200 per discharge 3 For any discharge greater than the 23 000th 0 In this example discharges for each year were greater than bothi 149 and 23 000 so the maximum number of discharges that can be counted are 21 851 23 000 1 149 which then gets multiplied by the 200 per discharge 200 Eligible Fiscal Calculated Eligible Per Discharge Year Discharges Discharges
13. compmeted Avatable actors for a top wil be Getermened by axrert progress level To start a topx select the Begia button To modfy 2 top where entries have been made select the EDIT button for a top to modiy any previously entered r ormabon Select Previews to retum Completed Lesko Progress Clink al Quality Measures Note When ai tooxs are marked as completed select the Seve amp Continue button to complete the attestation process Previews Seve A Continue 126 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide Meaningful Use Menu Set Measures This initial screen provides information about the Meaningful Use Menu Measures for Stage 2 Click Begin to continue to the Meaningful Use Menu Measures Selection screen MAPIR HOSPITAL e Name CCN Payment Year Print Contact Us Exit Thursday 10 02 2014 5 08 26 PM EDT NPI Hospital TIN Program Year 2011062207 2014 RBA Contect Info wy Eligibility py Patient Volumes py Attestation a f Review Y Submit M N MEN M As part of the meaningful use attestation process Eligible Hospitals are required to complete 3 out of 6 Menu Set Measures in Stage 2 Some Meaningful Use Objectives may not apply to the EH thus you would not have any eligible patients or actions for the measure denominator In these cases the EH would be excluded from having to meet that measure HELP H The Core
14. proceeding to the Submit section Once your application is submitted you will not have the opportunity to change it Click Print to generate a printer friendly version of this information NOTE If the Continue button is pressed it will take the applicant to where they left off on the previous tabs or if done with the previous tabs it will take the applicant to the Submit tab Connecticut Medicaid Electronic Health Record Incentive Program This is screen 1 of 3 of the Review tab display Name MAPIR Memorial Hospital NPI 9999999999 CCN 999999 Hospital TIN 999999999 Payment Year 2 Program Year 2015 Get Started R amp A Contact Info Eligibility Patient Volumes Attestation F Review Submit Eligible Hospital User Guide The Review panel displays the information you have entered to date for your application Select Print to generate a printer friendly version of this information Select Continue to return to the last page saved If all tabs have been completed and yo are ready to continue to the Submit Tab please click on the Submit Tab itself to finish the application process Incomplete 160 CEHRT ID Information CMS EHR Certification ID A014E01EPAKJEA3 R amp A Verification Legal Business Name Hospital NPI CCN 999999 Hospital TIN 9999999999 999999999 Business Address 1600 Pennsylvania Avenue Washington DC 20500 Business Phone 999 999 9999 Incentive Program MEDICAID Deemed Medicare E
15. 22 2013 10 16 32 AM EDT Casing fat Cantcclical MAPIR HOSPITAL NPI 2011062207 CCN 070098 Hospital TIN a Payment Year j Program Year 2013 Get Started R amp A Contact Info Eligibility Patient Volumes Attestation 7 a ea You have the option of choosing Adopt Implement Upgrade or Meaningful Use attestation in your first year of attestation Dually eligible hospitals are required to attest at CMS for Meaningful Use Once approved by CMS your next step would be to complete the MAPIR application Children s Hospitals that have already completed the AIU attestation in the first payment year are required to choose Meaningful Use with Medicaid Please refer to the Eligible Hospital Provider Manual for additional guidance on Adopt Implement Upgrade and Meaningful Use Eligible Hospital User Manual You may also refer to the CMS Web site at http www cms gov Regulations and Guidance Legislation EHRIncentivePrograms Meaningful_Use html In Part 2 of 3 If you selected Implement or Upgrade in Part 1 of 3 you will need to indicate whether tasks are Planned In Progress or Complete If Meaningful Use is selected then the hospital will attest to a 90 day period for the first year of Meaningful Use and a full year during the second or third year attestation In Part 3 of 3 verify payment designation Eligible hospitals must confirm that they are an acute care hospital or children s hospital The address of the payee that you desig
16. ContactUs Exit Wednesday 12 04 2013 3 26 01 PM EST NPI 187 1536227 2013 Hospital TIN Progeam Year Goce D God Do ROCKVILLE GENERAL HOSPITAL 187 1536227 Click here if you would Mke to eliminate all information saved to and start over from the begenning Navigation Keys within the system Save and Continue At the bottom of each screen it is importent that yov utilize the Sawe amp Continue button This allows you to come back to yoor records after leaving a MAPIR session im the event you are unable to complete the entire registration at one time Previous Allows you to move to the previous screen Reset Allows you to reset the valves withen the screen you are currently on Note You will be able to review sod ecit all entered information before submitting welcome to Connecticuts Medical Assistance Provider Incentive Repository MADPIR A few key points to assist you in maevigating MAPIR as you complete the registration process Your MAPIR eser session ends if there is no user activity longer than 60 monutes You will receive timeout warnings Please note that whoever begins the MAPIA applicaton must be the same person who comnpletes the application when a MAPIA electronic tab is completed a green check mark will appear in the corner of the tab Vou can go beck im the application tabs to review informatica content but not forward 32 February 2015 HOSPITAL R amp A AND CONTACT INFORMATION
17. Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Dashboard This dashboard will display your progress on the various measures as you progress through the application The Attestation Meaningful Use Measures are divided into three distinct topics Core Measures Menu Set Measures and Clinical Quality Measures You may choose which set of measures you wish to begin first as you do no need to go in order All three topics must be completed To start a Topic click the Begin button Click Save amp Continue to proceed with the attestation process or Previous to return Print ContactUs Exit Twesday 02 52 2013 3 03 42 OM BOT RRA Contact Info Eligibility Patient Volumes Attestation ig Review Submit Attestation Meaningful Use Measures The data required for thes attestation is grouped into topics In order to complete your attestation you must complete ALL of the following topics The system will show checks for each item when completed The progress level of each topic will be displayed as measures are completed Available actions for a topic will be determined by current progress level To start a topic select the Begin button To modify a topic where entries have been made select the EDIT button for a topic to modify any previously entered information Select Previous to return Completed OS Action _Begin Menu Set Measures _Begin Begin
18. Hip arthroplasty dccce Dhaai e Performance Rate 3 Exclusion 3 Population Criteria 4 Knee arthroplasty Numerator 4 Denominator 4 Performance Rate 4 Exclusion 4 Population Criteria 5 Colon surgery Memerator Denominator 5 Performance Rate 5 Exclusion 5 Population Criteria 6 Abdominal hysterectomy Numerator 6 Denominator 6 Performance Rate 6 Exclusion 6 Population Criteria 7 vaginal hysterectomy Numerator 7 Denominator 7 Performance Rate 7 Exclusion 7 Population Criteria 8 Vascular surgery gt anaes se a anamen tb Performance Rate 8 Exclusion 8 Previous Reset Save amp Continue 150 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Clinical Quality Measures Screen 5 This screen layout is only used for Measure Number CMS26 v2 and CMS110 v3 To view more details about this measure click the here link located on the screen Please complete all required fields The denominator numerator and exclusion entries must be positive whole numbers including zero Click Save amp Continue to review your selection click Previous to go back or click Reset to restore the panel to the starting point MAPIR Memorial Hospital _ 9999999999 CCN 999999 Hospital TIN 999999999 Pay
19. Measure List Table The first time a topic is accessed you will see an Edit option for each measure Once information is successfully entered and saved for a measure it will be displayed in the Entered column on this screen Click Edit to enter or edit information for a measure or click Return to return to the Measures Topic List Connecticut Medicaid Eligible Hospital User Guide Electronic Health Record Incentive Program Tweedey ON IDWOLI DiD43 Ow GOT yess On etry of mehea wA i i i H I i i i i i i i i i i j i 7 IH February 2015 80 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Core Measures Measure Selection for Core Measure 1 Measure Code EHCMU01 Core Measure 1 has two options the Original Core Measure 1 or the Optional Core Measure 1 On the Measure Selection for Core Measure 1 screen choose if you would like to attest to the Original Core Measure 1 or the Optional Core Measure 1 If you return at a later time and change your selection any information entered for the measure prior to that point will be removed Click Continue to proceed to the appropriate core measure screen for the option you selected or click Previous to go back Print Comtact Us Exit CONNECTICUT DEPARTMENT of Social SERVICES Wednesday 12 04 2013 4 00 48 PM EST Paming kat Caaneniinni ROCKVILLE GENERAL H
20. Pless enter patient volumes where indicated Wher ready click the Save amp Continue button to review your selection or click Previous to go back Click Reset to restore this panel to the starting point C Red asterisk indicates required field 2011062207 O08020870 SWAMP ROAD FARMINGTON CT oso32 223 Main Street Anytown AL 12345 6789 Click Save amp Continue to review your selection or click Previous to go back Click Reset to restore this panel to the starting point Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide PATIENT VOLUMES cont This screen displays the patient volumes you entered all values summarized and the Medicaid Patient Volume Percentage The Medicaid Patient Volume Percentage Formula is In State Medicaid Discharges Inpatient and ED Visits Other Medicaid Discharges Inpatient and ED Visits Divided by Total Discharges All Lines of Business Inpatient and ED Visits Note the Total patient volume field This percentage must be greater than or equal to 10 to meet the Medicaid patient volume requirement Click Save amp Continue to continue or Previous to go back Print ContactUs Exit Connecticut DEPARTMENT oF SociaL SERVICES Tuesday 03 12 2013 2 02 24 PM EDT Casing par Cammeclioal MAPIR HOSPITAL NPI 2011062207 g 070098 ani Payment Year 1 Program Year 2013 Patient Volume Part 2 of 3 Enter Volume
21. Record Incentive Program Eligible Hospital User Guide Meaningful Use Menu Measure Screen Example Menu Measure 1 Drug Formulary Checks Screen 1 Menu Measure 2 Advance Directives Screen 2 Menu Measure 3 Clinical Lab Test Results Screen 3 Menu Measure 4 Patient List Screen 1 Menu Measure 5 Patient Specific Education Resources Screen 4 Menu Measure 6 Medication Reconciliation Screen 3 Menu Measure 7 Transition of Care Summary Screen 3 Menu Measure 8 Immunization Registries Data Submission Screen 5 Menu Measure 9 Report Lab Results to Public Health Agencies Screen 5 Menu Measure 10 Syndromic Surveillance Data Submission Screen 5 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Menu Measures There are a total of 10 Meaningful Use Menu Measure screens As you proceed through the Meaningful Use Menu Measure section of MAPIR you will see five different screen layouts Instructions for each measure are provided on the screen For additional help with a specific Meaningful Use Menu Measure click on the link provided above the blue instruction box Screen layout examples are shown below Screen 1 The following Meaningful Use Menu Measures use this screen layout Menu Measures 1 and 4 To view more details about either measures click the here link located on the screen Please complete all required fields Click Save amp Conti
22. Sept 30 2011 The following is an example of a representative consecutive 90 day period from the previous federal fiscal year April 1 2010 June 29 2010 FFY 2010 Medicaid FFS MLIA and HUSKY A 9995 Inpatient Discharges and ED Visits i Total Hospital Inpatient Discharges and 725 ED Visits The eligibility calculation is as follows Medicaid Discharges Medicaid ED Visits Total Discharges Total ED Visits 2 225 Medicaid Patient Volume 6 725 33 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide 6 Hospital Incentive Payments The federal rule also sets forth the methodology that states must use to calculate EHR incentive payments The Department will calculate patient volume and payments for all eligible hospitals using information submitted by the hospital upon application with the Department The Department is responsible for using auditable data sources to calculate EHR hospital incentive amounts and will use OHCA filings as well as other Departmental data to validate the self reported information The Department will make payments to eligible hospitals over a three year time period 50 percent in the first year 30 percent in the second year and 20 percent in the third year CMS rules allow the Department to audit and validate the 3 year calculation as cost report data is received Payments will be issued via the standard financial cycle that runs twice a
23. When you completed the R amp A registration your registration information was sent to Connecticut Medicaid program This section will ask you to confirm the information sent by the R amp A and matched with Connecticut Medicaid program information It is important to review this information carefully The R amp A information can only be changed at the R amp A but Contact Information can be changed at any time prior to application submission The initial R amp A Contact Info screen contains information about this section Click Begin to access the R amp A Contact Info screen to confirm information and to enter your contact information See the Using MAPIR section of this guide for information on using the Print Contact Us and Exit links Print ContactUs Exit Connecticut DEPARTMENT OF SOCIAL SERVICES Tuesday 03 12 2013 1 20 24 PM EDT Casing far Ciancelicat MAPIR HOSPITAL NPI 2011062207 CCN 070098 Hospital TN ME Payment Year Program Year 2013 Get Started RBA Contact Info 7 Eligibility Patient Volumes Attestation GEA Submit The information you provided to the Medicare amp Medicaid EHR Incentive Program Registration and Attestation System R amp A vill be displayed in this section You vill need to verify the accuracy of information provided by the Medicare amp Medicaid EHR Incentive Program Registration and Attestation System R amp A If there are errors or discrepancies in the information you need to return to the M
24. and chart changes n the following vital sgns heght length and weight no age tng blood pressure ages 3 and over calculate and Gsplay body mass mndex BMI and plot and Gaplay growth charts for paterts 0 20 years ndudng Bm Measure More than 60 percent of af unique patients admitted to the eligble hosptal s or CAH s mpabent of emergency department POS 21 t 23 Guring the EMR reporting pernod Nave blood pressure for patents age 3 and over only and or height length and weight for all ages recorded as structured data PATIENT RECORDS Please select whether the data used to support the measure was extracted from ALL pabent records or only from patient records martained using Certfied EHR Technology Thes Gata was extracted from ALL patient records not just those mantained uang Certified FPR Technology Thes Gata was extracted only from pabernt records maintaned use Certhed EHR Technology Numerator Number of pabents in the denominator who have at least one entry of thew heght ength and weg af ages and or diood pressure ages 3 and over recorded as structured data Denominator Number of ureque patents seen by the authonred proveder or admated to an ebgdle hospital s of CAs robert of emergency department POS 21 of 23 dunno the EHR reporting penod Numerator Denominator Connecticut Medicaid Electronic Health Record Incentive Program ATTESTATION cont Meaningful Use Core Measures Screen 4 The
25. and name of specific product services purchased e Contracts which must include name s of company principals name of the specific product services purchased signatures and dates e License agreement which must include company name and name of the specific product services purchased e Purchase orders which must include name s of company principals name of the specific product services purchased date of purchase and costs which may be redacted e MU dashboard screenshots printouts and or reports which must include numerator denominator exclusions and percentages for each of the required Core and Menu items MU Only e The initial Submit screen contains information about this section e Click Begin to continue to the submission process Print Contact Us Exit i Connecticut DEPARTMENT of Socia SERVICES Thursday 10 02 2014 5 21 33 PM EDT Canang dame Canneckicai Name MAPIR HOSPITAL NPI 2011062207 CCN Hospital TIN Payment Year a Year 2014 schol ae Ee A a You have the option of choosing Adopt Implement Upgrade or Meaningful Use attestation in your first year of attestation Dually eligible hospitals are required to attest at CMS for Meaningful Use Once approved by CMS your next step would be to complete the MAPIR application Children s Hospitals that have already completed the AIU attestation in the first payment year are required to choose Meaningful Use with Medicaid Please refer
26. ars ret on Get as mncdred Seta DATION G2 CO 0S Pesce setect ethethear She Gates uted te support er meses wat ext acted from ALL pedont ecor Os oF onh trom Dabert records mart armed uung Carthied PRA Tectrusiozy Tus Sate wes este ated hon ALL Ostet reari net peut Thote ant ered usr Certified 66 Tetewtogy There Gates 26 aD ted Ord form Debord recor ert ares veg CerttHed re Tetera SRC SIO Ans giie Mose a or CAm ist samits no OebEts aot 63 rears Sig OF Chie Arno Te ER reporna s3 Does es eackveeer apoi te the botee Poamtal or Car ves D thee ee auon domes mot apply to yor pleave ompirte the foflowmg Eformefan Numerator Me rarior of paberit the Jeroma o gt Swe am eed alee Of a aOv ake Grectee she evtered Re Saat Gata OQuessentmater The rarer of wrest Saterts aoe 62 of cher SGried to a ebotte Nosed als or Carts rosera Cop artemert POS 21 Arro he DA reporters pernod eener eter Demominstor Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Menu Measures Screen 2 The following Meaningful Use Menu Measures use this screen layout Menu Measures 2 3 4 and 6 To view more details about any of these measures click the here link located on the screen Please complete all required fields The denominator entered must be greater than or equal to the numerator entered Click Save amp Continue to proceed Pre
27. attest to will display on the Meaningful Use Menu Measure Worksheet The example below displays the six measures selected on the previous screen example You must complete all measures on this screen Once information is successfully entered and saved for a measure it will be displayed in the Entered column on this screen Click Edit to enter or edit information for a measure or click Previous to return to the Measures Topic List Peet Cental tet Tweedey O2 52 2013 3 52 45 Ow BOT o enter Of ebt etormamen select Che TOIT Aton mast to the menre at you mof ibe to edt AB progress on ertr of meanres we be reared A pms eston a tamne Wien of masmas Nore been Sted and roy we Aed wth the atres pelet the Previees Inston to cers It man mesne rene cone of ErP Or AD OAG one ir mwe Or Gered Dy an matured Don ae poceti Cwoug Cert ed DR provda of the Pega of CAH tow paberis my epe y orir a Gepartmers POS 21 23 Arvo he Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide The following is a list of the six Meaningful Use Menu Measures that you may attest to Click on the Screen Example to see an example of the screen layout Meaningful Use Menu Measure Screen Example Menu Measure 1 Advance Directive Screen 1 Menu Measure 2 Electronic Notes Screen 2 Menu Measure 3 Imaging Results Screen 2 Menu Measure 4 Family Health History Screen 2 Menu Me
28. back Click Reset to restore this panel to the starting point You are acquiring certified EHR Technology Implementation You are installing certified EHR Technology Upgrade You are expanding functionality of certified EHR Technology Meaningful Use You are capturing meaningful use measures using a certified EHR technology Proceed to page 69 of this guide 60 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Implementation Phase Part 1 of 3 For Implementation select the Implementation button Click Save amp Continue to proceed or click Previous to go back Click Reset to restore this panel to the starting point Print ContactUs Exit CONNECTICUT DEPARTMENT oF SOCIAL SERVICES Tuesday 03 12 2013 2 18 08 PM EDT Casing has Cangeclioal MAPIR HOSPITAL NPI 2011062207 070098 Hospital TIN Payment Year Program Year 2013 Attestation Phase Part 1 of 3 Please select the appropriate EHR System Adoption Phase When ready click the Save amp Continue button to review your selection or click Previous to go back Click Reset to restore this panel to the starting point a Adoption You are acquiring certified EHR Technology P airiai Implementation 7 You are installing certified EHR Technology Upgrade You are expanding functionality of certified EHR Technology Meaningful uUse
29. be excluded from having to meet that measure HELP HINT The Core Menu and Clinical Quality Measures can be completed in any order For more details on each measure select the click here link at the top of each screen You may review the completed measures by selecting the Edit button After completing all of the core measures you will receive a checkmark indicating the section is complete The checkmark does not mean you passed or failed the measures Evaluations of MU measures are made after the application is submitted Instructions Users must adequately answer each measure they intend to meet by either correctly filling in the numerator and denominator values or successfully marking down exclusion when applicable Two types of percentage based measures are included in demonstrating Meaningful Use With this there are two different types of denominators 1 Denominator is all patients seen or admitted during the EHR reporting period The denominator is all patients regardless of whether their records are kept using a certified EHR technology 2 Denominator is actions or subsets of patients seen or admitted during the EHR reporting period whose records are kept using EHR technology 78 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Core Measures The screen on the following page displays the Meaningful Use Core
30. click Previous to go back Click Reset to restore this panel to the starting point Adoption You are acquiring certified EHR Technology Implementation You are installing certified EHR Technology Sinas You are expanding fynaelonality of certified EHR Technology il Meaningful Use You are capturing meaningful use measures using a certified EHR technology Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Upgrade Phase Part 2 of 3 Select your Upgrade Activities by selecting the Planned or Complete button for each activity Click Other to add any additional Upgrade Activities you would like to supply Click Save amp Continue to proceed or click Previous or Reset to clear unsaved data and move to the screen where the last data was saved Click Clear All to remove activity selections and clear the fields on this page Print ContactUs Exit CONNECTICUT DEPARTMENT OF SOCIAL SERVICES Tuesday 03 12 2013 3 01 52 PM EDT Casing fas Cannsakical MAPIR HOSPITAL NPI 2011062207 070098 Hospital TIN errr err Payment Year 1 Program Year 2013 Attestation Phase Part 2 of 3 Please select the activities where you have Planned to include In Progress or completed an upgrade It is important to know that the information you select about your Planned to include In Progress and completed upgrade tasks is optional and wil
31. complete the entire registration at one time Previous Allows you to move to the previous screen Reset Allows you to reset the values within the screen you are currently on Note You will be able to review and edit all entered information before submitting 178 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide This screen asks you to confirm your selection to start the application over and delete all information saved to date This process can only be done prior to submitting your application Once your application is submitted you will not be able to start over Click Confirm to Start Over and Delete All Progress Print Contact Us Exit CONNECTICUT DEPARTMENT OF SociAL SERVICES Thursday 06 30 2011 11 26 56 AM EDT Caring far Canmectiaut Name MAPIR HOSPITAL NPI 2011062207 CCN 070098 Hospital TIN E Get Started Eligibility Patient Volumes Attestation GED Submit Start Over and Delete All Progress To submit your request to delete all information saved to date select Confirm Select Cancel to return to the previous screen Important gy electing to start over you are opting to permanently erase all data previously saved for your application Cancel Confirm If you clicked Confirm you will receive the following confirmation message To continue click OK Print Contact Us Exit CONNECTICUT DEPARTMENT OF SOCIAL SERVICES Thursda
32. encounters in the same 90 day period DSS encourages providers to select the previous fiscal year as a continuous 90 day volume reporting period to ensure a date range is selected that falls within the last completed fiscal year Also while MAPIR will allow providers to select 12 Months Preceding Attestation Date CT cannot support that selection Providers will be directed to select the last completed fiscal year preceding the payment year Furthermore EHs who select 12 months preceding attestations may experience a delay in payment Part 2 of 3 contains screens to enter locations for reporting Medicaid Patient Volumes and at least one location for Utilizing Certified EHR Technology adding locations and entering patient volumes for the chosen reporting period You will be asked to enter the total CT Medicaid encounters in the continuous 90 day period in the preceding fiscal year and the total encounters in the same 90 day period Part 3 of 3 contains screens to enter your hospital Patient Volume Cost Data information This information will be used to calculate your hospital incentive payment amount This will be accessible in Year One only this screen will already be completed in second payment year s attestation and cannot be modified Hospitals will be required to provide and attest to the following information for the incentive payment to be calculated e Total Discharges inpatient for the most recent 4 fiscal years e Total Number of Me
33. fo review your selection or cick Previows to go beck Click Reset to restore this panel to the starting pore Red asterisk indicates a required field Objective Use certi ied EHR technology to sdentty pabert spectik edcahon resources and provide those resources to the pubent Ipp opiate Measure More than 10 of af ureque paberts aamtted to the ebgible hosptal s or Carts robert or emergerxy departmert Place of Service POS 21 of 23 dunno the EMR reporting period are provided patert spectk education rescertes Complete the Fobomng Information Numerator A postre whole number Denominator A postre whole number Numerator ATTESTATION cont Meaningful Use Menu Measures Screen 5 The following Meaningful Use Menu Measures use this screen layout Menu Measures 8 9 and 10 To view more details about any of these measures click the here link located on the screen Please complete all required fields The denominator entered must be greater than or equal to the numerator entered Click Save amp Continue to proceed Previous to return or Reset to clear all unsaved data 100 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide Suet Semtectsts fact Commectracur Denantmans of Goce Senwces Wedresday 12704 2023 4 29 56 Pw EST am oe SSS ROCKVILLE GENERAL HOSPITAL 28715306229 c fee o roe OS GCideines for is mesmre ee e ay e
34. for thes attestabon is grouped into topics In order to complete your attestation you must complete ALL of the following topics The system will show checks for each tem when completed The progress level of each topic will be splayed as measures are completed Available actions for a topic will be determined by current progress level To start a topic select the Begin button To modify a topic where entries have been made select the EDIT button for a topic to modify any previously entered informadon Select Previous to return Completed Topics Proaress Action Clinical Quality Measures Note When all topics are marked as completed select the Save amp Continue button to complete the attestation process Previous Save amp Continue 136 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide Meaningful Use Measures Summary for Stage 2 This screen displays a summary of all entered meaningful use attestation information Review the information for each measure If further edits are necessary click Previous to return to the Measures Topic List where you can choose a topic to edit If the information on the summary is correct click Save amp Continue to proceed to Part 3 of 3 of the Attestation Phase Print ContactUs Exit Connecnicut DEPARTMENT oF Socia SERVICES Friday 12 06 2013 11 38 51 AM EST MAPIR Mem
35. free of sanctions or exclusions Note In some cases hospitals will be re directed to the R amp A to correct discrepant data 20 February 2015 12 Connecticut s Secure Provider Portal Access to MAPIR Hospitals can access MAPIR through Connecticut Medical Assistance Program s secure provider portal at www ctdssmap com NOTE The secure provider portal is located under Provider Secure Site Eligible hospitals must log in with their acute care inpatient ID number CONNECTICUT DEPARTMENT oF SociAL SERVICES Caring far Canneclital Home Information CEH trading Partner ConnPACE Pharmacy Information Claims Eligibility Prior Authorization Trade Files MAPIR Messages Account provider enrollment provider enrollment tracking provider matrix provider services providersearch drug search provider fee schedule download ehr incentive program The Connecticut Department of Social Services Medical Assistance Program secure website is intended for providers clerks and billing agents If you have received your Personal Identification Number letter click on the setup account button User ID Password If you have forgotten your password please click the reset password button In order to access MAPIR every hospital has existing Web Secure Provider Portal IDs most likely several IDs Most hospitals will be able to gain access to this ID through their billing office as they access the Web secure provider port
36. have not completed this registration you will receive the following screen Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide MAPIR Name Not Available Applicant NPI Not Available Status Not Registered at R amp A Our records indicate that you have not registered at the CMS Medicare amp Medicaid EHR Incentive Program Registration and Attestation System R amp A You must register at the R amp A prior to applying for the Medicaid EHR Incentive Program Please dick here to access the R amp A registration website If you have successfully completed the R amp A registration please contact the lt state gt for assistance Please access the federal Web site below for instructions on how to do this or to register For general information regarding the Incentive Payment Program http www cms gov EHRIncentivePrograms To register https ehrincentives cms gov hitech login action You will not be able to start your MAPIR application process unless you have successfully completed this federal registration process Once MAPIR has received and matched your provider information you will receive an email to begin the MAPIR application process Please allow at least two days from the time you complete your federal registration before accessing MAPIR due to the necessary exchange of data between these two systems 3 Be enrolled in the Connecticut Medical Assistance Program 4 Be
37. here link located on the screen Enter information in all required fields The denominator entered must be greater than or equal to the numerator entered Click Save amp Continue to review your selection click Previous to go back or click Reset to restore this panel to the starting point Print Contact Ue Exit CownecrouTt DEPARTMENT of Soci Serwces Wednesday 12 04 2013 4 01 53 PM EST anna fae annenin CCN ROCKVILLE GENERAL HOSPITAL NPr 187 1536227 7000 15 Hospital TIN Paymeet Year 2 Program Yesr 2013 Ge 6a Oe Gee BO Oe Chek here to rever CMS Guicetices for Svs messwre Whee ceecy och che Save amp Continue button to review poor selection or Click Previous to oo beck Ock Reset to restore this panel co the starting point Red asterisk indicates gt required field Objsective Use computerized physician order entry CPOE for medication orders directly entered by any lhcensed Measure hesithcarce professional who can enter orders iato the medical record per state local anc profes sional ovidelimes More than 30 of all unique patients with at least one medication in their mechcation Nist admerted to the eligible hospital s of CAH s impatient or emergency department POS 25 or 23 have at least one medicatron order entered using CPOE PATIENT RECORDS Please select whecher the data used to support the measure was extracted from ALL patent records or only fom patent records maintained useng
38. located on the screen Please complete all required fields The denominator entered must be greater than or equal to the numerator entered Click Save amp Continue to proceed Previous to return or Reset to clear all unsaved data Print Contacts Exit Cownecnicut DEPARTMENT of Soci Seavices Tuesday 03 32 2013 3 12 45 PM EOT Comag dar Canngotara MAPIR Memorial Hosprtal P NPI 9999999995 CCN mMm Hospital TIN MEE Payment Year gt Program Year 2014 camates f ascom noto ER Y cttw E o rate nts SS eee 7 ase E Altesiation Meaniegtul Use Measures Core Measure 7 Protect Tlectroak Health Information Chick here to review CMS Guidelines for this measure wi en nena tag ener neers iene br E ht comet lah to restore this panel to the starting point Red asterisk indicates a required field Objective Protect electrons heath information created or mantaned by the Certified EHR Technology through the implementation of appropnate techncal capabaties Measure Conduct of review a secunty rsk analysis in accordance with the requrements under 45 CFR 164 308 a 1 including addresang the encryphon securty of data stored in CEMRT in accordance wth requirements under 45 CFR 164 312 a 2 rv and 45 CFR 164 306 G 3 and implement security updates as necessary and correct identified secunty definences as part of the provider s nsk management process for ebgible hosptais Ebbie hospitals and CAs must conckxt of rewew a
39. of each topic will be displayed as measures are completed Available actions for a topic will be determined by current progress level To start a topic select the Begin button To modify a topic where entries have been made select the EDIT button for a topic to modify any previously entered information Select Previous to return Clinical Quality Measures Note When all topics are marked as completed select the Save amp Continue button to complete the attestation process Previous Save amp Continue Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide Meaningful Use Measures Summary for Stage 1 This screen displays a summary of all entered meaningful use attestation information Review the information for each measure If further edits are necessary click Previous to return to the Measures Topic List where you can choose a topic to edit If the information on the summary is correct click Save amp Continue to proceed to Part 3 of 3 of the Attestation Phase CONNECTICUT DEPARTMENT oF Socia SERVICES Camng fas Canncelacal MAPIR Memorial Hospital Print ContactUs Exit Friday 12 06 2013 11 38 51 AM EST NPI NAD mhuir pallette Program Year 2014 Core Measure 1 CPOE for Medcation Orders Optional 106 The Meaning ul Use Measures you Nave attested to are Gepkted below Pease review De current informacion to verity what you hav
40. or cick Previous to go back Cick Change Data to change previously entered data Red asterisk indicates a required field 10 01 2008 09 30 2009 ee 10 01 2006 09 30 2007 9805 10 01 2009 09 30 2010 Ka 1200 189885 1 178 756 696 00 554 457 000 00 Once you have submitted the application MAPIR recalculates the incentive payment for that year based on the revised hospital cost data as well as the remaining payments If the new calculation results in a revised payment for the current year you will receive a payment for the revised amount 56 February 2015 PATIENT VOLUMES cont This screen confirms you successfully completed the Patient Volumes section Note the check box in the Patient Volumes tab Click Continue to proceed to the Attestation section ContactUs Exit Connecticut DEPARTMENT oF Socia SERVICES Tuesday 03 12 2013 2 09 33 PM EDT Casing har Canmcclieal MAPIR HOSPITAL NPI 2011062207 CCN 070098 N Hospital TIN ME Payment Year Program Year 2013 Get Started R amp A Contact Info Eligibility Patient Volumes Attestation a GLa You have now completed the Patient Volumes section of the application You may revisit the section at any time to make corrections until such time as you actually Submit the application The Attestation section of the application is now available Before submitting your application please review the information that you have provided in this section and all previous
41. patients 65 ears old or older ars old or older admitted to the eligible hospital s or CAH s inpatient department POS 21 have an indication of an advance directive status recorded as structured incorporate clinical lab test results into More than 40 of all clinical lab tests ertified EHR as structured data results ordered by an authorized provider of the eligible hospital or CAH for patients admitted to its inpatient or emergency department POS 21 or 23 during the EHR Generate lists of patients by specific Generate at least one report listing onditions to use for quality improvements ipatients of the eligible hospital or CAH with duction of disparities research or a specific condition outreach pability to submit electronic data to Performed at least one test of certified EHR mmunization registries or immunization technology s capacity to submit electronic nformation systems and actual submission data to immunization registries and follow according to applicable law and practice up submission if the test is successful unless none of the immunization registries ito which the eligible hospital or CAH submits such information has the capacity to receive the information electronically The following is a list of the Meaningful Use Menu Measures that you may attest to Click on the Screen Example to see an example of the screen layout 94 February 2015 Connecticut Medicaid Electronic Health
42. payment for 2012 the start of your continuous 90 day period must start and end between October 1 2010 and September 30 2011 the preceding fiscal year Enter a Start Date or select one from the calendar icon located to the right of the Start Date field Click Save amp Continue to review your selection or click Previous to go back Click Reset to restore this panel back to the starting point or last saved values Print Contact Us Exit Connecticut DEPARTMENT oF SociaL SERVICES Monday 03 04 2013 2 51 10 PM EST ising har Cammoctiand MAPIR HOSPITAL 2011062207 CCN 070098 Payment Year 1 REA Contact Info Engipmtty If applying as an Acute Care hospital you must demonstrate that you serve the Medicaid population to participate The continuous 90 day volume reporting period may be from either the last completed fiscal year preceding the payment year or the previous 12 months Prior to the attestation date Select either previous fiscal year or previous 12 months then enter the Start Date of your continuous 90 day period When ready click the Save amp Continue button to review your selection or click Previous to go back Click Reset to restore this panel to the starting point Red asterisk indicates a required field Please select one of the following two options Last Completed Fiscal Year Preceding the Payment Year 12 Months Preceding Attestation Date Start Date eae mm dalyyyy Please Note T
43. screen 4 of 5 of the Meaningful Use Measures Summary CMS71 v4 CMS72 v3 CMS73 v3 CMS105 v3 CMS109 v3 140 Clinical Process Effectiveness Clinical Process Effectiveness Clinical Process Effectiveness Clinical Process Effectiveness Clinical Process Effectiveness Clinical Process Effectiveness Clinical Process Effectiveness Clinical Process Effectiveness Clinical Process Effectiveness Fibrinolytic Therapy Received Within 30 Minutes of Hospital Arrival Anticoagulation Therapy for Atrial Fibrillation Flutter Antithrombotic Therapy By End of Hospital Day 2 Venous Thromboembolism Patients with Anticoagulation Overlap Therapy Thrombolytic Therapy Discharged on Antithrombotic Therapy Discharged on Statin Medication Venous Thromboembolism Patients Receiving Unfractionated Heparin with Dosages Platelet Count Monitoring by Protocol or Nomogram Elective Delivery Eligible Hospital User Guide Numerator 120 Denominator 130 Performance Rate 45 0 Exclusion 3 Exception 9 Numerator 50 Denominator 100 Performance Rate 56 0 Exclusion 3 Exception 5 Numerator 28 Denominator 45 Performance Rate 56 0 Exclusion 7 Exception 8 Numerator 230 Denominator 450 Performance Rate 35 0 Exclusion 9 Numerator 90 Denominator 100 Performance Rate 79 0 Exception 4 Numerator 240 Denominator 500 Performance Rate 89 0 Ex
44. sections Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION This section will ask you to provide information about your EHR System Adoption Phase Adoption phases include Adoption Implementation Upgrade and Meaningful Use Based on the adoption phase you select you may be asked to complete additional information about activities related to that phase If your adoption phase is Meaningful Use you will be required to provide information about the dates you were a Meaningful User of Certified EHR Technology For the first year of participation in the Medicaid EHR Incentive Payment program Eligible Hospitals are only required to attest to Adoption Implementation or Upgrade This initial Attestation screen provides information about this section Click Begin to continue to the Attestation section If you are a Dually Eligible Hospital but have not been approved for Meaningful Use Attestation during the current Program Year at the CMS Medicare amp Medicaid EHR Incentive Program Registration and Attestation System R amp A you will not be permitted to proceed with the MAPIR application process until you have completed this process at the R amp A and CMS forwards the attestation information to the state Click Exit to exit the MAPIR application or select any of the previously completed tabs Print Contact Us Exit Connecticut DEPARTMENT oF SOCIAL SERVICES Friday 03
45. securty risk analysis n accordance with the requrements under 45 CPR 164 308 aN 1 and enplemert security updates as necessary and correct identihed security defences pror to of Gurng the ER reporting period to meet this measure Mave you successfully met the measure Yes No Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Core Measure Screen 8 The following Meaningful Use Core Measures use this screen layout Core Measure 12 To view more details this measure click the here link located on the screen Please complete all required fields The denominator entered must be greater than or equal to the numerator entered Click Save amp Continue to proceed Previous to return or Reset to clear all unsaved data Prist Contect s Cuit CONNECTICUT DEPARTMENT of Social SEROCES Tuesday 03 12 2023 3 12 45 PM EDT VRP venons mortal Core Meswere 17 Summary of Care Chek bere fe reven OMS Gandeiras Sy the eenee When ready chee the Seve A Continue DEION to fewsew your selection or click Reset to restore tows pene to the Ret avterish inf ates 2 required feta Cogectrve The ebpbte hosptal or CAM who transors ts pabent to another sething of care or srowder of care or refers ta pabert to another prodor of Care probes a summary Care record tor each tr anson of Care ot refert at Meare 1 The ehptte hosptal or CAM that trametions
46. than or equal to the numerator entered Click Save amp Continue to proceed Previous to return or Reset to clear all unsaved data Print ContactUs Exit CONNECTICUT DEPARTMENT oF Social SERVICES Wednesday 12 04 2013 4 26 44 PM EST Casing par Cammontiiont ROCKVILLE GENERAL HOSPITAL NPI 1871536227 con 700015 Hospital TIN EE Payment Year 2 Program Year 2013 eee H D Attestation Meanang Menu Measure 3 Click here to review CMS Guidelines for this measure Wher ready click the Save amp Continue button to review your selection or click Previous to go back Click Reset to restore this pane to the starting pont Red asterisk indicates a required field Objective Incorporate clinical lab test results into certified EHR as structured cata Measure More than 40 of all clinical lab tests results ordered by an authorized provider of the eligible hospital or CAH for patients admitted to its inpatient or emergency department POS 21 or 23 during the EHR reporting period whose results are either in positive megative or numerical format are incorporated in certified EHR technology as structured data PATIENT RECORDS Please select whether the data used to support the measure was extracted from ALL patient records or only from patient records maintained using certified EHR technology This data was extracted from ALL patient records not just those maintained using certified EHR technology This data was extracted on
47. to the Eligible Hospital Provider Manual for additional guidance on Adopt Implement Upgrade and Meaningful Use Eligible Hospital User Manu You may also refer to the CMS Web site at http www cms gow Regulations and Guidance Legisiation EHRincentivePrograms Meaningful_Use html In Part 2 of 3 If you selected Implement or Upgrade in Part 1 of 3 you will need to indicate whether tasks are Planned In Progress or Complete If Meaningful Use is selected then the hospital will attest to a SO day period for the first year of Meaningful Use and a full year during the second or third yea attestation In Part 3 of 3 verify payment designation Eligible hospitals must confirm that they are an acute care hospital or children s hospital The address of the payee that you designated must also be confirmed Once your attestation is complete you will go to the Review tab You still have the opportunity to review and revise your application until you submit IN ORDER TO SUBMIT YOUR APPLICATION YOU MUST CLICK THE SUBMIT TAB ONCE YOU HAVE COMPLETED ENTERING YOUR INFORMATION TEs gt Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide SUBMIT cont This screen lists the current status of your application and any error messages identified by the system You can correct these errors or leave them as is You can submit this application with errors however errors may impact your eligibil
48. to the starting point Year 2 and subsequent years will see their Cost Data as it was submitted in Year 1 This data was used to calculate their total hospital incentive payment for all three years Modifications must not be made to this data unless there was a change in the year one data that should result in change in payment If you would like to change the hospital cost data refer to the Change Hospital Cost Data section of this manual If you would like to proceed using the existing hospital cost data from the previous paid application click Save amp Continue If you are accessing MAPIR for the first time and received one or more incentive payments from another state the Hospital Cost Data Part 3 of 3 screen will display zeroes You will not be able to enter data After submitting your application contact the HP EHR Assistance Center either by email at ctmedicaid ehr hp com or by phone at 1 855 313 6638 toll free Print Contact Us Exit Connecticut DEPARTMENT oF SociAL SERVICES Tuesday 03 05 2013 2 30 54 PM EST Casing hat Canmeclicad Name MAPIR HOSPITAL NPI 2011062207 CCN 070098 Hospital TIN Payment Year 2 Program Year Get Started R amp A Contact Info Eligibility Patient Volumes ig Attestation Review Submit Hospital Cost Report Data Fiscal Year Part 3 of 3 Please enter the Start Date of the most recent completed hospital fiscal year When ready click the Save amp Continue butto
49. was extracted from ALL patient records or only from patient records maintained using certified EHR technology This data was extracted from ALL patient records not just those maintained using certified EHR technology This data was extracted only from patient records maintained using certified EHR technology EXCLUSION Based on ALL patient records An eligible hospital or CAH that admitted no patients 65 years old or older during the EHR reporting period would be excluded from this requirement Exclusion from this requirement does not prevent an eligible hospital or CAH from achieving meaningful use Does this exclusion apply to you Ves No If the exclusion does not apply to you please complete the following information Numerator Number of patients in the denominator with an indication of an advanced directive entered using Structured data Denominator Number of unique patients age 65 or older admitted to an eligible hospital s or CAH s inpatient department POS 21 during the EHR reporting period Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Menu Measures Screen 3 The following Meaningful Use Menu Measures use this screen layout Menu Measures 3 6 and 7 To view more details about any of these measures click the here link located on the screen Please complete all required fields The denominator entered must be greater
50. would kke to edt Al progress on entry of measures wil be retamed d your sesmon is terminated When al measures have been ected and you are satshed with the entres select the Retura button to access the man attestation top it Heasningiul Use Core Measure List Table comexKenred provider order ertry CPOE for More than 60 percent of medcabon 30 percent Gcabon laboratory and racology orders of laboratory and 30 percert of racology order Grexthy entered dy any keensed heakhcare created by achonzed prowders of the ebgbie profesmonal who can enter orders nto the hoptal s or CAH s roabert or emergency nedcal record per state local and profesmonal department POS 21 or 23 during the DR reporting pernod are recorded using CPOE More than 60 percent of af ureque pabents seen by the authorized provider ot admatted to the ehgble hospital s of CA s inpabent or emergency department POS 21 or 23 Gauteng the EMR reporting pernod have Gemographacs recorded a5 structured data ord and chart changes n the folowing vital More than 80 percent of af ureque patents ons heightlength and weight no ag imt admtted to the ebgdile hospitals or CAH s od pressure apes 3 and over caldate and inpabert or emergency departmert POS 21 or body mass index BMI and plot and 23 Gung the EMR reporting period have diood Growth charts for paters 0 20 years pressure lor paberts age 3 and over only qe andor hesghe length and weight for al ages rec
51. you access MAPIR to perform the above activities and have not completed your registration changes you will receive the following screen ContactUs Exit Thursday 11 21 2013 3 44 14 PM EST Name ROCKVILLE GENERAL HOSPITAL Applicant NPI 1871536227 Status Registration in Progress IMPORTANT Our records indicate that your registration is in progress at the CMS Medicare and Medicaid EHR Incentive Payment Program Registration and Attestation System R amp A and you must complete that registration process before you can access your application here The R amp A website https www cms gov EHRIncentivePrograms 20 RegistrationandAttestation asp will have instructions on how to save your registration after a modification You must choose Submit Registration at the R amp A after you have reviewed and confirmed the information is correct Please allow 24 to 48 hours after saving your registration at the R amp A before accessing your EHR Medicaid Incentive application if you have successfully completed the CMS R amp A registration please contact ctmedicaid ehr hp com for assistance Should the R amp A report your registration as In Progress and an application be incomplete or under review following the application submission MAPIR will send an email message reporting that such notification has been received if a valid email address was provided by either the R amp A or by the provider on the incentive application
52. 0 percent of unique patients admitted to the 132 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide After you enter information for a measure and click Save amp Continue you will return to the Meaningful Use Menu Measure Worksheet The information you entered for that measure will be displayed in the Entered column of the table as shown in the example below please note that the entire screen is not displayed in this example You can continue to edit the measures at any point prior to submitting the application Click on the Edit button for the next measure Print ContactUs Exit Friday 12 06 2013 11 38 51 AM EST MAPIR Memorial Hospital sn NPI 9959999999 CCN 999999 Hospital TIN MEEN Payment Year 2 Program Year 2014 To enter or edt information select the EDIT button next to the measure that you would lke to edit Al progress on entry of measures wil be retaned f your session is terminated When al measures have been edited and you are satisfied with the entries select the Previous button to access the man measure years old or older admitted to the eligible hosp al s or CAH s inpatient departmert POS 21 Guring the EHR reporting penod have an mxdicabon of an advance directive status recorded as structured data Record electronic notes in pabent records Enter at least one electron progress note created edted and signed by an
53. 09 This act provides for incentive payments to Eligible Professionals EP Eligible Hospitals EH and Critical Access Hospitals to promote the adoption and meaningful use of interoperable health information technology and qualified electronic health records EHR Under ARRA states are responsible for identifying professionals and hospitals that are eligible for these Medicaid EHR incentive payments making payments and monitoring payments The Medical Assistance Provider Incentive Repository MAPIR is a Web based program administered by the CT Department of Social Services DSS that allows Eligible Professionals and Eligible Hospitals to apply for incentive payments The incentive payments are not a reimbursement but are an incentive intended to encourage adoption and meaningful use of EHRs The Centers for Medicare amp Medicaid Services CMS is responsible for implementing the provisions of the Medicare and Medicaid EHR incentive programs CMS issued the Final Rule on the Medicaid EHR Incentive Program on July 28 2010 http edocket access gpo gov 2010 pdf 2010 17207 pdf For more information on CMS EHR requirements link to CMS FAQ s at https www cms gov EHRIncentivePrograms 95 FAQ asp TopOfPage 4 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide 2 Purpose of the Eligible Hospital User Guide The Medical Assistance Program Incentive Repository Eligible Hospita
54. 45 Other Medicaid 500 Total Discharges 1000 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide REVIEW cont This is screen 3 of 3 of the Review tab display Hospital Cost Report Data Fiscal Year Part 3 of 3 Fiscal Year Start Date Jan 01 2010 Fiscal Year End Date Dec 31 2010 Hospital Cost Report Data Part 3 of 3 01 01 2010 12 31 2010 28802880 1 188 756 696 00 56 452 000 00 01 01 2009 12 31 2009 01 01 2008 12 31 2008 01 01 2007 12 31 2007 Attestation Phase Part 1 of 3 EHR System Adoption Phase Meaningful Use 90 Days Attestation EHR Reporting Period Part 1 of 3 Start Date Jan 14 2015 End Date Apr 13 2015 Attestation Phase Meaningful Use Measures Do at least 80 of unique patients have their data in the certified EHR during the EHR reporting Yes period Attestation Meaningful Use Measures Attestation Meaningful Use Measures may be accessed by selecting the link below Meaningful Use Measures Attestation Phase Part 3 of 3 Please confirm that you are either an Acute Care Hospital with an average length of stay of 25 days or fewer or a Children s Hospital NOTE Definition of an acute care hospital for purpose of the Medicaid EHR Incentive Payment Program as those hospitals with an average patient length of stay of 25 days or fewer and with
55. Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide Connecticut Medicaid Electronic Health Record EHR Incentive Program and Medical Assistance Provider Incentive Repository MAPIR System User Guide For Eligible Hospitals O 1 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Document Control Revision History Eligible Hospital User Guide Change Version Date Modified By Control Revision Description V4 7 07 11 S Pausmer Create CT MAPIR EH User Manual V 2 5 15 2012 S Pausmer MAPIR Upgrade version 3 and 4 updates V 3 10 30 2012 S Pausmer MAPIR Upgrade version 4 3 V 4 11 27 2012 J Sandhu Submit Splash Screen V 5 03 15 2013 R Coogan MAPIR Upgrade version 5 0 V 5 1 06 18 2013 R Coogan MAPIR Upgrade version 5 1 R Coogan Upgrade to EH Manual directing providers not to vo 10 09 2013 select previous 12 months for patient volume V 5 2 2 26 2014 R Coogan MAPIR Upgrade version 5 2 V 5 4 10 17 2014 J Sandhu MAPIR Upgrade version 5 4 V 5 5 02 13 2015 D Lewandowski MAPIR Upgrade version 5 5 References Document Author Date Version MAPIR Detailed Requirements and Specifications HP 2 5 2011 2 0 Document MAPIR Technical Specifications Release A HP 3 2 2011 1 1 MAPIR Technical Specifications Release B For HP 5 20 2011 1 3 Comment MAPIR Technical Specificati
56. Denominator 5 100 Performance Rate 5 78 0 Exclusion 5 4 Numerator 6 56 Denominator 6 100 Performance Rate 6 45 0 Exclusion 6 5 Numerator 7 123 Denominator 7 200 Performance Rate 7 67 0 Exclusion 7 6 Numerator 8 79 Denominator 8 100 Performance Rate 8 78 0 Exclusion 8 7 ICMS190 v3 Intensive Care Unit Venous Thromboembolism Prophylaxis Patient Safety Numerator 45 Denominator 78 Performance Rate 79 0 Exclusion 3 Exception 2 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide From the Meaningful Use Clinical Quality Selection screen click Return to return to the Measure Topic List Stage 1 This screen displays the Measures Topic List for Stage 1 with all three Meaningful Use Measure topics marked complete Click Save amp Continue to view a summary of the Meaningful Use Measures you attested to For Stage 1 proceed to the Meaningful Use Measures Summary screen on page 106 Print ContactUs Exit CONNECTICUT DEPARTMENT of Socia SERVICES Friday 12 06 2013 11 38 51 AM EST Pasing fer Caansntina APIR 1 Nt Memorial Hospital NPI cen sss Hospital TIN EEEE Payment Year gt Program Year 014 cman H D M Attestation Meaningtel Use Messures The data required for thus attestation is grouped rito topes In order to complete your attestation you must complete A
57. E CORE MEASURES Stage 2 As part of the meaningful use attestation Eligible Hospitals are required to complete 16 Core Measures in Stage 2 Some Meaningful Use Objectives may not apply to the EH e g if the hospital does not have any eligible patients or actions for the measure denominator In these cases the EH would be excluded from having to meet that measure HELPFUL HINTS The Core Menu and Clinical Quality Measures can be completed in any order For more details on each measure select the click here link at the top of each screen You may review the completed measures by selecting the Edit button After completing all of the core measures you will receive a checkmark indicating the section is complete The checkmark does not mean you passed or failed the measures Evaluations of MU measures are made after the application is submitted Instructions Users must adequately answer each measure they intend to meet by either correctly filling in the numerator and denominator values or successfully marking down exclusion when applicable Two types of percentage based measures are included in demonstrating Meaningful Use With this there are two different types of denominators 1 Denominator is all patients seen or admitted during the EHR reporting period The denominator is all patients regardiess of whether their records are kept using a certified EHR technology 2 Denominator is actions or subsets of patients seen or
58. Exit Thursday 10 02 2014 5 22 32 PM EDT 2 Ca Name MAPIR HOSPITAL NPI 2011062207 CCN we Hospital TIN aymer Year Ea dE Year 2014 Application Submission Part ft of 2 You will now be asked to upload any documentation that you wish to provide as verification for the information entered in MAPIR You may upload multiple files The following documents are to be uploaded into MAPIR Must be in a pdf xis xIsx doc or docx format and no greater than 5 MB Invoice which must include name s of company principals name of the specific product services purchased and date of purchase User agreement which must include company name and name of specific product services purchased Contracts which must include name s of company principals name of the specific product services purchased signatures and dates License agreement which must include company name and name of the specific product services purchased Purchase orders which must include name s of company principals name of the specific product services purchased date of purchase and costs which may be redacted MU dashboard screenshots printouts and or reports which must include numerator denominator exclusions and percentages for each of the required Core and Menu items MU Only Certificate of Public Health Meaningful Use Stage 1 Testing if applicable Public health meaningful use measure exclusion letter if applicable KOE SPOON O PEE emis IO 99 cee ee W
59. HOSPITAL NPI 2011062207 070098 Hospital TIN m Payment Year Program Year 2013 Patient Volume Part 2 of 3 Location Please provide the information requested below to add a location to MAPIR for this Payment Incentive Application use only When ready click the Save amp Continue button to review your selection or click Previous to go back Click Reset to restore this panel to the starting point Red asterisk indicates a required field A Location Name pew Location Address Line 1 123 Main Street Address Line 2 Address Line 3 City lanytown State l Alabama ws 4 Zip 5 4 42345 6789 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide PATIENT VOLUMES cont In this example the screen shows one location on file and one added location Click Edit to make changes to the added location or Delete to remove it from the list Note The Edit and Delete options are not available for locations already on file Click Save amp Continue to review your selection or click Previous to go back Click Reset to restore this panel to the starting point Print Contact Us Exit CONNECTICUT DEPARTMENT OF SociaL SERVICES Tuesday 03 12 2013 1 56 16 PM EDT Caring far Canncclieal MAPIR HOSPITAL NPI 2011062207 CCN 070098 Hospital TIN EE Payment Year 1 Program Year 2013 R amp A Contact Info Eligibility Patient Volumes 7 Submit Pat
60. Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Menu Measures Screen 2 The following Meaningful Use Menu Measures use this screen layout Menu Measures 2 To view more details about this measure click the here link located on the screen Please complete all required fields The denominator entered must be greater than or equal to the numerator entered Click Save amp Continue to proceed Previous to return or Reset to clear all unsaved data Print ContactUs Exit CONNECTICUT DEPARTMENT ccm OF Soci Services Wednesday 12 04 2013 4 25 36 PM EST Paning hat Carmelita ROCKVILLE GENERAL HOSPITAL npr 1871536227 700015 Hospital TIN 060653151 Payment Year 2 Program Year SRA Content inte SE lhe ee Ge 8 GT hs er Menu Measure 2 Click here co review CMS Guidelines for this measure Wher ready click the Save amp Continue Sutton to review your selection or click Previous to go back Click Reset to restore this panel to the starting point Red asterisk indicates a required field Objective Record advance directives for patients 65 years old or older Measure More than 50 of all unique patients 65 years old or older admitted to the eligible hospital s or CAH s inpatient department POS 21 have an indication of an advance directive status recorded as structured data PATIENT RECORDS Please select whether the data used to support the measure
61. Hem The eco ete Meese gts Une Meee estates the bat Belen Bg tie eeptels are e6c dete ped ts select mena Mesreree ea mci Chey COs rapon Sed ta ciam sa Cache shee fet a Mate Tees ers thp a coooa MOre Dee aro ar remeng Meee Pessares tat ch me gasit Of J thero sore ne romeang Mets Mestereds OF Aad They ere obio Te repont este Aore Uecteocheng Meee Messore senelt che lose of arp Cote entered for that Messare at peet pna teat of comm ted Ene 2 copot to sebo t etectren t dete te ond ectes evbe men errectesre able lew end precoce hese spencer te lt b optie besptel e Can pech enter eter bere the Copetrts de recee st laost coa tent of corded Da ca ta pobi tesiri eyesces sec ectas pabaur ece a h B Capcity DO Groeete CDa apecramc corgaace mih spphcabie lew sad prect lt e teimme ewe i fhe test a bei lt ettin amlers some of ha pwin bas gt h egene as te ach pa etoile herprtei Svs names wen aw te nek gt ETRE me et take a a iah howe eee eetected svee f an Cuchenioe appes to al of the menu massere objectives thet are salected totei of frre actuation the pete eT menma meste Cb yem trees anette hospiti es Gare bos encdiaf thts and bes eccess ts st east ome mrernel or berotot e or CAs petient or ortment Pisce of Serce SOS 21 or adi sorog a a ar pe NE Se TEES ehegebe Senet el of CAN eRe rosane s patent eretber settens of Core or arrester of cere or masahe nauing ef abve ar greeter aka er ther petert te enethe
62. LL of the folowing topics The system wil show checks for each Rem when completed The progress level of each top wil be Gaplayed as measures are completed Avadable acbons for a top wil be determined by current progress level To start a topic select the Begin button To modiy a topic where entries have been made select the EDIT button for a topic to modify any previously entered evormaton Select Previous to return Tonics Proaress Action eon Clear All Eor Clear Alt Clinical Quality Measures Clear All Note When all topics are marked as completed select the Save amp Continue button to complete the sttestanon process lt gt Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide Stage 2 This screen displays the Measures Topic List for Stage 2 with all three Meaningful Use Measure topics marked complete Click Save amp Continue to view a summary of the Meaningful Use Measures you attested to For Stage 2 proceed to the Meaningful Use Measures Summary screen on page 137 Print ContactUs Exit CONNECTICUT DEPARTMENT of Socia SERVICES Friday 12 06 2013 11 38 51 AM EST Name MADR Memorial Hospital NPL rrr con 399 Hooke i a Payment Year 2 Program Year 2014 Attestation Meant The data requred for thes attestabon s grouped ito topics In order to complete your attestabon you must complete ALL of the following topics The sy
63. Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Upgrade Phase Part 2 of 3 Review the Upgrade Activities you selected Click Save amp Continue to proceed or Previous to return Tuesday 03 12 2013 2 41 10 PM EDT Attestation Phase Please review the list of activities where you have planned or completed an upgrade When ready click the Save amp Continue button to continue or click Previous to go back Upgrade Activity Upgrading Software Version O Clinical Decision Support Other Reviewed EHR Certification Information iene eee sg 68 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Attestation Phase Part 3 of 3 Part 3 of 3 of the Attestation Phase contains questions regarding the average length of stay for your facility and confirmation of the address to which the incentive payment will be sent Click Yes to confirm you are either an Acute Care Hospital with an average length of stay of 25 days or fewer or a Children s Hospital Click the Payment Address from the list below to be used for your Incentive Payment contingent on approval for payment Click Save amp Continue to proceed to Final Attestation or Previous to return or Reset to clear all data Print Contacts fait of Socar Seawces Tuesday 02 32 2013 3 03 42 PM GOT Camag dar Memmewiawa Please answer th
64. Medicaid Share the hospital will need to provide the following information from the hospital fiscal year that ends during the federal fiscal year prior to the fiscal year that serves as the first payment year Total Number of Total Total Charity Inpatient Medicaid Inpatient Total Charges for Care for All Bed Days Days All Discharges Discharges Calculate the Non Charity Care ratio by subtracting charity care ALL CHARGES INPATIENT AND OUTPATIENT from total charges for all discharges and outpatient and dividing by total charges for all discharges this includes outpatient The charity care adjustment is the percentage of the total charges that are not associated with charity care Total charges 10 000 000 Charity Care 1 300 000 8 700 000 c gt _ 8 700 000 10 000 000 87 Charity Care Adjustment Calculate the Medicaid Share Medicaid Share Medicaid Inpatient Bed Days Total Inpatient Bed Days X Charity Care Adjustment 7 000 21 000 X 87 0 383 18 270 Medicaid Share 38 3 Step 7 Calculate the aggregate incentive amount To arrive at the aggregate incentive amount multiply the overall EHR Amount of 15 925 500 by the Medicaid Share of 38 3 15 925 500 X 383 6 099 467 Total Incentive Payment Amount 6 099 467 This is the total Incentive Amount a hospital can receive for this example Step 8 Distribute Incentive Payments over a 3 year period Connecticut Medicaid Electroni
65. Menu and Clinical Quality Measures can be completed in any order For more details on each measure select the click here link at the top of each screen You may review the completed measures by selecting the Edit button After completing the 3 measures you will receive a checkmark indicating the section is complete The checkmark does not mean you passed or failed the measures Evaluations of MU measures are made after the application is submitted Ween D d Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide From the Meaningful Use Menu Measures Selection screen choose a minimum of three Meaningful Use Menu Measures to attest to If a measure is selected and information is entered for that measure unselecting the measure will clear all information previously entered Click Save amp Continue to proceed or click Return to go back Click Reset to restore this panel to the starting point Tweedey O2 32 2013 3 12 45 Ow OT Cigtte Moi ate must report a mrm of wee 9 Mearunghd Une Menu Measures Pease Note Uncheching a Menu Measure m reak in the loss of any Gata ertered for that mease Seoapial labo send svuchwed clacksenic Gvucal lab conde te ine ardar provider for more than 20 percert of eectror ub 128 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide The measures you selected to
66. OON CIRI HAIR SIVO R CORRIE DID O en this panel to the starting point To upload a file type the full path or click the Browse button Files must be in a pdf xls xlsx doc or docx format and no greater than 5 MB in size File name must be less than or equal to 100 characters File Location Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide The Choose file dialog box will display Navigate to the file you want to upload and select Open Choose file Look in C MAPIR File Upload J e ck E R TO MAPIR File Upload pdf My Recent Documents Desktop My Network File name MAPIR File Upload pdf bz Places Files of type fan Files i 166 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide Check the file name in the file name box Click Upload File to begin the file upload process Print ContactUs Exit Connecticut DEPARTMENT oF SOCIAL SERVICES Thursday 10 02 2014 5 22 32 PM EDT Caning fas Guansalion 4 MAPIR HOSPITAL NPI 2011062207 070098 Hospital TIN Program Year 2014 ae Application Submission Part 1 of 2 You will now be asked to upload any documentation that you wish to provide as verification for the information entered in MAPIR You may upload multiple files The following documents are to be uploaded into MAPIR Must be in a pdf xis xIsx doc or doc
67. OSPITAL Npr 187 1536227 700015 Hospital TIN eee Program Year 20 13 Attest stion Meaningful Use Measures Measure Selection for Core Measure 1 Please cheese from the following options to attest to this measure If you return at a later time and change your selection any information eatered for the measere prior to that point will be removed Whee ready click the Continue burren co review your selection or click Previous to go back Red asterisk indicates 2 required field ease select from the following options Original Core Messure 2 More than 30 of all unique patients with at least one medication in the r medication list admitted to the eligible hospital s or CAH s impatient cr emergency department POS 21 or 23 have at least one medication order entered using CPOE Optional Core Measure 1 More than 30 of medication orders crested by authorized providers of the eligible hospital s or CAH s inpatient or emergency department POS 21 or 23 during the EHR reporting period are recorded using CPOE Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Core Measures The following is a list of the 11 Meaningful Use Core Measures that you must attest to Core Measure 1 has two versions to choose from Click on the Screen Example to see an example of the screen layout Meaningful Use Core Measure S
68. OU WILL RECEIVE No information is required on this screen Note This is the final step of the Submit process You will not be able to make any changes to your application after submission If you do not want to submit your application at this time you can click Exit and return at any time to complete the submission process To submit your application click Submit Application at the bottom of this screen Print ContactUs Exit CONNECTICUT DEPARTMENT Thursday 06 30 2011 7 54 45 PM EDT Name MAPIR HOSPITAL NPI 2011062207 CCN 070098 Hospital TIN CR A I A o ation Submission Part 2 of 2 Based on the Medicaid EHR incentive rules the following chart provides an example of the maximum potential amount per year of a three year payment The columns represent the first year of participation and the rows represent the three years of potential participation To submit your application click the Submit Application button you will not be able to make any changes to your application after submission Example Payment Disbursement over 3 Years Year1 50 Year 2 30 Year 3 20 Example Calculation Example Amount 15 925 500 50 7 962 750 15 925 500 30 4 777 650 15 925 500 20 3 185 100 LL S S S e a e e e o o o a e n ai Submit Application 170 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide SUBMIT cont The check indicates your ap
69. PIR application must be completed by the actual Provider or by an authorized preparer In some cases a provider may have more than one Internet Portal account available for use Once the MAPIR application has been started it must be completed by the same Internet Portal account To access MAPIR to apply for Medicaid EHR Incentive Payment Program under a different Internet Portal account select Exit and log on with that account To access MAPIR using the current account select Get Started All application for previous years will be re associated with the current account and the previous user account will lose access to these applications Exit Get Started 30 February 2015 GETTING STARTED cont If you selected an incentive application that you are not associated with you will receive a message indicating that a different Internet Portal account has already started the Medicaid EHR Incentive Payment Program application process and that the same Internet Portal account must be used to access the application for this Provider ID If you are the new user for the provider and want to access the previous applications you will need to contact ctmedicaid ehr hp com for assistance Click Confirm to associate the current Internet Portal account with this incentive application The applicant can either Select Cancel and return to the Get Started screen or Select Confirm to associate the current Internet Portal account with th
70. S Guidelines for this measure When ready cick the Seve amp Continue to review your selection or cick to restore this pane to the Red asterisk indicates a required feid Objective Use circai deasion support to morove performance on high pnorty health condibons tIplement five cincai Geasion support mterveribons related to four or more Cirucal Quality Measures at a relevant point patient care for the entre EHR reporting penod Absent four Clewcal Quality Measures related to an eboble hosptal s or CAN s pabert populabon the cirwcal Geasson support mterventons must be related to hugh pnorty heath condmions it is suggested that one of the frre chrucal deamon support interventions be related to morong heakthcare efficency Did the eboidle hospital of CAH implement five dirucal deaason support terventions related to four or more chrecal quality measures at a relevant port n pabert care for the entire EMR reporting period Yes No The ebgdle hospital or CAH has enabled the functionality for drug drug and rug allergy interacdon checks for the ertire EMR reporting penod Ord the ebgible hospital or CAH enable and enplement the funchonality for drug drug and drug allergy wteracton checks for the entire EHR reporting penod Yes No Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Core Measure Screen 6 The following Mea
71. Social SERVICES Wednesday 12 04 2013 4 09 53 PM EST Camag fat Canmertamal ROCKVILLE GENERAL HOSPITAL NPI 187 1536227 com 700015 Hospital TEN ay Payment Year 2 Program Year 2013 Cn ee gO oO Ml D Attestation Meaningful Use Meas er Core Measure 8 Click here to review CMS Guidelines for this meesure Whee ready click the Save amp Continue burton o review your selection oc click Previous to 9 back Click Reset to restore this pane to the starting point Red asterisk indicates a required field Objective Record Smoking Statws for patients 13 years old or older Measure More than 50 of all enique patients 13 years old or older admitted to the eligible hospital s or CAH s inpatient of emergency department POS 21 of 23 have smoking status recorded as structured dats EXCLUSION Based on ALL patient records An eligible hospital or CAH that sees no patients 13 years or older would be excluded from this requirement Exclusion from this requirement does not prevent an eligible hospital or CAM from achieving meaningful use Does this exclusion apply to you Ves No If the exclusion does sot apply please complete the following information Numerator Number of patients in the denominator woth smoking states recorded as structured data Denominator Number of unique patients age 13 or older admitted to the eligible hospital s inpatient or emergency Cepartment POS 21 or 23 during the EHR reporting period Nu
72. TATION cont Meaningful Use Core Measures Screen 2 The following Meaningful Use Core Measures use this screen layout Core Measures 2 10 and 11 To view more details about any of these measures click the here link located on the screen Please complete all required fields The denominator entered must be greater than or equal to the numerator entered Click Save amp Continue to proceed Previous to return or Reset to clear all unsaved data Print ContactUs Exit CONNECTICUT DEPARTMENT of Social Services Tuesday 03 12 2013 3 12 45 PM EOT MAPIR Memorial Hospital 999999 2 Core Measure 2 Record Demographics Cick here to review CMS Guidelines for this measure When ready cick the Save amp Continue button to review your selection or click Previous to 90 beck Click Reset to restore thes panel to the starting point Red asterisk indicates a required field Objective Record af of the following demograpiucs preferred language sex race ethructy date of beth and date and prelimmary cause of death in the event of mortality in the ebgdle hosptal or CAH Measure More than 80 percent of al ureque patients seen by the authorized provider or admitted to the ebgble hosptal s or CAW s p2berkt of emergency department POS 21 or 23 during the EMR reporting penod have Gemographes recorded as structured data Numerator The number of pabents m the Genoemnator who have af the elemerts of Gemograptecs or a speafic notado
73. UT DEPARTMENT of Socu Saawces Wedsesdey 02 23 2013 3 07 13 PM COT es Get Started RB amp A Contact Info t ligibility Patient Volumes Attestation i B 6 E a R plication Submission Part 2 of 2 As the preparer of this location on behalf of the fac ty please attest to the accuracy of all information entered and to the following This is to certify that the foregoing information is true accurate and complete ETEME 10 Cary SAE TOS O OA lng Sadar depp acre T DR incentive payments submitted under this provider number will be from Federal funds and that any falsification or concealment of a material fact may be prosecuted under Federal and State laws Red asterisk indicates a required field le g y By checking the box you are indicating that you have reviewed all information that has been entered into Mabie Tas 7 asaye 00 the Review panel J ne E a aa nan ri hier Preparer NameHospital Preparer To attest cick the Electronically wil not be able to make changes to esorare ake Ck previous 29 9o oac CICE abet to Tantere thie pant to cha uimaan Cerevious ea ineeset ses pee be ewe eee L Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide SUBMIT cont Your actual incentive payment will be calculated and verified by Connecticut Medicaid program office This screen shows an Example Payment Disbursement over 3 Years THIS IS NOT THE AMOUNT Y
74. a CCN that falls in the range of 0001 0879 Short term Hospitals or 1300 1399 Critical Access Hospitals The mailing address below will be used for your Incentive Payment if you are approved for payment 999999999 9999999999 MAPIR Memorial 1600 Pennsylvania Avenue NW Washington DC 20500 162 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide Submit Your Application In this section you will able to review the information that you submitted in MAPIR and upload documentation supporting our attestation MAPIR displays the information and allows you to print the information entered Please review the information you ve provided for accuracy and completeness This will be your opportunity to make changes prior to final submission Review and Check Errors MAPIR will check you application for errors If errors are present you will have the opportunity to go back to the tab where the error occurred and correct it If you do not want to correct the errors you can still submit your application however the errors may affect the processing of your application The following documents are to be uploaded into MAPIR Must be in a pdf xls xlsx doc or docx format and no greater than 5 MB e Invoice which must include name s of company principals name of the specific product services purchased and date of purchase e User agreement which must include company name
75. a e ee ae beck Cho eset te resmre Ds pene m De C7 Red asterisk indicates s cequred feid Ortec e Copedicy to subat electron cate te zenon rep stes or Om teen nfermeten sy srceme anc actuel sebas sion according te sspcabie lo ond Derfermes ot besst ome test ofc tolon 2S sutas s e sbie Dospan of CAH sutras sec 2 Beeed oe ALE potent recorde An atigibie bos cit immer setens Coming the Em remeirement Joes Net grever on elrg bie Bosprte or Can trom schiewing Oces this exclesion apsty te wou vex ne SCE USO 2 Based oe ALE potiest recorde If there is no immenizanon regestry thet bas the capacity to CAH cuis be exceed fom tis siea kom thes Teg rement Coes fot pre ert an etoile hosptal or CAH from schienge Dees ches exctesien epety to you ves Neo 15 Chee ec treton does mot eppiy to woe pierre ompiete the fallowees tn formato Ded woe perform at less one test of corcties EHR Soghoctouy s lt spectr so sober immen enen regestnes and te sss Seccesstet uniess sone oft reses te mhich the ebicibie Mospaal es CAH subewes such intormanen has he capacity us votare he im Rorrm a bom ehectrossc sihe wes o Eecer che neme of the wmmmanizston registry usec Dranse setec Dimmers eters ere sot foo v estes Gers He ENR resstins secs There ee o eotity lt acetbia of ternes Surins the EH reserties ceased wore BE yon would Uhe ce spiont information Ghee voo feet jansfias hts antaen Stee use the spiced fie fan
76. admitted during the EHR reporting period whose records are kept using EHR technology Eten Begin gt el 110 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide The screens on the following two pages display the Meaningful Use Core Measure List Table The first time a topic is accessed you will see an Edit option for each measure Once information is successfully entered and saved for a measure it will be displayed in the Entered column on this screen Click Edit to enter or edit information for a measure or click Return to return to the Measures Topic List Connecticut Medicaid Eligible Hospital User Guide Electronic Health Record Incentive Program This is screen 1 of 2 of the Meaningful Use Core Measure List Table Prdey EDOS S023 2 2 23 Ow OST Am el te et Ee EET ee meet te Ee meme Ft pe AE ee Oe AF pe eee oe re ST meres oe ee ms Cee oer oe twee eee hea eee eiel ami r ee Ct Ee ees Seat ae Reema te te eee fat ee at eet aterm tee L i i ilj A a nll me it lite i i i Le i ba i fF ce February 2015 112 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide This is screen 2 of 2 of the Meaningful Use Core Measure List Table doses are tracked Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide The follow
77. ained directly from the certified EHR system HELPFUL HINTS 1 The Core Menu and Clinical Quality Measures can be completed in any order 2 You may review the completed measures by selecting the Edit button 3 When all measures are complete you will receive a checkmark indicating the section is complete 142 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide This screen displays the Meaningful Use Clinical Quality Selection screen There are 29 Meaningful Use Clinical Quality Measures available for you to attest to Select a minimum of 16 Meaningful Use Clinical Quality Measures from at least three different domains Click Save amp Continue to proceed or click Return to go back Click Reset to restore this panel to the starting point Name MAPIR Memorial Hospital NPI 9999999999 CCN 999999 Hospital TIN 999999999 Payment Year 1 Program Year 2014 Get Started R amp A Contact Info Eligibility Patient Volumes Attestation E Attestation Meaningful Use Measures Instructions Select a minimum of 16 clinical quality measures by checking the box next to the measure you are attesting The measures selected must be chosen from at least three different domains Please note Clinical quality measures are sorted by Domain and then by CMS Measure Number eS a emsa v3 lincal Process eociveoasschsive Bast mikre J cms30 v4 Ginial Process effectveness Statin Prescribed at Dis
78. al on a regular basis In order to access the MAPIR system the administrator of your hospital s INPATIENT AVRS Web ID will need to create a clerk ID for the individual that will be completing the hospital s attestation in MAPIR It is important that they do not use the Outpatient AVRS ID because access to MAPIR cannot be gained through that ID The hospital Web ID administrator should already know how to set up a clerk account as these IDs must not be shared The full instructions are on our Web site www ctdssmap com under Information Publications Provider Manuals Chapter 10 Web Portal Creating a clerk If you have questions regarding Web ID set up please contact the Provider Assistance Center at 1 800 842 8440 Changes to your R amp A Registration Please be aware that when accessing your R amp A registration information should any changes be initiated but not completed the R amp A may report Registration in Progress This will result in your application Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide being placed in a hold status within MAPIR until the R amp A indicates that any pending changes have been finalized You must complete your registration changes on the R amp A website prior to accessing MAPIR or certain capabilities will be unavailable For example it will not be possible to submit your application create a new application or abort an incomplete application If
79. als Medicaid only hospitals will attest to MU through MAPIR Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide 8 Attestations and Audits The Department may access all relevant records and documentation and take any other appropriate quality assurance measures it deems necessary to verify provider attestations or conduct pre payment or post payment audits to assure compliance with the provisions of sections 17b 34 1 to 17b 34 9 inclusive of the Regulations of Connecticut State Agencies and other regulatory and statutory requirements The department may disallow or recover any amounts paid or pending to the provider for which required documentation is not maintained or not provided to the department upon request For purposes of documenting AIU the provider shall make available to the department all relevant documents including but not limited to one or more of the following documents as directed by the department 1 Contract 2 software license 3 receipt or evidence of cost 4 purchase order 5 evidence of cost or contract for training or 6 payroll record demonstrating hiring of staff to assist with the implementation After conducting an audit if the department finds that the provider was not eligible for payments made to the provider the department may disallow and recover those funds The provider shall promptly repay all disallowed funds to the department not more than
80. arges All Discharges Inpatient and Outpatient and Total Charges Charity Care Inpatient and Outpatient Important Note Nursery Psych and Rehab bed days and discharges are not to be used in cost data Click Save amp Continue to review your selection or click Previous to go back Click Reset to restore this panel to the starting point If you have questions about the calculation please see Section 5 Print ContactUs Exit Connecticut DEPARTMENT oF SOCIAL SERVICES Tuesday 03 05 2013 2 34 46 PM EST MAPIR HOSPITAL NPI 2011062207 cen 070098 Hospital IN Payment Year 1 Program Year R amp A Contact Info Eligibility Patient Volumes jg Attestation Review Please enter your hospital cost report data for the hospital fiscal year selected in the first row Complete the first column in the table below for your last four full fiscal years Only acute care discharges and acute care bed days are to be included in Total Discharges Total Inpatient Medicaid Bed Days and Total Inpatient Bed Days Nursery days must be excluded from these entries Note You will not be able to change the Fiscal years which were previously entered When ready click the Save amp Continue button to review your selection or click Previous to go back Click Reset to restore this panel to the starting point Red asterisk indicates a required field 2 2 t 2 pe eet ee eare paa e r evan an a oo oo 7 Reset Save amp Contiowe_ _
81. asure 5 ePrescribing eRx Screen 1 Menu Measure 6 Lab Results to Ambulatory Providers Screen 2 130 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Menu Measures There are six Meaningful Use Menu Measure screens As you proceed through the Meaningful Use Menu Measure section of MAPIR you will see two different screen layouts Instructions for each measure are provided on the screen For additional help with a specific Meaningful Use Menu Measure click on the link provided above the blue instruction box Screen 1 The following Meaningful Use Menu Measures use this screen layout Menu Measures 1 and 5 To view more details about any of these measures click the here link located on the screen Please complete all required fields The denominator entered must be greater than or equal to the numerator entered Click Save amp Continue to proceed Previous to return or Reset to clear all unsaved data Conmecmour Demarment of Socom Somwces wara errors tong st Ch bere fo cee CS CU neers fe Oe mere C7 Sed extern edie ates required fidd Cpe twee Record Aether s pbort 63 yems oid or iber hat an Orare Grectuw Mesmre More tues 3 percent of af urupa pateras 65 ress cid oF Aiar aGrnETEd te The egiie Morpa s o Cans rera DOS TE POS 21 ures Ihe EI remortang Dero Nae an ovine ate Of a Oe are Oe eters Sf
82. atients seen in the ED and admitted as an inpatient who have a diagnosis consistent with psychiatric mental health disorders Measure Observation 3 Measure Population 3 Reset Save amp Continue Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Clinical Quality Measures Screen 2 The following Measure Numbers use this screen layout CMS104v3 CMS71v4 CMS72v3 CMS105v3 CMS190v3 and CMS30v4 CMS100v3 CMS60v3 To view more details about any of these measures click the here link located on the screen Please complete all required fields The denominator numerator and exclusion entries must be positive whole numbers including zero Click Save amp Continue to review your selection click Previous to go back or click Reset to restore the panel to the starting point MAPIR Memorial Hospital sane 9999999999 CCN 999999 Hospital TIN 999999999 Payment Year 2 Program Year 2014 Get Started R amp A Contact Info Eligibility Patient Volumes Attestation Submit Attestation Meaningful Use Measures Clinical Quality Measure 3 Click here to review CMS Guidelines for this measure When ready click the Save amp Continue button to review your selection or click Previous to go back Click Reset to restore this panel to the starting point Red asterisk indicates a required field R
83. ator 2 Oenominator 2 The ekpdie horptai or CAM must ately ore of the two foliowmng atena ComBxcts one or more successhs chactromc exchanges of a summary of Care document ath n comted n messure Y For e amp gtie hosptals ard Carts the measure at 495 60 1 1XeKE WED a repent whe has DR technology that was Semgned Dy 2 Afferert ER techrotogy developer Man the sender s EHR technology cert ied to 43 CFR 170 314 ves Neo on COMDATE one OF more SUCCESSAS tests with the CHS demgnated test DR Annog the EPR reporting penod ves 122 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Core Measures Screen 9 The following Meaningful Use Core Measures use this screen layout Core Measures 13 14 and 15 To view more details about any of these measures click the here link located on the screen Please complete all required fields Click Save amp Continue to proceed Previous to return or Reset to clear all unsaved data Print ContactUs Exit CONNECTICUT DEPARTMENT of Soci Services Tuesday 02 22 2023 3 12 45 PM EOT Caaneg jar aanredora Mana Memorial pospet al were Poyment Year gt Cece tree fe erea OMS Coceirnes ter the messire Red asterisk Ind ates a required etd Capaddity to mimt efectromc data to MUE ston OPINE of EION eformabon systems excest where DrohOted and n accordurce wth sopkcsbie l
84. authonzed provider of the ekgible hospital s or CAH s moatient or emergency department POS 21 or 23 for more than 30 percent of unique patents adenited to the eligible hosptal or CAH s moaten or emergency department dunng the EHR reporting penod The text of the electronic note must be text searchable and may contain drawings and other content Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide Once you have attested to all the measures for this topic click Previous to return to the Meaningful Use Menu Measure Selection screen Print ContactUs Exit Friday 12 06 2013 11 38 51 AM EST NPI 9999999999 Hospitaiv n rm Payment Year 2 Program Yeor 2014 cma ln eae a oo EE TAN To enter of edt information select the EDIT button next to the measure that you would like to edt Al progress on entry of measures wil be retained if your session is termmnated EOE CORE aS SE ES EAS 08 ERNE IIE Semen eee ne TONE DOMED aREIE OM ETT Numerator 3 inpatient or department meagan a ee data entry for one or more first degree More than 10 percent of hosptal Gecharge pepe haters eke yee eer pS for new changed and refilled prescriptions are queried for drug formetary and transmitted Hosptali labs send structured electronx chrwcallab Numerator 100 hgeone 1a p decane nt nat ot aa Denocemnator 100 134 February 2015 Connecticut Medicaid Electronic Health Record Incenti
85. aw and prackoe Sucess ongoa admeten of ehectromec enemurErabon Cats trom Certithed EHR Tehnology to an eura ston regetry On me ation wtormaton system tor the etra 98 porny perces The EBgSte Hosptali or CAM must attest Ves or Neo to the foboweng ON QED HOHE was BORD Pered for a OE epo DEMOS N 2 DI VOR Bd Orra DENA The arent reporting penod wang other the csrert standards at 45 CFR 170 314 7K 5 and 1X2 oF the standards extaced n the 2011 Editor EMR Cortticsmom eena adosted by ONC Gunng the pror EPM reporting pened when ongow ng submeton nas aPeeved ves No Regits don weh the Abi Mesh Agency cr other Body to whom the eformaton m deng mom ted of rtert to noste NGONG bmn mas made by the Sesine wets 60 Gays of the stat of the ER reporting pencd and ongong ROT eon aaa a teeved ves Neo Regit aon of mtent to niste Gorg MOm nas made Dy the Serine and the mthorred prowster or hosptal s SRB engaged N tereng and abdaton of ongona electron mimenon ves Ne Regt bon of tert to niste Cron OmoN aa made Dy he Seline and the sorted prodor or hosptal s Da BEING MEEN to Deon testing and EION vee mo SS If any of the measures stove are Yes hen Go not select an Eechzon Wf 28 of the bove mesnres are ren weet one on more of the Ecusons beloa Arry Chgtie aspis or CAM at meets one or more of the todowng anina ner Dee eecheded from thes obret e Does Aot aerereeter ary of Dre eeemurersbors te any of the populdons for mench Gates ie coBected by the
86. ayment Year 1 Program Year 2014 R amp A Contact Info Eligibility Patient Volumes Attestation E a Submit Attestation Meaningful Use Measures Clinical Quality Measure 1 i Click HERE to review CMS Guidelines for this measure When ready click the Save amp Continue button to review your selection or click Previous to go back Click Reset to restore this panel to the starting point Red asterisk indicates a required field Responses are required for the clinical quality measure displayed on this page Domain Patient and Family Engagement Measure Number CMS55 v3 Measure Title Median Time from ED Arrival to ED Departure for Admitted ED Patients Measure Description Median time from emergency department arrival to time of departure from the emergency room for patients admitted to the facility from the emergency department Measure Observation A positive whole number including zero Use the Click HERE above for a definition of the Measure Observation Measure Population A positive whole number including zero Use the Click HERE above for a definition of the Measure Population ED 1 1 All patients seen in the ED and admitted as an inpatient Measure Observation 1 Measure Population 1 ED 1 2 All patients seen in the ED and admitted as an inpatient who do not have a diagnosis consistent with psychiatric mental health disorders Measure Observation 2 Measure Population 2 ED 1 3 All p
87. c Health Record Incentive Program Eligible Hospital User Guide The Department will issue hospital incentive payments over a 3 year period The following illustrates the payments in 3 consecutive years at 50 30 and 20 respectively The hospital would need to continue to meet the eligibility requirements and meaningful use criteria in all incentive payment years 2011 50 2012 30 2013 20 3 049 734 1 829 840 1 219 893 14 February 2015 7 Adopt Implement or Upgrade AIU and Meaningful Use MU The goal of the Connecticut Medicaid EHR Incentive Program is to promote the adoption implementation upgrade and meaningful use of certified EHRs Hospitals are required to attest to the status of their current certified EHR adoption phase O Adopted acquired purchased or secured access to certified EHR technology Implemented installed or commenced utilization of certified EHR technology capable of meeting meaningful use requirements Upgraded expanded the available functionality of certified EHR technology capable of meeting meaningful use requirements at the practice site including staffing maintenance and training or upgrade from existing EHR technology to a federally certified EHR technology Meaningful User Eligible Hospitals can attest to meeting meaningful use requirements as set forth by CMS Dually eligible hospitals will attest to reaching the MU requirements at the CMS R amp A website Children s hospit
88. caid Health Program Office State To State Switch Incentive Application The first incentive application from an EH that has switched from one state to another TIN Taxpayer Identification Number February 2015
89. certified EHR technology This cate wes extracted from ALL patient records not just those meintsines using certifies BHR technology This cate wes extracted only from petient records maintaiced using certified EHR technology Cometete the following information Numerator The number of patients in the denominator that have at least one medication order entered wsing CPOE Oesominatoe Number of unique patients with at least one medication in their mechcation Dst seen by the eligible hosperel or CAH during the EHR reporting period Muaewerator Deeormimatos Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Core Measures Screen 2 The following Meaningful Use Core Measures use this screen layout Core Measures 2 10 and 14 To view more details about any of the measures click the here link located on the screen Please complete all required fields Click Save amp Continue to proceed Previous to return or Reset to clear all unsaved data Print Contert We Exit CommacrcuT DEPARTMENT oF Socia Services Wedeanday 12 04 2013 4 03045 PM EST o Thuy gle Emmet Name ROCKVILLE GENERAL HOSPITAL MPI 1871335227 EEH 700015 Hospital TIM SEN Payment Year 2 Program Year 2013 6 wT 6 eens oe Altecta tion Hessin Core Measure 7 Ofek Aang oo rien CMS Govelelinaan far chin rune When ready click che Sve A Combinat barton no nv
90. charge SSCS Clinical Process Effectiveness Primary PCI Received Within 90 Minutes of Hospital Arrival Clinical Process Effectiveness Fibrinolytic Therapy Received Within 30 Minutes of Hospital Arrival Clinical Process Effectiveness Anticoagulation Therapy for Atrial Fibrillation Flutter Dosages Platelet Count Monitoring by Protocol or Nomogram Efficient Use of Healthcare Prophylactic Antibiotic Selection for Surgical Patients Resources Efficient Use of Healthcare Initial Antibiotic Selection for Community Acquired Pneumonia CAP in Resources Immunocompetent Patients ICMS26 v2 Patient and Family Engagement Home Management Plan of Care HMPC Document Given to Patient Caregiver Patient and Family Engagement Median Time from ED Arrival to ED Departure for Admitted ED Patients Patient and Family Engagement Stroke Education ICMS110 v3 Patient and Family Engagement Venous Thromboembolism Discharge Instructions Prophylactic Antibiotic Received Within One Hour Prior to Surgical Incision Postoperative Day 2 POD 2 with day of surgery being day zero Return Reset ave amp Continue gt Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide The screen below displays the Meaningful Use Clinical Qualit
91. clusion 5 Exception 8 Numerator 30 Denominator 60 Performance Rate 90 0 Exclusion 5 Exception 1 Numerator 79 Denominator 100 Performance Rate 87 0 Exclusion 3 Numerator 90 Denominator 150 Performance Rate 78 0 Exclusion 6 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide This is screen 5 of 5 of the Meaningful Use Measures Summary Median Time from ED Arrival to ED Patient and Family Engagement Departure for Admitted ED Patients Incidence of Potentially Preventable Patient Safety Venous Thromboembolism Prophylactic Antibiotic Received Within One Hour Prior to Surgical CMS171 v4 Patient Safety Incision Intensive Care Unit Venous CMS190 v3 Patient Safety Thromboembolism Prophylaxis Previous Save amp Continue Measure Observation 1 12 Measure Population 1 28 Measure Observation 2 34 Measure Population 2 67 Measure Observation 3 43 Measure Population 3 89 Numerator 45 Denominator 98 Performance Rate 85 0 Exclusion 4 Numerator 1 50 Denominator 1 100 Performance Rate 1 78 0 Exclusion 1 3 Numerator 2 75 Denominator 2 143 Performance Rate 2 89 0 Exclusion 2 3 Numerator 3 87 Denominator 3 132 Performance Rate 3 90 0 Exclusion 3 3 Numerator 4 57 Denominator 4 123 Performance Rate 4 56 0 Exclusion 4
92. complete and click on continue you will then see this page A status of Not Registered at R amp A indicates that you have not registered at the R amp A or the information provided during the R amp A registration process does not match that on file with Connecticut Medicaid Program If you feel this status is not correct you can click the Contact Us link in the upper right for information on contacting the state Medicaid program office A status of Not Started indicates that the R amp A and Connecticut MMIS information have been matched and you can begin the application process Please verify that the Payment Year and the Program Year listed at the top of the page are the ones you chose to complete The Status will vary depending on your progress with the application The first time you access the system the status should be Not Started Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide GETTING STARTED cont Enter the 15 character CMS EHR Certification ID Click Next to review your selection Click Reset to restore this panel back to the starting point Click Exit to exit MAPIR The system will perform an online validation of the CMS EHR Certification ID you entered A CMS EHR Certification ID can be obtained from the Office of the National Coordinator ONC Certified Health IT Product List CHPL website http onc chpl force com ehrcert MAPIR HOSPITAL 2011062207 Tf you are attesti
93. creen Example Core Measure 1 CPOE for Medication Orders Original Screen 1 Core Measure 1 CPOE for Medication Orders Optional Screen 1 Core Measure 2 Drug Interaction Checks Screen 2 Core Measure 3 Maintain Problem List Screen 3 Core Measure 4 Active Medication List Screen 3 Core Measure 5 Medication Allergy List Screen 3 Core Measure 6 Record Demographics Screen 3 Core Measure 7 Record Vital Signs Screen 1 Core Measure 8 Record Smoking Status Screen 4 Core Measure 10 Clinical Decision Support Rule Screen 2 Core Measure 12 Electronic Copy of Discharge Instructions Screen 5 Core Measure 14 Protect Electronic Health Information Screen 2 82 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Core Measures There are 12 Meaningful Use Core Measure screens Core Measure 1 has two screens to choose from As you proceed through the Meaningful Use Core Measure section of MAPIR you will see five different screen layouts Instructions for each measure are provided on the screen For additional help with a specific Meaningful Use Core Measure click on the link provided above the blue instruction box Screen layout examples are shown below Screen 1 The following Meaningful Use Core Measures use this screen layout Core Measures 1 Original and Optional and 7 To view more details about either measure click the
94. ction fosd om the Seit 14 the cert wee successie piesse enter the dace 206 mme of rme test Dere MOON Tirma me senn ee fue OF 1S er D yeu ere meres Ves to nos voer teet eeccesetel the fello s Wes s foilon up Submissson done w Neo ATTESTATION cont Meaningful Use Menu Measures After you enter information for a measure and click the Save amp Continue you will return to the Meaningful Use Core Menu Measure Worksheet The information you entered for that measure will be displayed in the Entered column of the table as shown in the example below please note that the entire screen is not displayed in this example You can continue to edit the measures at any point prior to submitting the application Click on the Edit button for the next measure Connecticut Medicaid Electronic Health Record Incentive Program 102 Attestation Mevnhnayful lice Hensies Heanngqlul Use Menu Measure Worksheet Eligible Hospital User Guide Aides CATOIA AS Pee OST To enter of ect nformaten delect the DDT button next to the messua that you would kka to adt All prograde on entry of ured ell be retaned if your terion a bermnated When all mezuez hove been edited und you bre datahed with the entred select the Previews button to sceeds the min tecon advance directives for patents 65 warg ohj or older Tha obgble hospital or CAH has enabled thig funchenalty and has access te at least one intemal or ex
95. ctronic Health Record EHR Incentive Payment Program An eligible provider hospital starts the process by registering for the Program at the CMS EHR Incentive Program Registration and Attestation System R amp A at https ehrincentives cms gov MAPIR will interface with the CMS system and match the data supplied by the R amp A to the provider s data in the MMIS Once matched the provider will be able to access the MAPIR to register and attest to the EHR Certification Number for the EHR technology adopted implemented or upgraded and provide Medicaid encounter and total patient encounter volumes Please complete each of the steps in the MAPIR application When you have completed all of the steps please click on the submit button to submit your application Open MAPIR Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide 13 Completing the MAPIR Application The remainder of the Eligible Hospital User Guide consists of instructions on how to complete each screen component within seven electronic MAPIR application tabs that comprise the registration document e Get Started e R amp A and Contact Info e Eligibility e Patient Volume e Attestation e Review e Submit MAPIR uses this tab arrangement to guide you through the application You must complete the tabs in the order presented You can return to previous tabs to review the information or make modifications until you submit the applica
96. d attest to the validity of data thus improving the accuracy and quality of the data The MAPIR system will be used to process provider applications including Interfacing between the Department and the R amp A to e Receive initial hospital registration information e Report eligibility decisions to CMS e Report payment information payment date transaction number etc to CMS Verify information submitted by applicant Determine hospital eligibility Allow hospitals to submit e Attestations e Payee information e Submission confirmation digital signature Communicate Payment Determination To begin in the MAPIR application process hospitals must 1 Go to the following link and fill out the information requested so your CCN can be updated in the Medicaid Management Information System that interfaces with MAPIR http www surveymonkey com s EHR_ Registration Information 2 Enroll at the R amp A if this is your first payment year and the hospital has not already registered at the R amp A Please access the federal Web site below for instructions on how to do this or to register For general information regarding the Incentive Payment Program http www cms gov EHRIncentivePrograms To register https ehrincentives cms gov hitech login action You must register at the CMS Medicare and Medicaid EHR Incentive Program Registration and Attestation System also known as R amp A website before accessing MAPIR If you access MAPIR and
97. dicaid Inpatient Bed Days e Total Number of Inpatient Bed Days e Total Charges for all Inpatient and Outpatient no exclusions e Total Charges for Charity Care for all Inpatient and Outpatient no exclusions Note All bed day totals and discharges should exclude nursery psych and rehab days Do not exclude nursery psych and rehab from Charges Children s hospitals separately certified children s hospitals with CCNs with last four digits in the 3300 3399 range are not required to meet the 10 Medicaid patient volume requirement Based on a hospital s CCN MAPIR will bypass these patient volume screens 40 February 2015 PATIENT VOLUMES cont The initial Patient Volumes screen contains information about this section If you represent a Children s hospital click Begin to go to the Patient Volume Cost Data Part 3 of 3 Note Children s Hospitals will not see any patient volume related screens If you are a Children s Hospital please click here to advance to the next appropriate page in the user guide If you represent an Acute Care or Critical Access Hospital click Begin to proceed to the Patient Volume 90 Day Period Part 1 of 3 screen Connecticut DEPARTMENT oF SOCIAL SERVICES Friday 03 22 2013 9 57 38 AM EDT Casing far Canncelioal MAPIR HOSPITAL NPI 2011062207 CCN 070098 Hospital TIN p Payment Year 1 Program Year 2013 Get Started R amp A Contact Info Eligibility Patient Volumes Attestation Sub
98. digits in the 3300 3399 range are not required to meet the 10 Medicaid patient volume requirement MAPIR will know based on your CCN to bypass the patient volume screen click on Begin to bypass to Part 3 of this section Eligible Hospital User Manual Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide PATIENT VOLUMES cont Part 1 of 3 Patient Volume 90 Day Period The Patient Volume 90 Day Period section collects information about the Medicaid Patient Volume reporting period Enter the start date for the 90 day reporting period in which you will demonstrate the required Medicaid patient volume participation level The start date is the first day of the continuous 90 day period for reporting patient volume in the preceding fiscal year or in the 12 months preceding the attestation date by the total encounters in the same 90 day period DSS encourages you to select the previous fiscal year as a continuous 90 day volume reporting period to ensure a date range is selected that falls within the last completed fiscal year and then enter your start date NOTE While MAPIR will allow providers to select 12 Months Preceding Attestation Date CT cannot support that selection Providers will be directed to select the last completed fiscal year preceding the payment year Furthermore EHs who select 12 months preceding attestations may result in a delay in payment EXAMPLE If requesting an EHR Incentive
99. e This dete wer estraceed from ALL pstient recorde not jutt thore ma ntsined uring certified EHR techn slegr This date was tracted onby from patent records maintained usieg certified EHF technology EXOLUSDON Based on ALL patient recomda An eligible hoapitel or CAH thar has no regsesrs From parienta or their agente for an electronic copy of their discharge inwetnections dering the EHR reporting period th wewhd be eoochueced Fom this requenmmenr Esochusias from this nequiremest does hort prevent an eligible bes pineal or CAH from achieving meaningful use Does this exclusion apply te you Wer Ne Tf the exclusion does not apply pierast coneplete the Following infomation Hemersbor Thee number of pateents in the denominator whe ane provided an electronic copy of discharge nsiractions Deemominston umber of patients discharged from an eligible hospitals or Cees inpatient or emergency department POS 21 er 23 whe request oe eleceronie copy of their discharge inseructiana during te HR Meera priced teers ber Dheeominabos Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Core Measures After you enter information for a measure click the Save amp Continue button You will be returned to the Meaningful Use Core Measure List Table The information you entered for that measure will be displayed in the Entered column of the tabl
100. e a positive whole number You have indicated that you qualify for the exclusion As a result a numerator and denominator should not be entered You must attest to at least one Public Health measure The measure selected may be an exclusion You must exit MAPIR and return in order to access a different program year incentive application You must choose an application The selection you have made is not a valid option at this time You have made an invalid selection The time you have entered is in an invalid format You must select at least 5 menu measures Values entered match the existing cost data on file The Start Date you have entered was attested to in a previous Payment Year You have not met the minimum number of documents required Please upload the minimum number of documents required to proceed Files must be in Excel Word and Portable Data Format PDF Files up to 5 megabytes MB in size are acceptable documentation to upload You have not completed the patient volumes Please return to the Patient Volume tab to enter patient volumes You have not attested to all MU Measures Please return to the Attestation tab to attest to all required measures You must answer all Exclusion questions with a Yes or No answer to proceed The Performance Rate value you entered is invalid it must be a combination of a whole number and a decimal The acceptable range f
101. e as shown in the example below please note that the entire screen is not displayed in this example You can continue to edit the measures at any point prior to submitting the application Click Edit for the next measure Priest Comtecivs Cuit Wedresdey 12 04 2013 4 14 29 OM OST Payment Year 1 To enter of e t mformaton select the EDIT button next to the measure that you would ike to odt AB progress on entry of measures wil be retamed if you session s ternrenated When af measures have been edited and you are satefed with the entries select the Return button to access the mar attestabon tope bet HMeanmendfiul Line ere Moeesure List Tabie computerized phymcian order entry CPOE More than 30 of al ureque patents with at Numerator 350 o medcation orders Grectly entered by any lest one medication n ther medication bet Dencemator 1000 eneed healthcare profeemonal who can enter adewtted to the ebgite hoaptal s of Casts d maed prr a a a ee ee Poent of emergency Gepartment POS 21 r 23 hove at east one medcabon order entered 9 CPOE The cgis hospital or CAH has enabled thes Se Ser OF ee OR repan an up te date problem tat of current Sore than 60 of a8 ungue patents smitta d active Gagroses to the ebpite hospitals or CA s inpatent or emergency department POS 21 of 23 heve at least one entry oF an extcabon that no problems are known for the patent recorded as structured data More than 60 of al ureque pat
102. e entered is Numerator 100 Oencenmator 100 Percentage 100 ence oo A tony Percentage 11 Numerator 155 Denominator 167 Percentage 92 Numerator 123456 Dencennator 234567 Percentage 52 Numerator 567888 Dencennator 678888 Percentage 83 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide This is screen 2 of 4 of the Meaningful Use Measure Review Meaningful Use Menu Measure Review Meaningful Use Clinical Quality Measure Review Numerator 4 Denominator 3 Performance Rate 25 0 Exclusion 2 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide This is screen 3 of 4 of the Meaningful Use Measures Review Cinical Clinical Process Effectiveness Clinical Process Effectiveness Clinical Process Effectiveness Clinical Process Effectveness Exclusion 4 Clinical Process Effectrweness Oischarged Clinical Process Effecttveness Clinical Process Effectiveness Patent Safety ee eee Stroke 2 Ischemic Stroke Denominator Discharged on Antthrombotic Therapy Exdusion PC 01 Elective Delivery Prior to 39 Completed Weeks Gestation Exdusion Emergency Department ED 1 Emergency Department Throughput Patient and Family Engagement Medan Time from ED Arrival to ED Departure for Admitted ED Patents poe 108 February 2015 Connecticut Med
103. e fobowwg quesdon ready Click the Save amp Continue Dutton to review your selecton sil test liad chess Click Reset to restore this pane to the starting point Red asterisk indicates a required field QOS SOOO TF 22225 Please confirm that you are ather an Acute Care Hospital with an g ves Mo o average length of stay of 25 days or fewer or a h dren s Hospital Steunsite NOTE EDO IGAN MRSA ef CAI GEAD must een adoh a COU UAIS is UNG SASO AT OUDE DEOD ORDADA Patient length of stay of 25 days or fewer and with a CCN that falls in the range of 0001 0879 Short term prime aigen 1300 1399 Critkal Access Hospitals Please select one payment address from the ist provided below to be used for your Incentive Payment if you are approved for payment If you do not see vald payment address pleate Contact Connecticut Oepartment of Social Services 2031062207 MAPIR HOSPITAL 195 SCOTT SWAMP ROAD 008020870 070008 FARMINGTON CY 06032 Oaa gt Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Attestation Phase Part 3 of 3 This screen confirms you successfully completed the Adopt Implement or Upgrade Phase of the Attestation tab Note the check box in the Attestation tab Click Continue to proceed to the Review section Get Started R amp A Contact Info Eligibility Patient Volumes Attestation 7 a Submit j You have now completed the At
104. e is no user activity longer than 60 minutes You will receive timeout warnings e Please note that whoever begins the MAPIR application must be the same person who completes the application e When a MAPIR electronic tab is completed a green check mark will appear in the corner of the tab e You can go back in the application tabs to review information content but not forward Applicant NPI 2011062207 174 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide Once your application has been processed by the State Medicaid Health Program Office SGMHPO you can click the Submission Outcome tab to view the results of submitting your application Print ContactUs Exit Connecticut DEPARTMENT oF SOCIAL SERVICES Caring har Cannecliaal Thursday 05 10 2012 12 56 52 PM EDT Name MAPIR HOSPITAL NPI 2011062207 CCN 070098 Hospital TIN ME Payment Year 1 Program Year 2012 Current Status Review Application Submission Outcome o The MAPIR Review panel displays the information that you have entered to Print Y date for your application Select Print to generate a printer friendly version of this information Status Completed Payment Amount You have been approved to receive a payment in the amount of 1 500 000 00 Provider Information Name MAPIR HOSPITAL Applicant NPI 2011062207 Connecticut Medicaid Electronic Health Record Incentive Prog
105. e or numerical format are presa Nato i EHR technology as structures Ga te lists of patients by speofic conditions to escent ages Gis Gea ST ee b eligible hosptal or CAM with a specific condition lor CAM submits such information has the capacty to receive the information electronically Connecticut Medicaid Electronic Health Record Incentive Program Click Return to return to the Measure Topic List Weodrerdey LOS DF12 4 33 13 OM EST 88719246227 M ea meh they oa sored ced Oe ciom oe eri taste tyr o mocs Meenas sah es08 here there sro Ht romenaj mane mee eeres ter chech tay peed o f More sro He fem eemng meny Meesered He Aed Wey ore sbio fs reget Fiesse Note Une hecneme s Mate Mestere T reroll ie the isss ef ety Cate etmered ter hat massere Teme msi eiet of lesit sas Mesmngiu Use Mens Messe fam Ihe pudin Rema t bol eres sf on fs beeen e app ed 2 CODED to sobet efectremc dete te cepatries sad oiea sp svimon 4 the sgercier end pcer sobir eon i eccertecce eager phe hen ond precoce at leant coe teet of conhet Ee B COPOS My FS porde Sect Stet Epecremec ce Cate Lo pedbc heoin egeecres sac felon tas aoa Mi The Lael a bocce ete onies Bene of BRE BOO RM Byers te mAch be Oly tie Meiste CAM sabeets sect omenen have he Capecty te pocer o cee Teme meet bet ott ne meee metre she hees enh o tele of tye Masmagt wwe Meme Meses here bees seis ted eves of sn sciemon sppiss te si of the mens masse cle trees thet
106. e purposes only The fiscal years entered on the payment year 1 application cannot be changed From the Hospital Cost Data screen click Change Data Print ContactUs Exit Friday 03 08 2013 11 14 55 AM EST Please review your hospital cost report data below If you wish to update the data shown below please select the Change Data button Note You will not be able to change the Fiscal years whech were previously entered soporte S mecca baal igen lagoon tN dems Cick Change Data to change previously entered data Red asterisk indicates a required field 10 01 2008 09 30 2010 01 2009 09 30 2010 1 178 756 696 00 178 756 696 00 854 487 000 00 457 000 00 10 01 2008 09 30 2009 10 01 2007 09 30 2008 sono 10 01 2006 09 30 2007 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide Change Hospital Cost Data cont Confirm if you want to proceed to change the hospital cost report data Be advised that if you elect to proceed the data that was previously entered for hospital cost report data will be erased Click Confirm to proceed Click Cancel to return to the previous screen Print ContactUs Exit CONNECTICUT DEPARTMENT OF SociaL SERVICES Tuesday 03 12 2013 4 18 06 PM EDT Casing fas Cammeclioal Ca N Ta HM MA cack To submit your request to delete al informadon select Confirm Select Cancel to return to the previous screen Important By select
107. eady click the Next button to continue Click Reset to restore this panel to the starting point Red asterisk indicates required field Please enter the 15 character CMS EHR Certification ID for the Complete EHR System A014E01EPAKJEA3 No dashes or spaces shouid de entered 28 February 2015 GETTING STARTED cont This screen confirms you successfully entered your CMS EHR Certification ID Click Next to continue or click Previous to go back Payment Year Program Year Name MAPIR HOSPITAL Applicant NPI 2011062207 a We have confirmed that you have entered a valid CMS EHR Certification ID Click here for additional information regarding the Certified Health IT Product List CHPL When ready click the Next button to continue or click Previous to go back A0O14E01GWCVMEAS CMS EHR Certification ID Gie Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide GETTING STARTED cont Click Get Started to access the Get Started screen or Exit to close the program If you click Exit or close the browser prior to clicking the Get Started button you will lose the data you entered on the previous screens Contact Us Exit Connecticut DEPARTMENT oF Sociat SERVICES Thursday 05 10 2012 11 41 05 AM EDT Caring fas Connecticut Payment Year Program Year Name MAPIR HOSPITAL Applicant NPI 2011062207 Status Not Started IMPORTANT The MA
108. ealth Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Attestation Phase Part 3 of 3 This screen confirms you successfully completed the Upgrade Phase of the Attestation tab Note the check box in the Attestation tab Click Continue to proceed to the Review section Print Contact Us Exit CONNECTICUT DEPARTMENT oF Socia SERVICES Wednesday 03 13 2013 2 19 29 PM EDT MAPIR HOSPITAL NPI 2011062207 oc 070098 Hospital TIN m Payment Year 1 Program Year 2013 You have now completed the Attestation section of the application You may revisit this section any time to make corrections until such time as you actually Submit the application The Submit section of the application is now available Before submitting the application please review the information you have provided in this section and all previous sections m am e gk _ ee ee 158 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide Review Application The Review section allows you to review all information you entered into your application If you find errors you can click the associated tab and proceed to correct the information When you have corrected the information you can click the Review tab to return to this section From this screen you can print a printer friendly copy of your application for review Please review all information carefully before
109. east one Public Health Measure must be included in the 5 choices You may complete more than 5 even though you are only required to complete 5 Click Begin to continue to the Meaningful Use Menu Measure Selection screen Print Contact Us Exit Connecticut DEPARTMENT oF SOCIAL SERVICES Thursday 10 02 2014 5 00 00 PM EDT Caring has Canmcclioal Name MAPIR HOSPITAL NPI 2011062207 CCN a Hospital TIN aaa Payment Year Program Year 2014 RBA Contact Info py Eligibility wy Patient Volumes py Attestation ig Review Submit NINGF MEN MEASURES As part of the meaningful use attestation process Eligible Hospitals are required to complete 5 out of 10 Menu Set Measures in Stage 1 Some Meaningful Use Objectives may not apply to the EH thus you would not have any eligible patients or actions for the measure denominator In these cases the EH would be excluded from having to meet that measure HELPFUL HINTS The Core Menu and Clinical Quality Measures can be completed in any order For more details on each measure select the click here link at the top of each screen You may review the completed measures by selecting the Edit button After completing the 5 measures you will receive a checkmark indicating the section is complete The checkmark does not mean you passed or failed the measures Evaluations of MU measures are made after the application is submitted t Was m a gt Connecticut Medica
110. ecto of click Previous to po back Chick Redde io saban MAg pane fe che JEKE Beet Red asterisk indicates a required Field Objective Maintain pa up te dace problem lige of current and pectiva diegnosas Massere More than SO of all uniges panest sdmimed to tha eligible baapitala or CAH a inpatient of emergency department POS 20 or 22 hawe at least one entry or en indication that oo problems are known fer the Patent recorded an geructured dara Complete the fallevcing information Nuneaton Number of patients in the denom nator who have at beast one entry or an ndication that no problema are known for che pariast recorded aa atructured dera in their problem lige Geneminatar Nembar of uniques pacientes admimced to an alegible hospital or CAH Ss inpatent or emangency dapartent POS 21 of 23 during the EHR reporting paricd Nuneerabows Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Core Measures Screen 4 The following Meaningful Use Core Measures use this screen layout Core Measure 8 To view more details about this measure click the here link located on the screen Please complete all required fields The denominator entered must be greater than or equal to the numerator entered Click Save amp Continue to proceed Previous to return or Reset to clear all unsaved data Print ContactUs Exit CONNECTICUT DEPARTMENT of
111. edicare amp Medicaid EHR Incentive Program Registration and Attestation System R amp A to make these updates prior to moving forvard in the MAPIR application process The following link will take you to the Medicare amp Medicaid EHR Incentive Program Registration and Attestation System R amp A to correct any errors noted https ehrincentives cms gov hitech login action pe O om Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide HOSPITAL R amp A AND CONTACT INFORMATION cont Check your information carefully to ensure all of it is accurate Compare the R amp A Registration ID you received when you registered with the R amp A with the R amp A Registration ID that is displayed Print ContectUs Exit Wedrescsy 03 23 2013 10 47 33 AM EDT NPI 2011062207 CCN Mospitel TIN Payment Yesr Program Year 2013 Gian gt Geel Gee L oO eee We Rave received the folowing information for your NPI from the CMS Medicare amp Medicaid ENR Incentive Program Regatration and Attestation System R amp A Please specify F the information is eccurste by selecting Yes or No to the question below When ready click the Seve amp Continue button to review your selection or click Previous to go beck Cick Reset to restore this pane beck to the starting point Hospital NPI 2012062207 o_o TT Business Address 195 SCOTT SWAMP ROAD FARMINGTON CT 06032 0000 Business Phone De
112. em 000000000000000 No dashes or spaces should be entered You have entered an invalid CMS EHR Certification ID 4 Exit Reset Next Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide Validation Messages Table 182 Please enter all required information You must provide all required information in order to proceed Please correct the information at the Medicare amp Medicaid EHR Incentive Program Registration and Attestation System R amp A The date that you have specified is invalid or occurs prior to the program eligibility The date that you have specified is invalid The phone number that you entered is invalid The phone number must be numeric The email that you entered is invalid You must participate in the Medicaid incentive payment program in order to qualify You must select at least one location in order to proceed The ZIP Code that you entered is invalid You must select at least one activity in order to proceed You must define all added Other activities Amount must be numeric You must verify that you have reviewed all information entered into MAPIR Please confirm You must not have any current sanctions or pending sanctions with Medicare or Medicaid in order to qualify You did not meet the criteria to receive the incentive payment All data must be numeric You must enter all requested information in order to submit the a
113. emed Medicare Eligible Status Bigible Hospitel Type Sovte_Care_Mospitels REA Registration Email Address jerett govois ne com CMS EHR Certification Number Red asterisk indicates required field a Is this information accurste G Yes Previous Reset Save amp Continue 1 After reviewing the information click Yes or No Click Save amp Continue to review your selection or click Previous to go back Click Reset to restore this panel back to the starting point The Reset button will not reset R amp A information If the R amp A information is not correct you will need to return to the R amp A to correct it 34 February 2015 HOSPITAL R amp A AND CONTACT INFORMATION cont Enter a Contact Name and Contact Phone Enter a Contact Email Address twice for verification Click Save amp Continue to review your selection or click Previous to go back Click Reset to restore this panel back to the starting point Print ContactUs Exit Thursday 10 02 2014 4 34 05 PM EDT NPI 2011062207 Hospital TIN ee Program Year 2014 Patient Volumes Attestation Review Submit Contact Information Please enter your contact information All email correspondence will go to the primary contact emal address entered below The ema address if any entered at the R amp A will be used as a secondary email address If an email address was entered at the R amp A all email correspondence will go to both email addresses
114. ents adetted to the ehpite hoapetal s of CAs inpahent or emergency department POS 21 of 23 have at least one entry or an inc amp cabon that the pabent s not currently prescribed any meGcabon recorded a8 structured data 88 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide Once you have attested to all the measures for this topic click Return to return to the Measures Topic List Wedresday 12 04 2053 4 19 52 OM BST Npr 16871536227 Mowpitai TIN m Program Year 2013 i CEOE eligible hospita or CAH has enabled functionality for the entire EHR incain sa up to date problem list of Vrem and active Gegneoses poe phen Si SE edn ebents the clighia heagieal s or CAW s ere than 80 of all usua p stents the eligitte kopito sor Caws EAEI dep anmeaz POS 3t 23 heve ot lesst one entry or an atisa lists medication sllargies discharge summery procedures ween priate technical capebiities Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Core Measures If all measures were entered and saved a check mark will display under the Completed column for the topic as displayed in the example below You can continue to edit the topic measure after it has been marked complete Click the Edit button to further edit the topic or click Clear All to clear the topic informatio
115. equired field 2 Application Select to Continue Stage Status Payment Year Program Year Available Actions Stage 1 Select the gt Con p 7 sosninofui Completed i 2013 Continue button Oays Select the Continue button Stage 1 to process this Meaningful Incomplete 2 aopkc ation of click Use to emanate all progress Note A state may allow a grace period which extends the specific Payment Year for a configured length of time If two applications are showing for the same Payment Year but different Program Years one of your incentive applications is in the grace period In this situation the following message will display at the bottom of the screen You are in the grace period for program year lt Year gt which began on lt Date gt and ends on lt Date gt The grace period extends the amount of time to submit an application for the previous program year You have the option to choose the previous program year or the current program year You may only submit an application for one Program Year so once you select the application the row for the application for the other Program Year will no longer display If the incentive application is not completed by the end of the grace period the status of the application will change to Expired and you will no longer have the option to submit the incentive application for that Program Year Once you choose the application you want to
116. equired field Responses are required for the clinical quality measure displayed on this page Domain Patient Safety Measure Number cMS171v3 Measure Title SCIP INF 1 Prophylactic Antibiotic Received within 1 Hour Prior to Surgical Incision Measure Description Surgical patients with prophylactic antibiotics initiated within one hour prior to surgical incision Patients who received Vancomycin or a Fluoroquinolone for prophylactic antibiotics should have the antibiotics initiated within 2 hours prior to surgical incision Due to the longer infusion time required for Vancomycin or a Fluoroquinolone it is acceptable to start these antibiotics within 2 hours prior to incision time Numerator A positive whole number including zero Use the Click HERE above for a definition of the Numerator Denominator A positive whole number including zero Use the Click HERE above for a definition of the Denominator Performance A percent value between 0 0 and 100 0 Use the Click HERE above for a definition of the Performance Rate Rate Exclusion A positive whole number including zero Use the Click HERE above for a definition of the Exclusion Population Criteria 1 Coronary artery bypass graft CABG procedures Numerator 1 Denominator 1 Performance Rate 1 Exclusion 1 Population Criteria 2 Other cardiac surgery Numerator 2 Denominator 2 Performance Rate 2 Exclusion 2 Population Criteria 3
117. er including zero Use the Click HERE above for a definition of the Denominator Performance A percent value between 0 0 and 100 0 Use the Click HERE above for a definition of the Performance Rate Rate Exclusion A positive whole number including zero Use the Click HERE above for a definition of the Exclusion Numerator Denominator Performance Rate Exclusion Previous Reset Save amp Continue Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Clinical Quality Measures Screen 4 The following Measure Numbers use this screen layout CMS171v4 CMS188v3 and CMS172v4 To view more details about either of these measures click the here link located on the screen Please complete all required fields The denominator numerator and exclusion entries must be positive whole numbers including zero Click Save amp Continue to review your selection click Previous to go back or click Reset to restore the panel to the starting point Name x MAPIR Memorial Hospital paeme PST ENERE CCN 999999 Hospital TIN 999999999 Payment Year 2 Program Year 2014 Click here to review CMS Guidelines for this measure When ready click the Save amp Continue button to review your selection or click Previous to go back Click Reset to restore this panel to the starting point Red asterisk indicates a r
118. erent screen layouts Instructions for each measure are provided on the screen For additional help with a specific Meaningful Use Core Measure click on the link provided above the blue instruction box Screen layout examples are shown below Screen 1 The following Meaningful Use Core Measure uses this screen layout Core Measure 1 To view more details about this measure click the here link located on the screen Please complete all required fields The denominator entered must be greater than or equal to the numerator entered Click Save amp Continue to proceed Previous to return or Reset to clear all unsaved data Cet Costeats Oa Connac nou DEPARTMENT Y of Socom Somocss dov OB 32 DOt3 3 12 45 Ow COT r Aay im hanain MADA htemonai Hosper a n were tonptei TIN Payment Veer s Progr em Veer oe eee l M MM Weed to SLODSHT the mesmre s extracted from 421 p 28 mart ee u OEI E TecPexctogy nG CEEA EE Ta roi Ana na at ted reor Oe wed uong Corttied PE TexPescicgy Measure 1 Mece ater Carrer lt b mee a cr ers eet Sed eng CPOE 4 rein stor or ers rre onred ponders m he shgiie heoemtaf s o lt OS 23 or 23 Arna Me OR reponn 3 Dery the denommnator recorded veng FOF ers a tie gde Mot af s CPOE Y St Gers rested By metered prount oF re egte Map als cr 23 Areg Oe OR epot perad en eter 3 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTES
119. esponses are required for the clinical quality measure displayed on this page Domain Clinical Process Effectiveness Measure Number CMS104v1 Measure Title Stroke 2 Ischemic Stroke Discharged on Antithrombotic Therapy Measure Description Ischemic stroke patients prescribed antithrombotic therapy at hospital discharge Numerator A positive whole number including zero Use the Click HERE above for a definition of the Numerator Denominator A positive whole number including zero Use the Click HERE above for a definition of the Denominator Performance A percent value between 0 0 and 100 0 Use the Click HERE above for a definition of the Performance Rate Rate Exclusion A positive whole number including zero Use the Click HERE above for a definition of the Exclusion Exception A positive whole number including zero Use the Click HERE above for a definition of the Exception Numerator Denominator Performance Rate Exclusion Exception Previous Reset Save amp Continue 148 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Clinical Quality Measures Screen 3 The following Measure Numbers use this screen layout CMS91 v4 CMS107 v3 CMS102 v3 CMS108 v3 CMS73 3 CMS109 v3 CMS114 v3 CMS113 v3 CMS53 v3 CMS178 v4 CMS9 v3 CMS185 v3 and CMS31 v3 To view more d
120. etails about any of these measures click the here link located on the screen Please complete all required fields The denominator numerator and exclusion entries must be positive whole numbers including zero Click Save amp Continue to review your selection click Previous to go back or click Reset to restore the panel to the starting point MAPIR Memorial Hospital NPI 9999999999 CCN 999999 Hospital TIN 999999999 Payment Year 2 Program Year 2014 Get Started R amp A Contact Info Eligibility Patient Volumes Attestation Submit Attestation Meaningful Use Measures Measure 5 Click here to review CMS Guidelines for this measure When ready click the Save amp Continue button to review your selection or click Previous to go back Click Reset to restore this panel to the starting point Red asterisk indicates a required field Responses are required for the clinical quality measure displayed on this page Domain Clinical Process Effectiveness Measure Number CMS91v3 Measure Title Stroke 4 Ischemic Stroke Thrombolytic Therapy Measure Description Acute ischemic stroke patients who arrive at this hospital within 2 hours 120 minutes of time last known va and for whom IV t PA was initiated at this hospital within 3 hours 180 minutes of time last known well Numerator A positive whole number including zero Use the Click HERE above for a definition of the Numerator Denominator A positive whole numb
121. eting the Stage 1 requirements for a 90 day period in their first year of Meaningful Use and a full year in their second year of Meaningful Use except for Program Year 2014 After meeting the Stage 1 requirements the EH then has to meet the Stage 2 requirements for two full years Stage 1 Meaningful Use and Stage 2 Meaningful Use requirements are addressed in different sections of this manual This screen displays the General Requirement question that needs to be completed in order to proceed with the attestation Click Yes or No to the first question Click Save amp Continue to proceed to review your selection or click Previous to go back Click Reset to restore this panel to the starting point Print ContactUs Exit CONNECTICUT DEPARTMENT OF SociaL SERVICES Tuesday 03 12 2013 3 17 31 PM EDT Gising far Cangeclioal MAPIR HOSPITAL iri 2011062207 CON 070098 Hospital TIN mm Payment Year 1 Program Year 2013 Attestation Meaningful Use Measures Please answer the following questions to determine your eligibility for the EHR Medicaid Incentive Payment Program When ready click the Save amp Continue button to review your selection or click Previous to go back Click Reset to restore this panel to the starting point Red asterisk indicates a required field Do at least 80 of unique patients have their data in the certified en EHR during the EHR reporting period a Sh 76 February 2015 Connecticut Medicaid
122. f 3 Review the Implementation Activity you selected Click Save amp Continue to proceed or click Previous to go back Tuesday 03 12 2013 2 41 10 PM EDT Program Year 7033 al en en eee Ceo Attestation Phase Part 2 of 3 Please review the ket of acthwites where you have planned or completed an implementation Whee ready Chick the Save A Continue button fo Contewe or Chok Previous to go beck Implementation Activity Planned Workflow Analysis v Workflow Redesign Mardware instalaton Perpherais insta amp abon Blectronsc Prescnitung Other Revewed OR Cerdfcadbon Informabon Proceed to page 69 of this guide 64 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Upgrade Phase Part 1 of 3 For Upgrade select the Upgrade button Click Save amp Continue to proceed or click Previous or Reset to clear unsaved data and move to the screen where the last data was saved Exit CONNECTICUT DEPARTMENT OF SOCIAL SERVICES Tuesday 03 12 2013 3 09 22 PM EDT Caring far Canncelieal MAPIR HOSPITAL NPI 2011062207 con 070098 Hospital TIN ummm Payment Year Program Year 2013 Get Started RAA Contact Info Eligibatty Patient Volumes Attestation 7 Gaa Gald Attestation Phase Part 1 of 3 Please select the appropriate EHR System Adoption Phase When ready click the Save amp Continue button to review your selection or
123. following Meaningful Use Core Measures use this screen layout Core Measures 4 and 16 Eligible Hospital User Guide To view more details about any of these measures click the here link located on the screen Please complete all required fields The denominator entered must be greater than or equal to the numerator entered Click Save amp Continue to proceed Previous to return or Reset to clear all unsaved data Prist Contacts Exit CONNECTICUT DEPARTMENT of Soca Seawces Twesdey 03 12 2013 3 Panong her Canmpolevat 12 45 Pm FOT MAPIR Memorial Horpital NPI HOMID ccn 999999 Hospitai r n E Payment Year gt Program Year 2014 Rn a see lo eT Ock here to review CMS Guidelines for this measure ea crane dear a mney open to review your or cick Previous to o beck Click Reset to restore this panel to the starting point Red asterisk indicates a required field Objective Record smoking status for patients 13 years old or cider Measure More than 60 percert of af ureque patents 13 years old or cider adrmtted to the ebobdle hospaal s or CAs inpatient of emergency Gepartmerts POS 21 of 23 dunno the EPR reporting penod have smotang status recorded as structured data PATIENT RECORDS Please select whether the data used to support the measure was extracted from ALL padent records of only from pabert records marittamed using Certified ER Technology This Gata was extracted from ALL patent records
124. formation Publications Provider Manuals Chapter 10 Web Portal Creating a clerk 5 To access MAPIR you will go to the secure provider portal on our Web site www ctdssmap com Applicants will need to verify the information displayed in MAPIR and will also need to enter additional required data elements and make attestations about the accuracy of the data elements entered in MAPIR Applicants will need to demonstrate e They meet Medicaid patient volume thresholds e They are adopting implementing upgrading or meaningfully using federally certified EHR systems e They meet all other federal program requirements e Applicants will need information such as CMS EHR Certification ID Dates for 90 day Medicaid volume Medicaid discharges ED visits Out of State Medicaid encounters ED visits Total discharges Total inpatient Medicaid bed days Total Charges All Discharges and Outpatient Total Charges Charity Care Inpatient and Outpatient Cost data information cannot be changed by an EH once the first payment has been issued e In the MAPIR application there is a section where you can upload documentation related to your application i e signed contracts volume reports etc e The Department will use its own information such as OHCA Filings and information in MAPIR to review applications and make approval decisions The Department will inform all applicants whether they have been approved or denied All approvals and denials are ba
125. forty five days after receiving notice of the disallowance In addition to taking any other lawful actions the department may also offset such funds against current or future payments that the department otherwise would have made to the provider A provider aggrieved by a decision in a final written audit conducted under this section may request a written review from the department The provider shall request such review in writing and not later than thirty days after the department s final audit report was issued together with a detailed written description of each specific item of aggrievement The scope of the review shall not include or consider facts or circumstances outside of the audit and the final written audit report An individual other than a person who conducted the audit or made the department s final audit determination shall conduct the review At the discretion of the person presiding over the review the person may make informal inquiries to the provider or the department accept written statements from the provider and the department and hold an informal conference with the department and the provider for the purpose of fact finding accepting oral statements or hearing witness testimony after giving appropriate notice thereof to the provider and the department After completing the final review the person presiding over the review shall issue a final written decision regarding what if any action will be taken including but not limi
126. g EHR technology The information will be used to determine your eligibility for the incentive program For purposes of calculating hospital patient volume a Medicaid encounter means e Services rendered to a Medicaid FFS Medicaid for Low Income Adults MLIA or HUSKY A individual per inpatient discharge where Medicaid MLIA or HUSKY A paid for part or all of the service or paid for part or all of the individual s premiums co payments and or cost sharing e Services rendered in an emergency department ED in any one day where Medicaid MLIA or HUSKY A paid for part or all of the service or paid for part or all of the individual s premiums co payments and or cost sharing NOTE Some hospitals use different NPIs for their inpatient and outpatient services Only their inpatient NPI AVRS ID will show in MAPIR In order to include emergency department services a provider may need to add the outpatient facility location to MAPIR If you have additional locations that you need in order to enter Patient Volume information you will be given the opportunity to add them Once all locations are added you will enter the required Patient Volume information All locations added to MAPIR should be under the same Centers for Medicare and Medicaid Programs CMS Certification Number CCN entered on your CMS R amp A Registration In order to meet the requirements of the Medicaid EHR Incentive Program you must provide information about your facility The i
127. he Start Date must fall within the period that is applicable to your selected wolume period Previous Reset Gave amp Continue 3 42 February 2015 PATIENT VOLUMES cont Review the Start Date and End Date information The 90 Day End Date has been calculated for you Click Save amp Continue to review your selection or click Previous to go back Print ContactUs Exit Connecticut DEPARTMENT oF SOCIAL SERVICES Tuesday 03 12 2013 1 45 51 PM EDT Casing far Canncclioal MAPIR HOSPITAL NPI 2011062207 070098 Masana Payment Year Program Year 2013 Patient Volume Part 1 of 3 90 Day Reporting Period Please review the Start Date and End Date of your selected continuous 90 day period for patient volume When ready click the Save amp Continue button to review your selection or click Previous to go back Start Date Feb 06 2012 End Date May 05 2012 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide PATIENT VOLUMES cont Part 2 of 3 Patient Volume Enter Volumes Once you have determined what time period to report patient volumes MAPIR will display your practice location s on file with the Connecticut Medical Assistance program office according to the NPI entered in your CMS R amp A Registration You must select at least one location where you are meeting Medicaid patient volume thresholds AND you are utilizin
128. he department s determination shall conduct the initial review The individual who conducts the initial review shall issue a written decision to the provider not more than thirty days after the department receives the request for initial review If the provider is aggrieved by the outcome of the initial review the provider may request an administrative hearing in writing to the commissioner together with a detailed written description of all items of aggrievement not more than fourteen days after the date the written initial review decision was issued The department shall conduct an administrative hearing requested pursuant to subsection c of this section in accordance with chapter 54 of the Connecticut General Statutes 18 February 2015 11 MAPIR Overview This section of the Connecticut Medicaid EHR Incentive Program Eligible Hospital User Guide describes how users apply for incentive payments through the Medical Assistance Provider Incentive Repository MAPIR MAPIR is the state level information system for the EHR Incentive Program that will both track and act as a repository for information related to payment applications attestations oversight functions and interface with the Medicare and Medicaid EHR Incentive Program Registration and Attestation System R amp A MAPIR is intended to streamline and simplify the hospital enrollment process by interfacing with other systems to verify data Hospitals will enter data into MAPIR an
129. icaid Electronic Health Record Incentive Program Eligible Hospital User Guide This is screen 4 of 4 of the Meaningful Use Measures Review Numerator 1 50 Denominator 1 100 Performance Rate 1 78 0 Exdusion 1 3 Numerator 2 75 Denominator 2 143 Performance Rate 2 90 0 Excision 2 3 Numerator 3 87 Denominator 3 132 Performance Rate 3 90 0 Exdusion 3 3 Numerator 4 57 Denominator 4 123 Performance Rate 4 56 0 SCIP INF 1 Prophylactic Antibiotic Exdusion 4 3 Received within 1 Hour Prior to Numerator 5 76 Denominator 5 100 Performance Rate 5 78 0 Exclusion 5 4 00 Performance Rate 6 45 0 Exclusion 6 5 Numerator 7 123 Denominator 7 200 Performance Rate 7 67 0 Exclusion 7 6 Denominator 8 100 Performance Rate 8 78 0 78 VTE 2 Intensive Care Unit ICU VTE Performance Rate 79 0 Exception 2 Proceed to the Attestation Phase Part 3 of 3 on page 157 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide Stage 2 Meaningful Use Core Measures This screen provides information about the Meaningful Use Core Measures for Stage 2 Click Begin to continue to the Meaningful Use Core Measure List Table Print ContactUs Exit Thursday 10 02 2014 5 07 38 PM EDT Name MAPIR HOSPITAL NPI 2011062207 CCN i Hospital TIN a indeed Year Program Year 2014 Ii iis D MEANINGFUL US
130. icaid Electronic Health Record Incentive Program Eligible Hospital User Guide SUBMIT cont Note the File has been successfully uploaded message Review the uploaded file list in the Uploaded Files box If you have more than one file to upload repeat the steps to select and upload a file as many times a necessary All of the files you uploaded will be listed in the Uploaded Files section of the screen The Upload Files screen may also display files that were uploaded by an Administrative User and made available for you to view To delete an uploaded file click the Delete button in the Available Actions column Click Save amp Continue to review your selection or click Previous to go back Click Reset to restore the panel to the starting point anemia oto anc MAPIR File June docx 12820 06 17 2013 File has been successfully uploaded Previous Reset Save amp Continue 168 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide SUBMIT cont This screen depicts the Preparer signature screen Check the BOX located on the left of the MAPIR screen to acknowledge that you have reviewed all of your information Enter your Preparer Name and Preparer Relationship Click Sign Electronically to proceed Click Previous to go back Click Reset to restore this panel to the starting point Print Contacts Exit CONNECTIC
131. id Electronic Health Record Incentive Program Eligible Hospital User Guide From the screen on the following page choose a minimum of five Meaningful Use Menu Measures to attest to One measure must be from the public health list first three measures listed on the top half of the screen The remainder of the measures can be any combination from the remaining public health list measures or from the additional Meaningful Use Menu Measures listed In the example shown on the following page one public health measure and four measures from the additional Meaningful Use Measures listed are selected If a measure is selected and information is entered for that measure unselecting the measure will clear all information previously entered Click Save amp Continue to proceed or click Return to go back Click Reset to restore this panel to the starting point 92 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide Wedceeetey 12 04 2512 4 23 03 Ow OST one of The Ae mertores Srst neaei aana Ega eee a eate Mo aj mot re pabi esits mere Wee Mess Meseeree la the remat eg pti teore 2 aa ehgdie Beng tal meets the lt cmrtens ter od cas ciam pa at Te pubic Beets mone Menecten hey morr sO select Gee potic heski metu Mees ere BES artes Chet thew Geet fer Ihe escien Thes Saat Tet select ety otter feat mesteres Hem He Mets Merswres Ach cpa Be COME ODEs HOM The rompang publ bestt Mors wesswes ir
132. idual enrolled in HUSKY A HUSKY C previously known as Medicaid FFS or HUSKY D previously known as MLIA program per inpatient discharge or e Services rendered in an emergency department ED on any one day to an individual enrolled in HUSKY A HUSKY C previously known as Medicaid FFS or HUSKY D previously known as MLIA program Part 3 of 3 of the Patient Volumes section Enter your hospital Patient Volume Cost Data information This information will be used to calculate your hospital incentive payment amount You will be required to enter the following information Total Discharges inpatient for the most recent 4 fiscal years Total Number of Medicaid Inpatient Bed Days Total Number of Inpatient Bed Days Total Charges for All Discharges Total Charges for Charity Care for all discharges In computing inpatient bed days the hospital may not include inpatient bed days where payment was made under Medicare Part A or inpatient bed days attributable to individuals who are enrolled with a Medicare Advantage organization under Medicare Part C NOTE Nursery bed days and discharges cannot be included in your cost data Eligible Hospital User Manual Enter Patient Volumes for each of the locations listed on the screen Connecticut DEPARTMENT or SOCIAL SERVICES Tuesday 03 12 2013 1 58 49 PM EOT Panin me Tammea MAPIR HOSPITAL NPI 2011062207 o70098 Hospital TIN j Program Year 2013 secev a A Enter Volume
133. ient Volume Part 2 of 3 Location CT has the following information on the locations for your facility If you vish to report patient volumes for a location or site that is not listed click Add Location When ready click the Save amp Continue button to review your selection click Previous to go back or click Refresh to update the list below Click Reset to restore this panel to the starting point 2011062207 MAPIR HOSPITAL 195 SCOTT SWAMP ROAD 008020870 FARMINGTON CT 06032 N A New Location 123 Main Street Anytovm AL 12345 6789 Add Location_ Refresh m Previous Reset __ Save amp Continue e a 46 February 2015 PATIENT VOLUMES cont Click Begin to proceed to the screens where you will enter patient volumes Print ContactUs Exit Connecticut DEPARTMENT oF SOCIAL SERVICES Friday 03 22 2013 10 11 05 AM EDT Casing far Canmectionl MAPIR HOSPITAL NPI 2011062207 CCN 070098 Hospital TIN x Payment Year ji Program Year 2013 Get Started R amp A Contact Info Eligibility Patient Volumes Attestation Submit Part 2 of 3 of the Patient Volumes section Once all locations are added you will enter the required Patient Volume information for the 90 days selected for each location and at least one location where you are Utilizing Certified EHR Technology For purposes of calculating hospital patient volume a Medicaid encounter means e Services rendered to an indiv
134. in Figure 1 below Figure 1 Hospital Eligibility Requirements per the CMS Final Rule Provider Type Requirements Threshold Eligible Hospitals Measured by Medical Assistance discharges over total discharges Acute Care Acute care CCNs between 0001 0879 includi pan Critical Access Hospitals CCNs between 1300 1399 CAH No patient CCNs between 3300 3399 volume requirement Children s Hospital Please note that a hospital is eligible for an incentive payment based on their CCN Note The Meaningful Use Stage 2 Final Rule introduced specific changes for Stage 1 and Stage 2 functionality that take effect in Program Year 2014 MAPIR Release 5 2 was enhanced to comply with the Stage 2 Final Rule 6 February 2015 4 Overview of the EHR Incentive Program Process The following steps describe the Connecticut Medicaid EHR Incentive Program application process for hospitals that are applying for their first year payment 1 Go to the following link and fill out the information requested so your CCN can be updated in the Medicaid Management Information System that interfaces with MAPIR http www surveymonkey com s EHR_ Registration Information The following information will be required e National Provider Identifier NPI e Hospital Name e Automated Voice Response System AVRS IDs previously known as Medicaid IDs any that are associated with your acute care CCN that you
135. in MAPIR Please allow at least two days from the time you complete your federal registration changes before accessing MAPIR due to the necessary exchange of data between these two systems Identify one individual to complete the MAPIR application Note You must use the same Web Secure Provider Portal User ID throughout the application process including if you start and then have to restart the application The same Web Secure Provider Portal User ID should be used in subsequent years as well If a password is forgotten the hospital s ID administrator must reset the password If there is a situation where the user who completed the application in previous years is no longer available for the current year s attestation please contact the HP EHR Assistance Center either by email at ctmedicaid ehr hp com or by phone at 1 855 313 6638 toll free Please include your name and NPI number on all correspondence Once logged into the secure site find the MAPIR link on the gray menu bar and click the Open MAPIR button to access the MAPIR screen 22 February 2015 CONNECTICUT DEPARTMENT OF SOCIAL SERVICES 7 ni Gendt Home Information Provider Trading Partner ConnPACE Pharmacy Information Claims Eligibility Prior Authorization Trade Files OGA Messages Account Connecticut Medical Assistance Provider Incentive Repository MAPIR is a web based application available to eligible providers and hospitals to apply for the Connecticut Medicaid Ele
136. ing is a list of the 16 Meaningful Use Core Measures that you must attest to Click on the Screen Example to see an example of the screen layout Meaningful Use Core Measure Screen Example Core Measure 1 CPOE for Medication Laboratory and Radiology Orders SOAL Core Measure 2 Record Demographics Screen 2 Core Measure 3 Record Vital Signs Screen 3 Core Measure 4 Record Smoking Status Screen 4 Core Measure 5 Clinical Decision Support Rule Screen 5 Core Measure 6 Patient Electronic Access Screen 6 Core Measure 7 Protect Electronic Health Information Screen 7 Core Measure 8 Clinical Lab Test Results Screen 3 Core Measure 9 Patient Lists Screen 7 Core Measure 10 Patient Specific Education Resources Screen 2 Core Measure 11 Medication Reconciliation Screen 2 Core Measure 12 Summary of Care Screen 8 Core Measure 13 Immunization Registries Data Submission Screen 9 Core Measure 14 Electronic Reportable Laboratory Results Screen 9 Core Measure 15 Syndromic Surveillance Data Submission Screen 9 oe 16 Electronic Medication Administration Records ene 114 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Core Measures There are 16 Meaningful Use Core Measure screens As you proceed through the Meaningful Use Core Measure section of MAPIR you will see nine diff
137. ing to Change Data you are opting to erase af data previously entered for Hospital Cost Report Oata canat _contem 54 February 2015 Change Hospital Cost Data cont On this screen you will re enter the hospital cost report data required to calculate your incentive payment In the first column enter Total Discharges for the Fiscal Years displayed to the left Enter the Total Inpatient Medicaid Bed Days Total Inpatient Bed Days Total Charges All Discharges and Total Charges Charity Care Click Save amp Continue to review your selection or click Previous to go back to the existing hospital cost report data Click Reset to restore this panel to the starting point Print Contact Us Exit Connecticut DEPARTMENT oF SociaL SERVICES Tuesday 03 05 2013 2 34 46 PM EST Caring far Canmcclieal MAPIR HOSPITAL NPI 2011062207 con 070098 Hospital IN Payment Year 1 Program Year Get Started R amp A Contact Info Eligibility Patient Volumes E Attestation Review Please enter your hospital cost report data for the hospital fiscal year selected in the first row Complete the first column in the table below for your last four full fiscal years Only acute care discharges and acute care bed days are to be included in Total Discharges Total Inpatient Medicaid Bed Days and Total Inpatient Bed Days Nursery days must be excluded from these entries Note You vill not be able to change the Fiscal years which were previo
138. ion for a measure and click Save amp Continue you will be returned to the Clinical Quality Measure List Table The information you entered for that measure will display in the Entered column of the table as shown in the example below please note that the entire screen is not displayed in this example You can continue to edit the measures at any point prior to submitting the application Click the Edit button for the next measure MAPIR Memorial Hospital NPI 9999999999 CCN 999999 Hospital TIN 999999999 Payment Year 2 Program Year 2014 Get Started R amp A Contact Info Eligibility Patient Volumes Attestation Submit Meaningful Use Clinical Quality Measures To enter or edit information select the EDIT button next to the measure that you would like to edit All progress on entry of measures will be retained if your session is terminated When all measures have been edited and you are satisfied with the entries select the Return button to access the main attestation topic list Meaningful Use Clinical Quality Measure List Table ICMS102v2 Stroke 10 Ischemic or Hemorrhagic Care Coordination Stroke Assessed for Rehabilitation Denominator 3 Performance Rate 25 0 Exclusion 2 ICMS31v2 EHDI 1a Hearing Screening Before Clinical Process Effectiveness Hospital Discharge ICMS53v2 AMI 8a Primary PCI Received within 90 Clinical Process Effectiveness Minutes of Hospital Arrival 152 February 2015 C
139. is incentive application Thursday 06 30 2011 2 49 23 PM EDT CONNECTICUT DEPARTMENT OF SOCIAL SERVICES Casing far Canpeclical Confirmation You have chosen to complete the MAPIR application using the current Internet account Once you have started the application process using this account you cannot switch to another account Select the Cancel button to return to the start page Select Confirm to associate the current Internet Portal account with MAPIR _ can el Confirm im If you have a State to State Switch or Program Switch incentive application you will not be able to proceed beyond this point MAPIR is unable to assign a Stage to your incentive application Click on Contact Us for further assistance There are information pages throughout the MAPIR Application that include guidance on how to complete the MAPIR Application For example this first screen includes general information about MAPIR and how the provider should navigate through the MAPIR Application Connecticut Medicaid Electronic Health Record Incentive Program GETTING STARTED cont Eligible Hospital User Guide The Get Started screen also contains information that includes your facility Name and Applicant NPI Also included is the current status of your application Click Continue to proceed to the R amp A Contact Info section ROCKVILLE GENERAL HOSPITAL OCN 700015 Poymeat Year gt mem p Print
140. ity and incentive payment amount To correct errors Click Review to be taken to the section in error and correct the information To return to this section at any time click the Submit tab Click Save amp Continue to continue with the application submission Wedeenday N 11 2013 2 28 12 PH EST _ Gel Started RAA Contact Into Eligibility E Patient Voluns Alteutal ion E Submit a Status Incomplete The MAPIR Check Errors panel displays errors that have occurred duning the application process The following error have been identified while reviewing your application For each error hated chek Review to be directed to the section of the apphcation that resulted in the error You will have the ability to correct your answer in that section Once you click on the Save amp Continue button on that page you may then select the Submit tab to continue with your renew Picate mote that you may abl submit the appkcabon with errors but the arora may mnpact the approval determination You must participate in the Medicaid incentive program in order to qualify Co SUBMIT cont 164 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide To upload files click Browse to navigate to the file you wish to upload Note Excel Word and Portable Data Format PDF files up to 5 megabytes MB in size are acceptable documentation to upload Print ContactUs
141. k che Saeed Catia boone DE Aner pn eden i clot PaA ne ge beck Clack Feet oe eae Chon me no cA ETO ee Co Bed aiterich dedecated a feqeered field 74 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Phase Part 1 of 3 This screen shows an example of a Start Date of Jan 01 2014 and a system calculated End Date of Mar 31 2014 for the period which you are attesting meaningful use Click Save amp Continue to proceed or click Previous to go back Pret Costect ws Exit Commecnecur DEPARTMENT oF Socr Semocss Tuesday O3 22 2023 3 12 45 Os EOT Cima fine hananman MASIR HOSETTAL 2021062207 Pesse reres the Sart Oeste ant fad Oste of the DE Reporting Parod The DE Reporting Pernod a aw contrast Gay period ett gt Dawmert yea A ame an ge Ont st or Cres a Access OEN Gemoret ates mea vee of Corttied A tectresogy mote The ered date of the Cortes FO day porod od De catidsted based on Me tat date ertered On edy Ot he Save amp Continue DATA O eww pour PERA OF ClO Prewious te go Dect Stort Dete las or 2094 fad Oete Mer DL 2008 mE Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Phase Part 1 of 3 The Medicaid EHR Incentive Program is staged in three stages with increasing requirements for participation All EHs begin participating by me
142. l Hospital NPI 9999999999 con TAN wii ii Payment Year 2 Program Year 20h cannon M Please select the appropriate ENR System Adoption Phase below The selection that you make wil determine the q uechons tht you wi be athed of subtequert pages pea hres yates A CONERO DIANID DO FORDE IIUT IISA tht att Meaningtul Use 90 days Pees A 60 Tent You are Canvey mero yee Terres Meaningtul Use Full Year Yow are CUTY Menon use Mensures uT certified EME fechnmiogy 72 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Phase Part 1 of 3 This screen shows that the 90 day Meaningful Use attestation option was chosen Click Save amp Continue to proceed to Final Attestation or Previous to return or Reset to clear all data Print ContactUs Exit Connecticut DEPARTMENT oF SOCIAL SERVICES Tuesday 03 12 2013 3 11 01 PM EDT Caring hat Canmecliant MAPIR HOSPITAL NPI 2011062207 070098 Hospital TIN MEE Program Year 2013 Please select the appropriate EHR System Adoption Phase below The selection that you make will determine the questions that you will be asked on subsequent pages When ready click the Save amp Continue button to review your selection or click Previous to go back Click Reset to restore this panel to the starting point 2 Hiveningfed Use 99 days 2 Tre Tasturing meaningful u
143. l Quality Measure 11 Screen 2 CMS114 v3 Clinical Quality Measure 15 Patient Safety Screen 3 CMS171 v4 Clinical Quality Measure 22 Screen 4 CMS178 v4 Clinical Quality Measure 24 Screen 3 CMS185 v3 Clinical Quality Measure 28 Screen 3 CMS188 v4 Clinical Quality Measure 21 Efficient Use of Screen 4 CMS172 v4 Clinical Quality Measure 23 Healthcare ReSgutTER Screen 4 146 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Clinical Quality Measures There are 29 Meaningful Use Clinical Quality Measure screens As you proceed through the Meaningful Use Clinical Quality Measure section of MAPIR you will see five different screen layouts Instructions for each measure are provided on the screen For additional help with a specific Meaningful Use Clinical Quality Measure click on the link provided above the blue instruction box Screen 1 The following Measure Numbers use this screen layout CMS55v3 CMS111v3 and CMS32v4 To view more details about any of these measures click the here link located on the screen Please complete all required fields The denominator and numerator entries must be positive whole numbers including zeros Click Save amp Continue to review your selection click Previous to go back or click Reset to restore the panel to the starting point Name MAPIR Memorial Hospital NPI 9999999999 CCN 999999 Hospital TIN 999999999 P
144. l User Guide is a resource for healthcare professionals who wish to learn more about the Connecticut Medicaid EHR Incentive Program including detailed information and resources on eligibility and attestation criteria as well as instructions on how to apply for incentive payments for eligible hospitals This user guide also provides information on how to apply to the program via the Medical Assistance Provider Incentive Repository MAPIR which is the Department s web based EHR Incentive Program application system The best way for a new user to orient themselves to the EHR Incentive Program requirements and processes is to read through each section of this user guide in its entirety prior to starting the application process In the event this user guide does not answer your questions or you are unable to navigate MAPIR or complete the registration application and validation process you should contact the EHR Assistance Center either by email at ctmedicaid ehr hp com or by phone at 1 855 313 6638 toll free Other Resources There are a number of resources available to assist providers with the Connecticut Medicaid EHR Incentive Program application process These resources can be found at www ctdssmap com under Provider EHR Incentive Program For example there are Important Messages that are frequently posted to the site to keep providers updated webinars describing various aspects of the application and attestation process and frequentl
145. l not impact your ability to receive an incentive payment This information is helpful to the State Medicaid Program Office in understanding the upgrade process If there are no applicable activities to select or list please select the Other Click to Add button and enter none When ready click the Save amp Continue button to review your selection or click Previous to go back Click Reset to restore this pane to the starting point After saving click the Clear All button to remove standard activity selections Red asterisk indicates a required field See ee SS Complete r Upgrade Activity Upgrading Software Version Upgrading Hardware or Peripherals Clinical Decision Support Electronic Prescribing Computerized Provider Order Entry Adding Functionality Modules personal health record mental health cental ot m m eee t Previous Reset Clear All Save amp Contions __ ena aae 66 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Upgrade Phase Part 2 of 3 This screen shows an example of entering activities other than what was in the Upgrade Activity listing Click Save amp Continue to proceed or click Previous or Reset to clear unsaved data and move to the screen where the last data was saved Click Clear All to remove activity selections and clear the fields on this page
146. le Hospitals EHs Eligible Hospital User Manual a 1 _ lt a Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ELIGIBILTY cont Select Yes or No to the eligibility questions Click Save amp Continue to review your selection or click Previous to go back Click Reset to restore this panel to the starting point 38 Name MAPIR Memorial Hospital NPI 9999999999 CCN 999999 Hospital TIN 999999999 Payment Year 2 Program Year 2015 R amp A Contact Info Eligibility Patient Volumes Attestation Review ility Questions Please answer the following questions so that we can determine your eligibility for the program When ready click the Save amp Continue button to review your selection or click Previous to go back Click Reset to restore this panel to the starting point Red asterisk indicates a required field Please confirm that you are choosing the Medicaid incentive program Do you have any sanctions or pending sanctions with Medicare or 2 Medicaid in Colorado Is your facility licensed to operate in all states in which services are rendered Reset Save amp Continue February 2015 ELIGIBILTY cont This screen confirms you successfully completed the Eligibility section Note the check box in the Eligibility tab Click Continue to proceed to the Patient Volumes section Print Contact Us Exit Connec
147. ligible Status Eligible Hospital Type Physician R amp A Registration ID 9999999999 R amp A Registration Email user email com CMS EHR Certification Number QOO00000IDCKMAA Is this information accurate February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide REVIEW cont This is screen 2 of 3 of the Review tab display Contact Information First Name Hospital Last Name Provider Phone 899 999 9999 Phone Extension 99999 Email Address hospital preparer com Department EHR Dept Address 888 Street City PA 89765 Alternate Contact Information First Name Alternate Last Name Contact Phone 777 777 7777 Phone Extension 77777 Email Address any email email com Questions Please confirm that you are choosing the Medicaid incentive program Do you have any sanctions or pending sanctions with Medicare or Medicaid in Colorado Is your facility licensed to operate in all states in which services are rendered Patient Volume Part 1 of 3 90 Day Reporting Period Start Date Feb 12 2014 End Date May 12 2014 Patient Volume Part 2 of 3 Enter Volume ar licaid Provider ID Location Name Address Encounter Volumes isch 9999999999 Smith Grace L 740 E State St In State Medicaid 883 10 Sharon PA 16146 3395 Other Medicaid 0 Total Discharges 8600 N A New Location 123 Main Street In State Medicaid 200 70 Anytown AL 123
148. linical Process Effectiveness Numerator 30 Denominator 60 Performance Rate 90 0 Exclusion 5 Exception 1 ICMS109 v3 Venous Thromboembolism Patients Receiving Unfractionated Heparin with IDosages Platelet Count Monitoring by Protocol or INomogram Clinical Process Effectiveness Numerator 79 Denominator 100 Performance Rate 87 0 Exclusion 3 ICMS113 v3 Elective Delivery ICMSS5 v3 Median Time from ED Arrival to ED Departure for Admitted ED Patients Clinical Process Effectiveness Patient and Family Engagement Numerator 90 Denominator 150 Performance Rate 78 0 Exclusion 6 Measure Observation 1 12 Measure Population 1 28 Measure Observation 2 34 Measure Population 2 67 Measure Observation 3 43 Measure Population 3 89 ICMS114 v3 Incidence of Potentially Preventable Venous Thromboembolism Patient Safety Numerator 45 Denominator 98 Performance Rate 85 0 Exclusion 4 ICMS171 v4 Prophylactic Antibiotic Received Within One Hour Prior to Surgical Incision Patient Safety Numerator 1 50 Denominator 1 100 Performance Rate 1 78 0 Exclusion 1 3 Numerator 2 75 Denominator 2 143 Performance Rate 2 89 0 Exclusion 2 3 Numerator 3 87 Denominator 3 132 Performance Rate 3 90 0 Exclusion 3 3 Numerator 4 57 Denominator 4 123 Performance Rate 4 56 0 Exclusion 4 3 Numerator 5 76
149. ly from patient records maintained using certified EHR technology Complete the Following Information Numerator Number of lab test results whose results are expressed in a positive or negative affirmation or as a number which are incorporated as structured data Denominator Number of lab tests ordered curing the EHR reporting period by authorized providers of the eligible hospital or CAH for patients admitted to an eligible hospital s or CAH s inpatient or emergency department POS 21 and 23 whose results are expressed in a positive or negative affirmation or as number Previous Reset Save amp Continue 98 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Menu Measures Screen 4 The following Meaningful Use Menu Measures use this screen layout Menu Measure 5 To view more details about this measure click the here link located on the screen Please complete all required fields The denominator entered must be greater than or equal to the numerator entered Click Save amp Continue to proceed Previous to return or Reset to clear all unsaved data Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide Print ContactUs Exit Wednesday 12 04 2013 4 32 19 PM EST Ock here to revera CMS Guidelines for fs messure When ready click the Seve amp Continue button
150. ment Year 2 Program Year 2014 Get Started R amp A Contact Info Eligibility Patient Volumes Attestation Submit Attestation Meaningful Use Measures Clinical Quality Measure 26 Click here to review CMS Guidelines for this measure When ready click the Save amp Continue button to review your selection or click Previous to go back Click Reset to restore this panel to the starting point Red asterisk indicates a required field Responses are required for the clinical quality measure displayed on this page Domain Patient and Family Engagement Measure Number CMS26v1 Measure Title Home Management Plan of Care HMPC Document Given to Patient Caregiver Measure Description An assessment that there is documentation in the medical record that a Home Management Plan of Care document was given to the pediatric asthma patient caregiver Numerator A positive whole number including zero Use the Click HERE above for a definition of the Numerator Denominator A positive whole number including zero Use the Click HERE above for a definition of the Denominator Performance A percent value between 0 0 and 100 0 Use the Click HERE above for a definition of the Performance Rate Rate Numerator Denominator Performance Rate Reset Save amp Continue Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide After you enter informat
151. merator 86 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Core Measures Screen 5 The following Meaningful Use Core Measures use this screen layout Core Measure 12 To view more details about this measure click the here link located on the screen Please complete all required fields The denominator entered must be greater than or equal to the numerator entered Click Save amp Continue to proceed Previous to return or Reset to clear all unsaved data Wednesday SS SOt a 4 13 18 PM EST SoSH WILE GENERAL HOSS AL APE 187 153652237 FOO eS Hospital TIN Payment Yaar Z Programi Yair 2013 Pn en ee O_o Core Menagure 12 Chok here fo mee CAS Guvcteicee for phe menene bech Click Reret to restore Gus panei oo Dha sei p nt C Red asterisk indicates a required field Obpectives Provide patience with an electronic copy of their discharge nstrections at tme of discharge upan regust Matures Mere chan SOS af all pariests whe are discharged fram on eligible Reapieal sr CAH Ss inpatieest depaeemaest or mneergency daearssenkt POS 22 or 23 and wh request on electrssic copy of thadr discharge ingtructican are provided it PATLENT RECORDS Piarre select whether tcha date uid to Support the Measure wes goctrected from ALL Patient records coronkby from patient records maintained ugieg certified EHF teckenologs
152. mit To be eligible for a Medicaid EHR incentive payment the EH must meet the following criteria e An acute care hospital must have at least a 10 percent Medicaid patient volume for each year for which the hospital seeks an EHR incentive payment e A children s hospital is exempt from meeting a patient volume threshold i The Patient Volume section gathers information about your facility locations the 90 day period you intend to use for meeting the Medicaid patient volume requirement and the patient volumes themselves A Medicaid enrolled acute care hospital must annually meet patient volume requirements Medicaid patient volume is calculated by dividing the total CT Medicaid encounters in any representative continuous 90 day period either in the preceding fiscal year or in the 12 months preceding the attestation date by the total encounters in the same 90 day period e Enter the start date for the 90 day reporting period in which you will demonstrate the required Medicaid patient volume participation level In order to meet the patient volume requirements of the Medicaid EHR Incentive Program you must provide information about your facility locations MAPIR will present a list of facility locations that the Connecticut Medicaid program office has on record If you have additional facility locations you will be given the opportunity to add them Children s hospitals Separately certified children s hospitals with CCNs with last four
153. month and hospitals will see their payments posted on their remittance advices Hospitals will be required to provide and attest to the following information for the incentive payment to be calculated e Total Discharges inpatient for the most recent 4 fiscal years e Total Number of Medicaid Inpatient Bed Days e Total Number of Inpatient Bed Days e Total Charges for all Inpatient and Outpatient no exclusions e Total Charges for Charity Care for all Inpatient and Outpatient no exclusions Note All bed day totals and discharges should exclude nursery psych and rehab days Do not exclude nursery psych and rehab from Charges No hospital may begin receiving incentive payments for any year after Fiscal Year FY 2016 and after FY 2016 a hospital may not receive an incentive payment unless it received an incentive payment in the prior fiscal year Connecticut Medicaid EHR Incentive Payment Program HOSPITAL PAYMENT CALCULATION EXAMPLE On the following pages there is an example of the steps that will be followed to calculate incentive payments to eligible hospitals for payment year 2011 MAPIR will be making these calculations based on data the hospital will enter into MAPIR at the time of registration and attestation 10 February 2015 Step 1 Calculating the Average Annual Growth Rate To calculate the average annual growth rate the hospital will report the total discharges from the 4 most recent fiscal year cost reports
154. n d the patient decined to provide ome or more elements of recording an element is cortrary to state law recorded as structured data Denominator Number of ureque paberts seen by authonzed prowder or admitted to an ebgdle hosptal or CAM npabent of emergency department POS 21 of 23 during the EHR reporting penod Numerator Denominator Previous Reset Save amp Continue 116 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Core Measures Screen 3 The following Meaningful Use Core Measures use this screen layout Core Measures 3 4 and 8 To view more details about any of these measures click the here link located on the screen Please complete all required fields The denominator entered must be greater than or equal to the numerator entered Click Save amp Continue to proceed Previous to return or Reset to clear all unsaved data of Soci Seavices Tuesday 03 22 2013 3 12 45 PM EOT Camng far Cammectoras MAPIR Memonal Hospital NPI sm com 999999 Hospitali TIN MEE Payment Year Program Year 2014 Aa A fe YT cova ST eerie CAD Core Measure 3 Record Vital Si Chick here to review CMS Guidelines for this messure wise ered EEE SONA CORAS dorsi EO EEE E garth oa Reset to restore this panel to the starting point Red asterisk indicates a required field Objective Record
155. n that was e When a MAPIR electronic tab is completed a green check mark entered on the application that was submitted will appear in the corner of the tab e You can go back in the application tabs to review information content but not forward Applicant NPI 2011062207 This screen shows that your MAPIR session has ended You should now close your browser window Connecticut DEPARTMENT oF Sociat SERVICES Wednesday 06 19 2013 11 35 45 AM EDT Caring far Cannceliout Exit MAPIR Your session has ended To complete the log out process you must close your browser lt _ 172 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide Post Submission Activities This section contains information about post application submission activities At any time you can check the status of your application by logging into the state Medicaid portal When you have successfully completed the application submission process you will receive an email confirming your submission has been received You may also receive email updates as your application is processed When you log in to MAPIR after submitting your application you will see the Medicaid EHR Incentive Program Participation Dashboard Notice that the Status of your application is Submitted You can only view an application in a Submitted status The next payment year application will be enabled when you become eligible to ap
156. n to review your selection or click Previous to go back Click Reset to restore this panel to the starting point Red asterisk indicates a required field Start Date 10 01 2011 mm d Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide PATIENT VOLUMES cont This screen displays your Fiscal Year Start Date and the Fiscal Year End Date If the Fiscal Year Start and End Dates are correct click Save amp Continue to review your selection or click Previous to go back Print ContactUs Exit Connecticut DEPARTMENT oF SOCIAL SERVICES Monday 03 04 2013 2 53 39 PM EST Caring far Canncelieal MAPIR HOSPITAL NPI 2011062207 CCN 070098 Hospital TIN MSE Payment Year 1 Program Year 2013 Get Started RE amp A Contact Info Eligibility Patient Volumes E Attestation Revkw Patient Volume Part 1 of 3 90 Day Reporting Period Please review the Start Date and End Date of your selected continuous 90 day period for patient volume When ready click the Save amp Continue button to review your selection or click Previous to go back Start Date Feb 06 2012 End Date May 05 2012 50 February 2015 PATIENT VOLUMES cont On this screen you will enter the data required to calculate your incentive payment In the first column enter Total Discharges for the Fiscal Years displayed to the left Enter the Total Inpatient Medicaid Bed Days Total Inpatient Bed Days Total Ch
157. n you entered Click Begin to start the next topic Print Combest Us Exit Conmecncut DEPARTMENT oF Soci Services Wednesday 32 04 2013 4 14 47 Om EST ROCKVILLE GENERAL HOSPITAL i 187 13236277 ccm 700035 Wospitsi TIN MEN Payment Year 2 Program Year 20 3 Po Yo n ee ie The Gata required for this attestation is grouped inte topecs In order te Complete your attestation you mest complete ALL of the following topics The system will show checks for each item when completed The progress level of each topic will be Gaplayed os measures are completed Awallable actions for a topic will be determined by current progress level To start a topic select the Segia botton Te modify a tepic where entrees have been mace select the EDIT berroa for a topic te modify any preveowsly entered informanmen Select Previous to return When all topics are marked as completed select the Save amp Coatings button to complete the attestation process Previews Save amp Continue 90 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Stage 1 Meaningful Use Menu Set Measures This screen summarizes the requirements for the Meaningful Use Menu Set Measures Please read this as it provides details that will make it easier to complete the application NOTE Eligible Hospitals are required to complete 5 out of 10 Menu Set Measures At l
158. nated must also be confirmed Once your attestation is complete you will go to the Review tab You still have the opportunity to review and revise your application until you submit IN ORDER TO SUBMIT YOUR APPLICATION YOU MUST CLICK THE SUBMIT TAB ONCE YOU HAVE COMPLETED ENTERING YOUR INFORMATION 58 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Attestation Phase Part 1 of 3 The Attestation Phase Part 1 of 3 screen asks for the EHR System Adoption Phase The screen shown below is the Attestation Phase Part 1 of 3 screen you will see if it is your first year participating Payment Year 1 If it is not your first year participating Payment Year 2 or beyond turn to page 71 of this guide NOTE Dually eligible hospitals will not see this screen since MU attestation is done at the CMS R amp A Web site If you have registered at the R amp A as a Dually Eligible hospital and are Deemed Eligible you will bypass Attestation Proceed to page 157 of this guide After making your selection the next screen you see will depend on the phase you selected Click Save amp Continue to review your selection or click Previous to go back Click Reset to restore this panel to the starting point Print Contact Us Exit Connecticut DEPARTMENT oF Sociaa SERVICES Tuesday 03 12 2013 2 18 08 PM EDT Casing har Cammecliaul
159. nd must be returned by the hospital When overpayments are identified the Department will initiate the payment recoupment process and communicate with CMS on repayments The Department will attempt to recover any overpayments from instances of abuse or fraud or error The Department will request that hospitals submit recoupment payments by check if a provider fails to submit a payment by check within 90 calendar days of the notice to return the EHR incentive payment the Department will generate an accounts receivable to offset payment of future claims to recoup the EHR incentive overpayments Federal law requires the Department to return overpayments within 365 days of identification Money is either recouped in accordance to federal timeline standards or during the reconciliation process at the beginning of the subsequent program year Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide 10 Appeals A provider aggrieved by a decision concerning only the issues set forth in 42 CFR 495 370 a or section 17b 34 c of the Connecticut General Statutes may request an initial review of the department s determination and such review shall occur only if the department receives the provider s written request for an initial review together with any supporting documents or data not more than thirty days after the provider received the department s determination An individual other than the person who made t
160. nformation will be used to determine your eligibility for the incentive program Facility locations MAPIR will present a list of locations that the state Medicaid program office has on record If you have additional locations you will be given the opportunity to add them Once all locations are added you will enter the required Patient Volume information Review the listed locations Add new locations by clicking Add Location Tuesday 03 12 2013 1 49 15 PM EDT NPI 2011062207 Hospital TIN s Program Year a a I CT has the following information on the locations for your facility If you wish to report patient volumes for a location or site that is not listed click Add Location Wher ready click the Save amp Continue button to review your selection click Previous to go back or click Refresh to update the fist below Click Reset to restore this panel to the starting point 295 SCOTT SWAMP ROAI FAR MINGTON CT 06032 123 Main Street Anytown AL 12345 44 February 2015 PATIENT VOLUMES cont If you clicked Add Location on the previous screen you will see the following screen Enter the requested information for your new location Click Save amp Continue to review your selection or click Previous to go back Click Reset to restore this panel to the starting point Connecticut DEPARTMENT oF SociaL SERVICES Tuesday 03 12 2013 1 50 52 PM EDT Casing has Canmeclieal MAPIR
161. ng to a Meaningful Use option that is different from what you were scheduled for you will be required to supply one or more delay reasons on the next screen Note If you are attesting to Adopt Implement or Upgrade you must be adopting implementing or upgrading to a 2014 certified edition If you are attesting to Meaningful Use please enter the certification number you Nad during your EHR reporting period Your certification number must De based on the edition of Certified Electronic Health Record Technology that you are attesting to For example e 2011 Edition Characters 3 5 of the Certification ID are any combo other than 14E or H13 e 2014 Edition Characters 3 5 of the Certification ID are 14E e Combination of 2011 and 2014 Edition Characters 3 5 of the Certification ID are H13 Providers sre required to save and uplesd the Office of National Coordinator ONC Certified Health IT Product List CHPL cart page displaying the Certification ID and selected EHR product s under the Submit tab of the application The Certification ID entered below must match the ONC CHPL cart page The EHR Incentive Payment Program requires the use of technology certified for this program Please enter the CMS EHR Certification ID that you Nave obtained from the ONC Certified Health IT Product List CHPL website Click here to access the CHPL website You must enter a valid certification number Click the Exit button to terminate your session When r
162. ningful Use Core Measures use this screen layout Core Measure 6 To view more details about this measure click the here link located on the screen Please complete all required fields The denominator entered must be greater than or equal to the numerator entered Click Save amp Continue to proceed Previous to return or Reset to clear all unsaved data Print Contacts Exit Teesdsy O3 22 20123 3 12 45 PM BOT MAPIA Memorial Hospital NPI IIIT rsrs Hospital TIN E Program Yoor 2014 ae o MD MED Attestation Meoningful Use Mesures Cick bere to rever CMS Guidetines for thas measure eset OEO COE EO ee pl BOTRE EE entree lg Seperate hth in ped ae S Reset to restore this panel to the starting point Red asterisk indicates a required field Obdjectrve Prowde paterts the abdity to vew onine download and transest wformateon about 2 hosptal adrwssson Measure 1 More than 50 percent of all ureque paberts Gscharged from the mnmpatert of emergency departments of the ebgble hosotal of CAH POS 21 of 23 dunno the EM reporting period have then eformaton avadable orne waiter 36 hours of a amp scharge Numerator 1 The number of patents in the Genorunator whose informadon is avadable onne wittun 36 hours of discharge Denominator 1 Number of ureque patients scharged from an ebgble hosptal s or CAH s mpatert of emergency departmere POS 23 or 25 ching tee aR Oat paring Numerator 1 Denominator 1 More than 5 perce
163. nned to include In Progress or completed an implementation It is important to know that the information you select about your Planned to include In Progress and completed implementation tasks is optional and will not impact your ability to receive an incentive payment This information is helpful to the State Medicaid Program Office in understanding the implementation process If there are no applicable activities to select or list please select the Other Click to Add button and enter none When ready click the Save amp Continue button to review your selection or click Previous to go back Click Reset to restore this panel to the starting point After saving click the Clear All button to remove standard activity selections Red asterisk indicates a required field Implementation Activity Workflow Analysis Workflow Redesign Software Installation Hardware Installation Peripherals Installation Internet Connectivity Broadband Uploading Patient Data Electronic Prescribing Health Information Exchange i e labs pharmacy Physical Redesign of Workspace e Reviewed EHR certification Information 5 Other ee C Other Glick to Add p Se Se Previous Reset Clear Al Save amp Continve or Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Implementation Phase Part 2 o
164. not just those mantamed usnog Certhed EHR Technology Thus Gata wast extracted only from pabent records martanved using Certhed DR Technology EXCLUSION Any ebgbie hosptal or CAM that nether sees nor admits arty paberts 13 years old or older Does ties exchumon apply to the ekgble hosptal or CAH ves No If the exclusion does not apply to you please complete the following information Numerator The number of paberts N the denominator with smoleng status recorded as structured data Denominator Number of ureque pabents age 13 or older seen by the suthonzed prowxder oe admitted to an eligible hospital s or CAH s inpatient of emergency Gepartmerits POS 21 of 23 Guring the EHR reporting pernod Numerator Denominator 118 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Core Measures Enter information in all required fields Screen 5 The following Meaningful Use Core Measures use this screen layout Core Measure 5 To view more details about this measure click the here link located on the screen Please complete all required fields Click Save amp Continue to proceed Previous to return or Reset to clear all unsaved data Print ContactUs Exit CONNECTICUT DEPARTMENT OF Social SERVICES Tuesday 03 12 2013 3 12 45 PM EOT Careng fas Campeoleval MAPIR Memorial Hospetal Click here to review CM
165. nt Records Only EHR Yes Yes 138 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide This is screen 3 of 5 of the Meaningful Use Measures Summary Meaningful Use Menu Measure Review Menu Measure 1 Drug Formulary Checks Menu Measure 2 Advance Directives Menu Measure 3 Clinical Lab Test Results Menu Measure 5 Patient Specific Education Resources Menu Measure 8 Immunization Registries Data Submission Additional Information EHMMUOS Immunization Registry Exclusion Reason No Test Successful Test Date amp Time Follow Up Submission Clinical Process Effectiveness Clinical Process Effectiveness Numerator 1 Denominator 1 Percentage 100 Numerator 23 Denominator 45 Percentage 51 Numerator 45 Denominator 102 Percentage 44 Assessed for Rehabilitation Hearing Screening Prior To Hospital Discharge Primary PCI Received Within 90 Minutes of Hospital Arrival Patient Records All Patient Records All Patient Records All See below for additional information Numerator 4 Denominator 3 Performance Rate 25 0 Exclusion 2 Numerator 100 Denominator 200 Performance Rate 50 0 Exclusion 5 Numerator 100 Denominator 200 Performance Rate 50 0 Exclusion 7 Connecticut Medicaid Electronic Health Record Incentive Program This is
166. nt of a8 ureque Datberts or ther authorized representatives who are Gecharged from the epabernt or emergency Gepartmert POS 21 of 23 of an ebobte hosptal or CAM wew Gownload or transmit to a Uwd party ther miormabon Gunng the ER reporting penod EXCLUSION Any ebgbte hosptal or CAH will be exctuded from the second measure f s located in a county that Goes not have 50 percent of more of ts housing unts wih 3Mbps broadband avadabdty accorang to the latest formation avaiable from the FCC on the first day of the EHR reporting penod mmn tus exduson apply to the ebgbdie hosptal ot CAP Yes No If the exctusion does mot apply to you please complete the following information Numerator 2 The number of urvque paberts or ther authonzred represertatrees o the denoemmator who have wewed orkne downloaded of transmitted to a thud party the G scharge eformabhon proved dy the ebgbte hosptal or CAH Denominator patents Gscharged from an ebgibie hospitals or CAH s mpabent or emergency penod 2 Number of ureque department POS 21 or 23 during the ENR reporting Numerator 2 Denominator 2 120 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Core Measures Screen 7 The following Meaningful Use Core Measures use this screen layout Core Measures 7 and 9 To view more details about any of these measures click the here link
167. nue to proceed Previous to return or Reset to clear all unsaved data Print ContactUs Exit Wednesday 12 04 2013 4 23 37 PM EST ROCKVILLE GENERAL HOSPITAL NPI 1871536227 CCN 700015 Hospital TIN Payment Year 2 Program Year 2013 a Content inde zea sem eee el od _ _ Attestation Meaningful Use Measures Click here co review CMS Guidelines for this measure When ready click the Save amp Continue button to review your selection or click Previous to go back Click Reset to restore this panel to the starting point Red asterisk indicates a required field Objective Implemented drug formulary checks Measure The eligible hospital or CAH has enabled this functionality and has access to at least one internal or external drug formulary for the entire EHR reporting period PATIENT RECORDS Please select whether the data used to support the measure was extracted from ALL patient records or only from patient records maintained using certified EHR technology This data was extracted from ALL patient records not just those maintained using certified EHR technology This data was extracted only from patient records maintained using certified EHR technology Did you enable the drug formulary check functionality and did you have access to at least one internal or external drug formulary for the entire EHR reporting period Ves No Reset Save amp Continue 96 February 2015 Connecticut Medicaid Electronic
168. ogram Eligible Hospital User Guide Post Submission Activities cont This section contains information about post application submission activities At any time you can check the status of your application by logging into Connecticut Medicaid portal When you have successfully completed the application submission process you will receive an email confirming your submission has been received You will receive email updates as your application is processed The screen below shows an application in a status of Completed You can click the Review Application tab to review your application however you will not be able to make changes If your application is in a Submitted Pended for Review or a Completed status you will have the option to upload additional documentation on the Document Upload tab however if your application is not in one of the statuses previously mentioned the Document Upload tab will not display Print Contact Us Exit CONNECTICUT DEPARTMENT OF SociAL SERVICES Wednesday 06 19 2013 11 58 04 AM EDT Caring far Canpecliaal MAPIR HOSPITAL NPI 2011062207 CCN 070098 Hospital TIN M Payment Year 1 Program Year 2013 Current Status Review Application Document Upload Name MAPIR HOSPITAL Welcome to Connecticut s Medical Assistance Provider Incentive Repository MAPIR A few key points to assist you in navigating MAPIR as you complete the registration process Status e Your MAPIR user session ends if ther
169. onnecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide The screens on the following pages display the Meaningful Use Quality Measures Worklist Table with data entered for every measure selected to attest to This is screen 1 of 2 of the Meaningful Use Quality Measures Worklist Table Name MAPIR Memorial Hospital NPI 9999999999 CCN 999999 Hospital TIN 999999999 Payment Year 1 Program Year 2014 Get Started R amp A Contact Info Eligibility Patient Volumes Attestation E Measures Meaningful Use Clinical Quali E To enter or edit information select the EDIT button next to the measure that you would like to edit All progress on entry of measures will be retained if your session is terminated When all measures have been edited and you are satisfied with the entries select the Return button to access the main attestation topic list Please note Clinical quality measures are sorted by Domain and then by CMS Measure Number ICMS102 v3 Assessed for Rehabilitation ICMS31 v3 Hearing Screening Prior To Hospital Discharge Care Coordination Clinical Process Effectiveness Denominator 3 Performance Rate 25 0 Exclusion 2 Numerator 100 Denominator 200 Performance Rate 50 0 Exclusion 5 ICMSS3 v3 Primary PCI Received Within 90 Minutes of Hospital Arrival ICMS60 v3 Fibrinolytic Therapy Received Within 30 Minutes of Hospital Arrival ICMS71 v4 Anticoag
170. ons Release B For HP 6 3 2011 1 4 Comment 2 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Contents Part I Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide Background 1 Introduction 4 2 Purpose of the Eligible Hospital User Guide 5 3 Who is Eligible 6 4 Overview of the EHR Incentive Program Process 7 5 Patient Volume Calculation 9 6 Hospital Incentive Payments 10 7 Adopt Implement or Upgrade AIU and Meaningful Use MU 15 8 Attestations and Audits 16 9 Overpayments 17 10 Appeals 18 Part II Connecticut Medicaid Assistance Program Incentive Repository System 11 MAPIR Overview 19 12 Connecticut s Secure Provider Portal 21 13 Completing the MAPIR Application 24 Get Started 26 R amp A and Contact Information 33 Eligibility 37 Patient Volume 40 Attestation 58 Adoption 60 Implementation 61 Upgrade 65 Meaningful Use 71 Review 159 Submit 163 Post Submission Activities 173 14 Appendix 177 Status Definitions 177 Additional User Information 178 Validation Messages 181 Validation Messages Table 182 Acronyms and Terms 184 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide 1 Introduction The American Recovery and Re investment Act ARRA of 2009 were enacted on February 17 20
171. or Performance Rate value is 0 0 to 100 0 You must select at least 3 menu measures to proceed You must select a minimum of 16 Clinical Quality Measures from at least 3 different Domains to proceed Your EHR Attestation selection does not match the stage selection made when you started your application ONC Service is unavailable Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide You have entered an invalid CMS EHR Certification ID for the current Health Information Technology Standards Implementation Specifications and Certification Criteria for Electronic Health Record Technology Rule Acronyms and Terms 184 CCN CMS Certification Number CHIP Children s Health Insurance Program HUSKY B clients CHPL ONC Certified Health IT Product List CMS Center for Medicare and Medicaid Services EH Eligible Hospital EHR Electronic Health Record EP Eligible Professional MAPIR Medical Assistance Provider Incentive Repository NPI National Provider Identifier ONC Office of the National Coordinator for Health Information Technology Program Switch Incentive Application The first incentive application from an EH that has switched from Medicare or Dually Eligible to Medicaid or from Medicaid to Medicare or Dually Eligible R amp A CMS Medicare and Medicaid EHR Incentive Program Registration and Attestation System SMHPO State Medi
172. or refers Rs patert to another setting of care or provider of Care provides gt uemmnary of Care record for more Than SO percent of trannborrs of Care and reter ais Numerator 1 The member of transtors of Care and referrats A the Genommatot where a Amay of care record was Drow3ed 1 Meander of transtore of care and reler ais Gunng the 8 reporang pened for mtech the eigbhe Nosotal s or CANS npabert Or emergency Gepartmere POS 21 of 23 was the Dansfering or refering prowder Numerator I Oenominator 1 2 The ebgdbie horptai or CAM Mut tramemons of refers Rs Dabert to ancther setting of Care or prober of Care provides gt eueermury Of Care record for more Mian 10 percert of such trane ons and referr ats etfer 2 ebectrorec aly U anam ted eng CENT to a renOmENt OF D where the eooni recevet The summary of Care record wa exchange fackt ated Dy an organar adon Phat s a NAIN Exchange parbopant of N 2 manner that a consatert wh the governance mecharesm ONC esfabbutes for the natorrwsde DERN eformsthon neta ort Mumerator 2 The number of tansmors of Care and referrals the Genommnator where D EAD of Care record was a ONC eatat ahes for the natocwate heath wfoonaton network The orgarntaten can be a Wr Darty oF the senders onn orgarazabon 2 hearer of transibons of care and referrats Gung the EHR reporting pernod for mhuch the egile hosotal s of Carts mpsbert of emergency departmerd POS 21 of 29 was the transferneng of refering prowder Memer
173. orded a6 structured data 124 February 2015 Eligible Hospital User Guide Once you have attested to all the measures for this topic click Return to return to the Measures Topic Electronic Health Record Incentive Program List Connecticut Medicaid Eo l i I cue side a HN RET witli dl i i eit upp iM TE TE i Fi meem e me e a ee me me ee o oal een e Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide If all measures were entered and saved a check mark will display under the Completed column for the topic as displayed in the example below You can continue to edit the topic measure after it has been marked complete Click the Edit button to further edit the topic or click Clear All to clear all topic information you entered Click Begin to start the next topic Proceed to the Meaningful Use Clinical Quality Measures Stage 1 and Stage 2 on 140 Poet Cattis et Commecncyut DEPARTMENT of Socu Samoces Teesdey 02 12 2083 2 12 43 OM OT may per Sew nie MASUR Ve iW sol moral WARA NPI mm eS Poyment Year gt Pregrem Year 2014 ccc lt acr Aitestation Meaning ul live Heavies The data requred for tvs attestation amp grouped rto tops In order to complete your attest abon you must complete ALL of the folowing topes The system wi show checks for each fem when completed The progress lewel of each top w be Geplayed a1 messures are
174. orial Hospital Attestation Meaningful Use Measures The Meaningful Use Measures you have attested fo are depicted Selow Please review the current information to verly whet you have entered is correct Core Measure 2 Record Demogr apivcs Core Measure 4 Record Smoking Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide This is screen 2 of 5 of the Meaningful Use Measures Summary Numerator Measure 1 Denominator Measure 1 1 Percentage 100 Core Measure 6 Patient Electronic Access Numerator Measure 2 1 Denominator Measure 2 Percentage 100 Core Measure 7 Protect Electronic Numerator 1 Core Measure 8 Clinical Lab Test Denominator 1 n 2 EHCMUO08 Results Percentage 100 Patient Records Only EHR Numerator 1 Core Measure 10 Patient Specific Denominator 1 Education Resources Percentage 100 Numerator 1 Core Measure 11 Medication Denominator 1 Reconciliation Percentage 100 Numerator Measure 1 1 Denominator Measure 1 Percentage 100 Numerator Measure 2 1 Denominator Measure 2 Percentage 100 EHCMU12 Core Measure 12 Summary of Care Core Measure 13 Immunization Registries Data Submission Core Measure 14 Electronic EHCMU14 Reportable Laboratory Results Core Measure 15 Syndromic oe Surveillance Data Submission Core Measure 16 Electronic semen i z 1 a Administration Records Percentage 100 Patie
175. pital Arrival ICMS71 v4 Anticoagulation Therapy for Atrial Clinical Process Effectiveness Fibrillation Flutter ICMS72 v3 Antithrombotic Therapy By End of Clinical Process Effectiveness Hospital Day 2 ICMS73 v3 Venous Thromboembolism Patients Clinical Process Effectiveness with Anticoagulation Overlap Therapy ICMS91 v4 Thrombolytic Therapy Clinical Process Effectiveness ICMS 104 v3 Discharged on Antithrombotic Clinical Process Effectiveness Therapy ICMS105 v3 Discharged on Statin Medication Clinical Process Effectiveness ICMS109 v3 Venous Thromboembolism Patients Clinical Process Effectiveness Receiving Unfractionated Heparin with Dosages Platelet Count Monitoring by Protocol or INomogram ICMS113 v3 Elective Delivery Clinical Process Effectiveness CMS55 v3 Median Time from ED Arrival to ED Patient and Family Engagement Departure for Admitted ED Patients ICMS114 v3 Incidence of Potentially Preventable Patient Safety Venous Thromboembolism ICMS171 v4 Prophylactic Antibiotic Received Patient Safety Within One Hour Prior to Surgical Incision ICMS190 v3 Intensive Care Unit Venous Patient Safety Thromboembolism Prophylaxis 144 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide The following is a list of the 29 Clinical Quality Measures available for you to attest to
176. plication has been successfully submitted Click OK Print ContactUs Exit CONNECTICUT DEPARTMENT OF Socia SERVICES Wednesday 03 13 2013 3 11 59 PM EDT Casing has Canmeclianl MAPIR HOSPITAL 2011062207 ccn 070098 Payment Year 1 Your application has been successfully submitted and will be processed within approximately 30 days You will receive an email message when processing has been completed Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide SUBMIT cont When your application has been successfully submitted you will see the application status of Submitted Click Exit to exit MAPIR Print ContactUs Exit Connecticut DEPARTMENT OF Sociat SERVICES Wednesday 06 19 2013 11 24 48 AM EDT Caring far Cannectiaal MAPIR HOSPITAL NPI 2011062207 CCN 070098 Hospital TIN Payment Year 1 Program Year 2013 Current Status Review Application Document Upload MAPIR HOSPITAL Welcome to Connecticut s Medical Assistance Provider Incentive Repository MAPIR A few key points to assist you in navigating MAPIR as you complete the registration process Status Submitted lt lt e Your MAPIR user session ends if there is no user activity longer than 60 minutes You will receive timeout warnings e Please note that whoever begins the MAPIR application must be oie the same person who completes the application Select Review Application to view the informatio
177. ply For status information please see the Status Definition table in the Post Submission Activities section of this manual When you log in to MAPIR after submitting your application you will see the Medicaid EHR Incentive Program Participation Dashboard Contact Us Exit Thursday 10 02 2014 5 30 52 PM EDT Medicaid EHR Incentive Program Participation Dashboard 1053477075 TIN E 070035 Red asterisk indicates a required field Application Select to Continue Stage Program Year Available Actions Select the Continue Implementation Completed 2012 41 080 96 button to view this application Stage 1 Select the Continue Meaningful Use Denied 2013 0 00 button to view this 90 Days application Select the Continue 2013 2 506 10 button to view this application Stage 1 Meaningful Use Submitted 2 90 Days Select the Continue Stage 2 button to process this Incomplete 3 2014 Unknown application or click Meaningful Use Abort to eliminate all progress Providers will not be able to select the Stage Adoption Implementation Upgrade or Meaningful Use stage EHR reporting period from the MAPIR dashboard For an application in a Not Started status providers will select the Stage of attestation by selecting the Application and clicking Continue The MAPIR Dashboard displays the Stage on previously submitted applications Connecticut Medicaid Electronic Health Record Incentive Pr
178. pplication The email address you have entered does not match You have entered an invalid CMS EHR Certification ID You must be licensed in the state s in which you practice You must select Yes or No to utilizing certified EHR technology in this location You have entered a duplicate Group Practice Provider ID You must select a Payment Address in order to proceed You must enter the email address twice for validation purposes You must be in compliance with HIPAA regulations You must be an Acute Care Hospital or a Children s Hospital to be eligible to receive the EHR Medicare Program Payment All amounts must be between 0 and 999 999 999 999 999 You must answer Yes to utilizing certified EHR technology in at least one location in order to proceed The amounts entered are invalid The denominator must be greater than or equal to the numerator The 90 day period you selected did not return any active locations for that time period please check the 90 day patient volume timeframe You must select at least one Public Health menu measure A total of 5 Menu measures must be selected February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide Validation Messages Table Numerator cannot be greater than denominator and numerator denominator cannot be a negative value The date you have entered is in an invalid format The number you have entered is invalid it must b
179. r Arisdkcdonrs EERE BOON ODETA OF REET IDO CEDA SYSTEM OG the EMR reoortung Dern ves Neo Oper ates N a parecer for atch NO EE amon regrtry Of eure ston eftormaben rvitem capstte of accepting the spect standards required for Certitted EHR Technology at the start of ther EMR reporting penod ves wo OD EF ates N a ADON WEE NO AELA COTY OF EEEL EA CEASA AE DODE EIN d ON Capatelity to recente ALOON Gata ves NO Oper stes N a RaEECDON for Rha NO IDON EP OF EDA ADON system Tat i Capsdie of accepting the spectc standards reqared Dy Certied EMR Tectinotogy at the start of they EMR reporting penod can errot additonal ebpbie horoatsis or Carts ves o Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide After you enter information for a measure click the Save amp Continue You will be returned to the Meaningful Use Core Measure List Table The information you entered for that measure will be displayed in the Entered column of the table as shown in the example below please note that the entire screen is not displayed in this example You can continue to edit the measures at any point prior to submitting the application Click Edit for the next measure Prist Contacts Exit Conmacncut DEPARTMENT OF Social Services Tuesday 02 22 2013 3 42 45 PM EOT Comag dar Cannsotnoad MAPIR Memorial Hospital To exter or c t informadon select the EDIT button next to the measure that you
180. r application over from the beginning you can click the Get Started tab Click the here link on the screen to start over from the beginning Print Contact Us Exit Connecticut DEPARTMENT oF SOCIAL SERVICES Thursday 06 30 2011 11 22 04 AM EDT Caring far Canmectiout Name MAPIR HOSPITAL NPI 2011062207 CCN 070098 Hospital TIN ay Get Started R amp A Contact Info jg Eligibility Patient Volumes Attestation Review Submit Welcome to Connecticut s Medical Assistance Provider Incentive Name MAPIR HOSPITAL Repository MAPIR A few key points to assist you in navigating MAPIR as you complete Applicant NPI 2011062207 the registration process status incomplete Your MAPIR user session ends if there is no user activity longer than 60 minutes You will receive timeout warnings Click here you would like to eliminate all information saved to Please note that whoever begins the MAPIR application must be date amt Start over from the beginning the same person who completes the application When a MAPIR electronic tab is completed a green check mark will appear in the corner of the tab oat Dae You can go back in the application tabs to review information Navigation Keys within the system content but not forward e Save and Continue At the bottom of each screen it is important that you utilize the Save amp Continue button This allows you to come back to your records after leaving a MAPIR session in the event you are unable to
181. r pre scer of care ahoetd summary of core record for esch tresetiee sf are Ot reami The five measures you selected to attest to will display on the Meaningful Use Menu Measure Worksheet The example below displays the five measures selected on the previous screen example Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide You must complete all measures Once information is successfully entered and saved for a measure it will be displayed in the Entered column on this screen Click Edit to enter or edit information for a measure or click Previous to return to the Measures Topic List Print ContactUs Exit CONNECTICUT DEPARTMENT oF Socia SERVICES Wednesday 12 04 2013 4 22 08 PM EST ROCKVILLE GENERAL HOSPITAL NPI 1871536227 CCN 700015 Hospital TIN Payment Year 2 Program Year 2013 Pn D D a ol n To enter or edit information select the EDIT button next to the measure that you would like to edit All progress on entry of measures will be retained if your session is terminated When all measures have been edited and you are satisfied with the entries select the Previous button to access the main measure topic list implemented drug formulary checks he eligible hospital or CAH has enabled this functionality and has access to at least one internal or external drug formulary for the entire EHR reporting Record advance directives for patients 65 More than 50 of all unique
182. r your aelecnen a click Previous 4 po back Click Rapat to nueare chin pane fo che starting pane Red ssberisk indicates a required field Otjective Implamect drug dreg and drug allargy interaction checks Measuee The aligible borpital or CAH bap enabled this functionality bor the entire BHA reporting pened Complete the follgwimeg inhgermptign Hove you enabled the henctionality for drugedrug and drug allergy interaction chacka for che entire EHR reporting pered E Yas amp Ne 84 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Core Measures Screen 3 The following Meaningful Use Core Measures use this screen layout Core Measures 3 4 5 and 6 To view more details about any of the measures click the here link located on the screen Please complete all required fields The denominator entered must be greater than or equal to the numerator entered Click Save amp Continue to proceed Previous to return or Reset to clear all unsaved data oF Socia Semwces wednesday 12 04 2013 4 04 21 PM EST ning at amaationt Mare ROCKVILLE GENERAL HOSPITAL HPI 187 1336227 con 7000153 Hospital TIN DE Payment Year gt Propam Year 3013 eae ieaare se M Athestatian Meaningful Use Measures Loe Peace I Oct bere co neon OMS Guidelines fer rhis measure Wien nady click che Sane Continue butter o revins your
183. ram Eligible Hospital User Guide Post Submission Activities Payment After the attestation is Payment Approved payment will be made during the regular financial cycle in 2 4 weeks depending on cut off dates for payment The financial transaction is reflected under the payee hospital s AVRS ID s Remittance Advice and included in their Electronic Fund Transfer EFT The payment will be reflected on the Financial Transaction page under Non Claim Specific Payouts and the transaction will be identified by a Reason Code of 8510 Medicaid EHR Incentive Payment REPORT CRA TRAN R interChange NNIS 09 16 2011 RA 1027704 MEDICAID MANAGEMENT INFORMATION SYSTEN i PROVIDER REMITTANCE ADVICE FINANCIAL TRANSACTIONS MAPIR HOSPITAL PAYEE ID 2011062207 PO BOX S027 ISSUE DATE 09 16 2011 MAPIR CT 06904 TAXONOMY 273R00000x P AVRS ID PAYOUT REASON APPLICANT APPLICANT CCN ANOUNT CODE CLIENT NO CLIENT NAME 100002113 1 415 866 07 6510 TOTAL PAYOUTS 1 41S 866 07 EOB Description Page FINANCIAL TRANSACTIONS REASON CODES EXPENDITURES REASON CODES RSN CODE REASON CODE DESCRIPTION 6510 Medicaid EHR incentive payment 176 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide 14 Appendix The following table lists some of the statuses your application may go through Status Definition Not Registered at R amp A MAPIR has not received a matching
184. ram Year 2013 Attestation Phase Part 3 of 3 Eligible Hospitals may be subject to the Centers for Medicare amp Medicaid Services process for audits and appeals of Meaningful Use attestations This includes Eligible Hospitals applying for a Medicaid only EHR incentive payment Please answer the following question When ready click the Save amp Continue button to review your selection or click Previous to go back Click Reset to restore this panel to the starting point Red asterisk indicates required field _ Please confirm that you are either an Acute Care Hospital with an f m Yes C No y average length of stay of 25 days or fewer or a Chikiren s Hospital aaa 7 _ al _ _ NOTE Definition of an acute care hospital for purpose of the Medicaid EHR Incentive Payment Program is 2 hospital with an average patient length of stay of 25 days or fewer and with a CCN that falls in the range of 0001 0879 Short term Hospitals or 1300 1399 Critical Access Hospitals Please select one payment address from the fist provided Delow to De used for your Incentive Payment if you sre approved for payment If you do not see a valid payment address please contact Connecticut Department of Social Services Payment Address gt a gt Ink ti fal 2011052207 MAPIR HOSPITAL 195 SCOTT SWAMP ROAD 7 008020870 FARMINGTON CT 06032 Reset Seve amp Continue Connecticut Medicaid Electronic H
185. registered with CMS example inpatient outpatient IDs e CMS Certification Number CCN This will be matched with the information provided by CMS e Contact name s and email s e Contact telephone number s 2 Complete your CMS Medicare amp Medicaid EHR Incentive Program Registration and Attestation System R amp A registration https www cms gov EHRIncentivePrograms 20_ RegistrationandAttestation asp Applicants will need to provide information such as e Payee s NPI and Tax Identification Number TIN e CMS Certification Number CCN e Incentive Program option of Medicare or Medicaid Connecticut Medical Assistance Program Note If Medicaid choose the state in which you are applying e Valid email contact information NOTE If you are applying for your second payment you will not go to the CMS R amp A to re register but if you are a dually eligible hospital applying for a second payment you will need to go to CMS to attest to Meaningful Use prior to submitting your application through our MAPIR System Children s Hospitals will not need to go to CMS to re register but will come directly into the MAPIR System to attest to Meaningful Use 3 Once successfully registered with the R amp A eligible applicants will receive a Welcome letter via email stating that they can register in MAPIR which is accessed through the provider secure portal at www ctdssmap com This may take up to two business days following successful registration
186. registration from both the R amp A and the state MMIS Incomplete The application is in a working status but has not been submitted and may still be updated by the provider Submitted The application has been submitted The application is locked to prevent editing and no further changes can be made Payment Approved A determination has been made that the application has been approved for payment Payment Disbursed The financial payment data has been received by MAPIR and will appear on your remittance advice Partial Recoupment Received An adjustment has been requested and the total amount has not been recouped Partial Remittance Received An adjustment has been processed and a partial recoupment has been made and will appear on your remittance advice Aborted When in this status all progress has been eliminated for the incentive application and the application can no longer be modified or submitted Appeal Initiated An appeal has been lodged with the proper state authority by the provider Appeal Approved The appeal has been approved Appeal Denied The appeal has been denied Denied A determination has been made that the provider does not qualify for an incentive payment based on one or more of the eligibility rules Completed The application has run a full standard process and completed successfully with a payment to the provider Cancelled An application ha
187. restore this panel to the starting point After saving click the Clear All burton to remove standard acti Implementation Activity Workflow Analysis Workflow Redesign Software Installation Hardware Installation Peripherals Installation Internet Connectivity Broadband Uploading Patient Data Electronic Prescribing Health Information Exchange i e labs pharmacy Physical Redesign of Workspace Training e Other click to add J Hospital TIN Program Year m Red asterisk indicates a required field 1m ww we ew eK eK ewe eK ee activity selections 62 T o ewe ee ee ee ee ee Tuesday 03 12 2013 2 41 10 PM EDT February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Implementation Phase Part 2 of 3 This screen shows an example of entering activities other than what was in the Implementation Activity listing Click Save amp Continue to proceed or click Previous or Reset to clear unsaved data and move to the screen where the last data was saved Click Clear All to remove activity selections and clear the fields on this page MAPIR HOSPITAL CCN 070098 Payment Year Attestation Phase Part 2 of 3 Tuesday 03 12 2013 2 44 17 PM EDT NPI 2011062207 Hospital TIN a Program Year 2013 sme Please select the activities where you have Pla
188. s been set to Cancelled status only when R amp A communicates a registration cancellation to MAPIR MAPIR cancels both the registration and any associated application Future This is a status that will be displayed against any application to indicate the number of future applications that the provider can apply for within the EHR Incentive Program Not Eligible This is a status that will be displayed against any application whenever the provider has exceeded the limits of the program timeframe Not Started This is a status that will be displayed against any application whenever the provider has not started an application but MAPIR received an R amp A registration and has been matched to an MMIS provider Expired An application is set to an Expired status when an application in an Incomplete status has not been submitted within the allowable grace period for a program year or when an authorized admin user changes an application to this status after the end of the grace period Once an application is in an Expired status the status cannot be changed and it is only viewable to the provider Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide Additional User Information This section contains an explanation of additional user information system messages and validation messages you may receive Start Over and Delete All Progress If you would like to start you
189. se measures using a certified EHR technology D Meaningful Use Full Year You are capturing meaningful use measures using a certified EHR technology Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Phase Part 1 of 3 Depending on the selection made on the previous screen the Attestation EHR Reporting Period Part 1 of 3 screen will display with the 90 day period or the full year period The example below displays the 90 day period for an incentive application in Program Year 2014 Enter a Start Date or use the calendar located to the right of the Start Date field For Program Year 2014 the 90 day EHR reporting period must fall within the Program Year begin and end date range and not include days in a grace period Click Save amp Continue to proceed or click Previous or Reset to clear unsaved data and move to the screen where the last data was saved Priest Comiect is Luit CommecnouT DEPATTMENT of ocw Seavces Teadd y QN L200 3 Bolter PM GOT BLA HOSPITAL 201 LOe2207 Abbetoberes HA Baepecettamey Pead Prt 1 af 1 adie acter the Start Bebe of thee EHE Ragormag Pernod The EHA Eipidhag Phares ii biy i sooner Gen any raraosan i Payment he ae eS erick pa Elbgble Heagetel er Ceca Agrada Hosp damea iibi abet wae of iether ES Bote Tha end daa ofthe conpeseuh Pi dar penpd bal be colowlated based on che tert date aaqered When sae chec
190. se saim bad totai of foe meiiens Ire ebgsie hespa ot CAs enables thie 1 e ae has access co Ot heast oae aceras or thar 30 of 08 empre peterts 3 paors oid or p mttod te the cipis Songtal e or CAN Gepertrrent DOS 25 here oe indication of om spbis heepra of CAM sMo reCenet s pobet beothe settesg of Care o prossber of core or ba encounter a Coben ant shovis portos be soother setnag of care or prewster of Core ar that patient te paoter prewtter of core sdosbs summary of Core recort far eech Wenetes si are o rate ii 104 Eligible Hospital User Guide February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide If all measures were entered and saved a check mark will display under the Completed column for the topic You can continue to edit the topic measure after it has been marked complete Click the Edit button to further edit the topic click Clear All to clear all topic information you entered or click Begin to start the next topic Print ContactUs Exit Wednesday 12 04 2013 4 34 36 PM EST ROCKVILLE GENERAL HOSPITAL NPI 1871536227 CCN 700015 Hospital TIN MEE Payment Year 2 Program Year 2013 a Attestation Meaningful Use Measures The data required for this attestation is grouped into topics In order to complete your attestation you must complete ALL of the following topics The system will show checks for each item when completed The progress level
191. sed on federal rules for the EHR Incentive Program e Payments will be issued via the standard CT Medical Assistance Program s financial payment cycle schedule that runs twice a month Hospitals will see their payments posted on their remittance advices and their annual 1099s e It is possible that the HP Enterprise Services or the Department may need to contact applicants during the application process before a decision can be made to approve or deny an application Applicants are encouraged to contact the HP EHR Assistance Center either by email at ctmedicaid ehr hp com or by phone at 1 855 313 6638 toll free if they have questions about the process Please include your name and NPI number on all correspondence Applicants have appeal rights available to them if for example an applicant is denied an EHR incentive payment The Department will convey information on the appeals process to all who are denied e SUBSEQUENT YEARS Once AIU has been completed for Medicaid the subsequent Meaningful Use attestations will take place at the CMS R amp A website for dually eligible hospitals and the EH will only need to specify that they are applying for Meaningful Use with Medicaid that year 8 February 2015 5 Patient Volume Calculation In order to be eligible for the Connecticut Medicaid EHR Incentive Program EHs must meet eligible patient volume thresholds with the exception of Children s Hospitals The general rule is that EHs must have at lea
192. st 10 percent patient volume attributable to patient discharges and emergency department encounters for individuals receiving Medicaid Total Medicaid encounters in any Total encounters in ati Medicaid representative the same Me continuous 90 day period in the preceding fiscal year Patient Volume continuous 90 day period Medicaid patient volume calculations are based on inpatient discharges and emergency department visits for which Medicaid paid any part Medicaid patient volume is measured over a continuous 90 day period in the previous hospital fiscal year and for all hospital locations Hospitals only need to enter the start date and MAPIR will calculate the end date For example if requesting a 2012 EHR incentive payment and your fiscal year is between October 1 September 30 the start of your continuous 90 day period must start and end between October 1 2010 and September 30 2011 For purposes of calculating EH patient volume a Medicaid encounter is defined as services rendered to an individual on any one day where Medicaid paid for part or all of the service or paid all or part of the individual s premiums copayments and cost sharing Note HUSKY B patients who in CMS terms are defined as members of a Children s Health Insurance Program CHIP do not count toward the Medicaid patient volume criteria EXAMPLE The hospital is applying to the EHR Incentive Program in Federal Fiscal Year 2011 Oct 1 2010
193. stem wil show checks for each tem when completed The progress level of each tope wil be displayed as measures are completed Available achons for a topic will be determined by current progress level To start a topx select the Begia button To modify a topic where entries have been made select the EDIT button for a topic to modify any previously entered information Select Previows to return Progress Action Clear All Clinical Quality Measures 16 16 Note When al topics are marked as completed select the Save amp Continue button to complete the attestaton process aoe sees 156 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide Attestation Phase Part 3 of 3 Part 3 of 3 of the Attestation Phase contains questions regarding the average length of stay for your facility and confirmation of the address to which the incentive payment will be sent Click Yes to confirm you are either an Acute Care Hospital with an average length of stay of 25 days or fewer or a Children s Hospital Click the Payment Address from the list below to be used for your Incentive Payment contingent on approval for payment Click Save amp Continue to proceed to Final Attestation or Previous to return or Reset to clear all data Print ContactUs Exit Tuesday 03 05 2013 4 41 44 PM EST NPI 2011062207 CCN 070098 Hospit l TIN Es Payment Year Prog
194. ted the incentive application the Stage column will display Adoption Implementation Upgrade or Meaningful Use If it is not your first year participating Payment Year greater than 1 the Stage column will only display the Stage not the Attestation Phase until you submit the incentive application If you are a Dually Eligible hospital the Stage column will display Adoption Implementation Upgrade or Meaningful Use The Status will vary depending on your progress with the incentive application The first time you access the system the status should be Not Started From this screen you can choose to edit and view incentive applications in an Incomplete or Not Started status You can only view incentive applications that are in a Completed Denied or Expired status Also from this screen you can choose to abort an incentive application that is in an Incomplete status When you click Abort on an incentive application all progress will be eliminated for the incentive application When an incentive application has completed the payment process the status will change to Completed The screen on the following page displays an EH that is in the second year of Stage 1 Meaningful Use Select an application and click Continue 26 February 2015 GETTING STARTED cont CONNECTICUT DEPA TIENI or Socia Services Tanang ae Tammann Medicaid EHR Incentive Program Participation Dashboard 9599999955 TNO Red asterisk indicates a r
195. ted to revising the final written audit or any other action within the scope of the department s authority 16 February 2015 MAPIR Attestations EHs will need to verify the information displayed in MAPIR and will also need to enter additional required data elements and make attestations about the accuracy of data elements entered in MAPIR For example applicants will need to demonstrate that they meet patient volume thresholds that they are adopting implementing or upgrading federally certified EHR systems or are attesting to being a meaningful user of a federally certified EHR system and that they meet all other federal program requirements The MAPIR system design is based on the CMS Final Rule for the EHR Incentive Program and Connecticut s specific eligibility criteria In addition to the MAPIR system reviews all eligible hospitals will be reviewed prior to payment The Department will verify the information submitted in the application and determine payment amounts A series of reviews will identify applicants who do not appear to be eligible based on the following elements of the application Applicants who do not meet patient volume thresholds Cost data Ineligible hospital types Sanctions Or O Oo oO 9 Overpayments MAPIR will be used to store and track records of incentive payments for all participating hospitals Once an overpayment is identified MAPIR will determine the amount of overpayments that have been made a
196. temal drug formulary tor the peo Ear p rg More than 50 of all unique pabents 65 years od or older admetted to the ekgsble hoapstal s oF CAHi npabent department POS 21 have an indcathan of an advance deectre status recorded ag structured data February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide Once you attested to all the measures for this topic click Previous to return to the Attestation Meaningful Use Measures screen Fray 12 06 2013 1 44 30 PM EST Name ROCKVILLE GENERAL HOSPITAL NPI 1873536227 CCN 700015 Hospital TIN Payment Year 2 Program Year 2013 Pam YY Yo re A Attestation Meaningful Use Measures Meaningful Use Menu Measure Worksheet Te erter or edt information select the EDIT Dutton next to the measure Mat you would ike to edt All progress of entry of messures will Be reteired f your session a terminated Wher sl measures Neve Deen ected and you ore satisfied wht the entries select the Previous Dutton to access the main messure topic Est eigivie hosptal or CAH ss enabled this functionality and Nas access to af least one internal or external drug formulary for the entire EHR or impatert department POS 21 Neve an indication of an advance Girectve status recorded as structured of Numerstor S45 Dencenmator 1000 emergency department POS 21 or 23 during the EHR reporting period whose results are either in a postive regstw
197. testation section of the application You may revisit this section any time to make corrections until such time as you actually Submit the application The Submit section of the application is now available Before submitting the application please review the information you have provided in this section and all previous sections hehehehe belt To Continue 7 seseaeesssseoee 70 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Phase Part 1 of 3 Note Dually eligible hospitals will not see this screen since Meaningful Use attestation is done at the CMS R amp A Web site You should select the Meaningful Use button if you have completed the meaningful use requirements for appropriate timeframes Click Save amp Continue to proceed or click Previous or Reset to clear unsaved data and move to the screen where the last data was saved Connecticut DEPARTMENT oF Socia SERVICES Tuesday 03 12 2013 3 09 22 PM EDT Caring far Canmcelioat MAPIR HOSPITAL NPI 2011062207 070098 Hospital TIN e Payment Year Program Year 2013 RAA Contact Info Eng ibatry Patient Volumes Attestation y Ge a A Attestation Phase Part 1 of 3 Please select the appropriate EHR System Adoption Phase When ready click the Save amp Continue button to review your selection or click Previous to go back Click Reset to res
198. th insurance coverage for all locations listed 10 01 2009 09 30 2010 10890 oe 109878943 10990988 10 01 2008 09 30 2009 ao7 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide GETTING STARTED PROGRAM PARTICIPATION DASHBOARD The screen below the Medicaid EHR Incentive Program Participation Dashboard is the first screen you will see when you begin the MAPIR application process This screen displays your incentive applications The incentive applications that you are eligible to apply for are enabled Your incentive applications that are in a Completed status are also enabled however you may only view these applications The Stage is automatically associated with a stage of Meaningful Use that is required by the current CMS rules or by the rules that were in effect at the time when the application was submitted This column displays the Stage and Attestation Phase attained by the current and previous applications The Stage column will be blank for incentive applications in a Not Started status You must attest to two years of Stage 1 Meaningful Use before proceeding to Stage 2 Meaningful Use and three years of Stage 1 if you have attested to Meaningful Use in Program Year 2011 You must then proceed to attest to two years of Stage 2 Meaningful Use If it is your first year participating Payment Year 1 the Stage column will be blank Once you have submit
199. the application You may revisit the section at any time to the make the corrections until such time as you actually Submit the application The Eligibility section of the application is now available Before submitting your application please review the information that you have provided in this section and all previous sections 36 February 2015 ELIGIBILTY The Eligibility section will ask questions to allow Connecticut Medicaid program to make a determination regarding your eligibility for the Medicaid EHR Incentive Payment Program The initial Eligibility screen contains information about this section Click Begin to proceed to the Hospital Eligibility Questions Print ContactUs Exit Connecticut DEPARTMENT oF SOCIAL SERVICES Thursday 02 12 2015 1 16 27 PM EST Caring far Canncclieal Name MAPIR HOSPITAL NPI 2011062207 CCN 070098 Hospital TIN Payment Year 1 Program Year 2015 R amp A Contact Info Eligibility Patient Volumes Attestation Review Submit To participate in the Medicaid Incentive Program you must first provide some basic information to confirm your eligibility for the program In the Eligibility tab you will be asked To confirm that your hospital intends to participate in the Connecticut Medicaid incentive program If your hospital has current Medicare or Medicaid sanctions If your hospital is HIPAA compliant For more detailed information please refer to the Provider Manual for Eligib
200. ticut DEPARTMENT oF Sociat SERVICES Tuesday 03 12 2013 1 38 28 PM EDT Casing har Canncelioal MAPIR HOSPITAL NPI 2011062207 CCN 070098 Hospital TIN x Payment Year Program Year 2013 You have now completed the Eligibility section of the application You may revisit the section at any time to make the corrections until such time as you actually Submit the application The Patient Volumes section of the application is now available Before submitting your application please review the information that you have provided in this section and all previous sections Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide PATIENT VOLUMES The Patient Volumes section gathers information about your facility locations the 90 day period you intend to use for reporting the Medicaid patient volume requirement and the actual patient volumes Additionally you will be asked about how you utilize your certified EHR technology e An acute care hospital must have at least a 10 percent Medicaid patient volume for each year for which the hospital seeks an EHR incentive payment e A children s hospital is exempt from meeting a patient volume threshold There are three parts to the Patient Volumes section Part 1 of 3 establishes the 90 day period for reporting patient volumes This 90 day period must be in the preceding fiscal year or in the 12 months preceding the attestation date by the total
201. tion You cannot proceed without completing the next tab in the application progression with the exception of the Get Started and Review tabs which you can access anytime Once you submit your application you can no longer modify the data It will only be viewable through the Review tab Also the tab arrangement will change after submission to allow you to view status information As you proceed through the application process you will see your identifying information such as Name National Provider Identifier NPI and Tax Identification Number TIN at the top of most screens This is information provided by the R amp A A Print link is displayed in the upper right hand corner of most screens to allow you to print information entered You can also use your Internet browser print function to print screen shots at any time within the application There is a Contact Us link with contact instructions should you have questions regarding MAPIR or the Medicaid Incentive Payment Program CONNECTICUT DEPARTMENT oF Sociat SERVICES Thursday 05 10 2012 12 26 38 PM ED Caring far Coancclical Contact Us Please contact us with any questions or concerns you have Email ctmedicaid ehr hp com or Call toll free 1 855 313 6638 Monday Friday 8 00 a m 5 00 p m except holidays 24 February 2015 Most MAPIR screens display an Exit link that closes the MAPIR application window If you modify any data in MAPIR witho
202. tore this panel to the starting point Adoption You are acquiring certified EHR Technology Implementation You are installing certified EHR Technology Upgrade You are expanding functionality of certified EHR Technology lt 3 Meaningful Use _ Vou ire tapung meaningful use measures using a certified EHR technology S Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide ATTESTATION cont Meaningful Use Phase Part 1 of 3 Select an EHR System Adoption Phase for reporting Meaningful Use of certified EHR technology The selections available to you will depend on the Program Year you are in If you are in Program Year 2014 you must attest to Meaningful Use 90 days therefore the Meaningful Use Full Year option will be disabled The screen below is an example of this scenario If you are in Program Year 2015 or higher and have previously attested to Adoption Implementation or Upgrade you may attest to Meaningful Use 90 days or Meaningful Use Full Year If you are in Program Year 2015 or higher and you have previously attested to Meaningful Use you must attest to Meaningful Use Full Year therefore only this option will display Click Save amp Continue to proceed to Final Attestation or Previous to return or Reset to clear all data Print Comtact Us Exit CONNECTICUT DEPARTMENT of Socia SERVICES Wednesday 12 04 2013 3 27 00 PM EST MAPIR Memoria
203. ulation Therapy for Atrial Fibrillation Flutter ICMS72 v3 Antithrombotic Therapy By End of Hospital Day 2 ICMS73 v3 Venous Thromboembolism Patients with Anticoagulation Overlap Therapy Clinical Process Effectiveness Clinical Process Effectiveness Clinical Process Effectiveness Clinical Process Effectiveness Clinical Process Effectiveness INumerator 100 Denominator 200 Performance Rate 50 0 Exclusion 7 INumerator 120 Denominator 130 Performance Rate 45 0 Exclusion Numerator 50 Denominator 100 Performance Rate 56 0 Exclusion 3 Exception 5 Numerator 28 Denominator 45 Performance Rate 56 0 Exclusion 7 Exception 8 Numerator 230 Denominator 450 Performance Rate 35 0 Exclusion 9 ICMS91 v4 Thrombolytic Therapy ICMS104 v3 Discharged on Antithrombotic Therapy Clinical Process Effectiveness Clinical Process Effectiveness Numerator 90 Denominator 100 Performance Rate 79 0 Exception 4 Numerator 240 Denominator 500 Performance Rate 89 0 Exclusion 5 Exception 8 EDIT Connecticut Medicaid Electronic Health Record Incentive Program This is screen 1 of 2 of the Meaningful Use Quality Measures Worklist Table Click Return to return to the Meaningful Use Clinical Quality Selection screen 154 Eligible Hospital User Guide ICMS105 v3 Discharged on Statin Medication C
204. usly entered When ready click the Save amp Continue button to review your selection or click Previous to go back Click Reset to restore this panel to the starting point Red asterisk indicates a required field fae Se a ee oe ES M a ae 10 01 2008 09 30 2009 If you re enter the hospital cost report data and the values match the existing hospital cost report data on file you will receive an error message The re entered data cannot match the existing data on file Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide Change Hospital Cost Data cont Review your revised hospital cost report data Once you save the revised hospital cost report data you cannot revert to the hospital cost report data on file At this point if you decide you do not want to revise the existing hospital cost data on file abort the current application and start over again Click Save amp Continue to continue with new amounts click Previous to go back to the first Hospital Cost Report Data screen or click Change Data to change the data again Print Contact Us Exit Friday 03 08 2013 11 14 55 AM EST Please review your hospital cost report data below If you wish to update the data shown below please select the Change Data button Note You will not be able to change the Fiscal years which were previously entered When ready cick the Save amp Continue button to continue
205. ut saving you will be asked to confirm if the application should be closed as shown to the right Windows Internet Explorer WARNING Any unsaved changes will be lost when exiting You should use the Save amp Continue button on the screen 2 before exiting or data entered on that screen will be lost The Previous button always displays the previous MAPIR Sat ee ee ees o window without saving any changes to the The Reset button will restore all unsaved data entry fields to their original values The Clear All button will remove standard activity selections for the screen in which you are working A red asterisk indicates a required field Select the Cancel button to contine working Note Use the MAPIR Navigation buttons in MAPIR to move to the next and previous screens Do not use the Internet browser buttons as this could result in unexpected results As you complete your incentive application you may receive validation messages requiring you to correct the data you entered These messages will appear above the navigation button See the Additional User Information section for more information Many MAPIR screens contain help icons to give the provider additional details about the information being requested Moving your cursor over the will reveal additional text providing more details For each reporting fiscal year enter the total tient Bed Total as All Total Chai Chari regardless of heal
206. ve Program Eligible Hospital User Guide Click Return to return to the Measure Topic List Friday 12 06 2013 11 38 51 AM EST Ebgible Hospitals must report a mirsenum of three 3 Meaningful Use Menu Measures Please Note Unchecking a Menu Measure wil resut in the loss of any data entered for that measure More than 10 percent of all tests whose result is one or more images by an ae em geia hosptal or CAH for patents admitted to ts inpatient or DOE as or oe Song Sees al ehgbie hospital s or CAW s inpabert or emergency arankan fa Apae egrang lipan darada structured data 0 of more first d Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide If all measures were entered and saved a check mark will display under the Completed column for the topic You can continue to edit the topic measure after it has been marked complete Click the Edit button to further edit the topic or click Clear All to clear all topic information you entered Click Begin to start the next topic Proceed to the Meaningful Use Clinical Quality Measures Stage 1 and Stage 2 on page 140 Print ContactUs Exit CONNECTICUT DEPARTMENT oF Socia SERVICES Friday 12 06 2013 11 38 51 AM EST Casing her Canaccliwal MAPIR Memorial Hos I one NPL 9999999999 CCN WIM Hospital TIN esse nal Payment Year 2 Program Year 2014 cot started TT naricontact inte a roteet voto o D Tmt BD The data required
207. vious to return or Reset to clear all unsaved data CONNECTICUT DEPARTMENT OF SOCIAL SERVICES Caring has Canmuclioal Print ContactUs Exit Friday 12 06 2013 11 38 51 AM EST MAPIR Memorial Hospital 999999 NPI HHHPH Hospital TIN MEE Program Year 2014 Menu Measure 2 Electronic Notes Click here to review CMS Guidelines for this measure When ready dick the Save amp Continue button to review your selection or click Previous to go back Click Reset to restore this panel to the starting point Red asterisk indicates a required field CAH s inpatent or emergency searchable data Numerator Objective Record electronic notes in patient records Measure Enter at least one electron progress note created edited and signed by an authorized provider of the eligible hospital s or department ebgible hosptal or CAW s inpatient or emergency department during the EHR reporting penod The text of the electronic note must be text searchable and may contan drawings and other content Numerator The number of urmque patents in the denominator who have at least one electronx progress note from an authorized provider of the eligible hosptal s or CAH s inpatient or emergency department POS 21 or 23 recorded as text Denominator Number of ursque patients admated to an eligible hospital s or CAH s inpatient or emergency department POS 21 or 23 dunno the EHR reporting penod POS 21 oF 23 for more than 3
208. with the R amp A MAPIR is the Department s Web based system that will track and act as a repository for information related to applications attestations payments appeals oversight functions and interface with R amp A You will be able to track the status of your application through the MAPIR system and should not go through the CMS R amp A system to verify application status Once successful R amp A registration is completed no changes will need to be made at the CMS R amp A in subsequent years unless there is a change in CCN TIN or NPI Numbers due to a change in ownership 4 In order to access MAPIR every hospital has an existing Web Secure Provider Portal IDs most likely several IDs Most hospitals will be able to gain access to this ID through their billing office as they access the Web secure provider portal on a regular basis In order to access the MAPIR system the administrator of your hospital s INPATIENT AVRS Web ID will need to create a clerk ID for the individual that will be completing the hospital s attestation in MAPIR It is important that they do not use the Outpatient AVRS ID because access to MAPIR cannot be gained through that ID Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide The hospital Web ID administrator should already know how to set up a clerk account as these IDs must not be shared The full instructions are on our Web site www ctdssmap com under In
209. x format and no greater than 5 MB Invoice which must include name s of company principals name of the specific product services purchased and date of purchase User agreement which must include company name and name of specific product services purchased Contracts which must include name s of company principals name of the specific product services purchased signatures and dates License agreement which must include company name and name of the specific product services purchased Purchase orders which must include name s of company principals name of the specific product services purchased date of purchase and costs which may be redacted MU dashboard screenshots printouts and or reports which must include numerator denominator exclusions and percentages for each of the required Core and Menu items MU Only Certificate of Public Health Meaningful Use Stage 1 Testing if applicable Public health meaningful use measure exclusion letter if applicable When ready click the Save amp Continue button to review your selection or click Previous to go back Click Reset to restore this panel to the starting point To upload a file type the full path or click the Browse button Files must be in a pdf xis xlsx doc or docx format and no greater than 5 MB in size File name must be less than or equal to 100 characters File Location C Users cooganr Documents MAPIR FILE 5 1 docx Browse Connecticut Med
210. y 06 30 2011 11 27 36 AM EDT Caring far Canneclical Name MAPIR HOSPITAL NPI 2011062207 CCN 070098 Hospital TIN o Get Started R amp A Contact Info Eligibility Patient Volumes Attestation Review Submit Start Over and Delete All Progress Your application has been reset and all saved data has been eliminated Please select OK to start from the beginning You will be redirected to the Get Started tab ok Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide Contact Us Clicking on the Contact Us link in the upper right corner of most screens within MAPIR will display the following Connecticut Medicaid program contact information Friday 07 01 2011 11 44 26 AM EDT Connecticut DEPARTMENT oF Socia SERVICES Caring far Cianecticat MAPIR rContact Us Please contact us with any questions or concerns you have Email ctmedicaid ehr hp com or Call toll free 1 855 313 6638 Monday Friday 8 00 a m 5 00 p m except holidays MAPIR Error Message This screen will appear when a MAPIR error has occurred Follow all instructions on the screen Click Exit to exit MAPIR ContactUs Exit CONNECTICUT DEPARTMENT OF SOCIAL SERVICES Thursday 06 30 2011 9 09 31 PM EDT Caring far Cannectical Pesca Expired Your MAPIR session has expired Please click Exit to close this window 180 February 2015
211. y Measure Worklist Table This screen displays the Meaningful Use Clinical Quality Measures you selected on the previous screen Click Edit to enter or edit information for the measure or click Return to return to the Meaningful Use Clinical Quality Selection screen Once information is successfully entered and saved for a measure it will be displayed in the Entered column on this screen Name MAPIR Memorial Hospital NPI 9999999999 CCN 999999 Hospital TIN 999999999 Payment Year 1 Program Year 2014 R amp A Contact Info Eligibility Patient Volumes Attestation E Review Submit Meaningful Use Clinical Quality Measures To enter or edit information select the EDIT button next to the measure that you would like to edit All progress on entry of measures will be retained if your session is terminated When all measures have been edited and you are satisfied with the entries select the Return button to access the main attestation topic list Please note Clinical quality measures are sorted by Domain and then by CMS Measure Number Meaningful Use Clinical Quality Measure List Table ICMS102 v3 Assessed for Rehabilitation Care Coordination ICMS31 v3 Hearing Screening Prior To Hospital Clinical Process Effectiveness Discharge ICMSS3 v3 Primary PCI Received Within 90 Clinical Process Effectiveness Minutes of Hospital Arrival ICMS60 v3 Fibrinolytic Therapy Received Within Clinical Process Effectiveness 30 Minutes of Hos
212. y asked questions 5 February 2015 Connecticut Medicaid Electronic Health Record Incentive Program Eligible Hospital User Guide 3 Who is Eligible The CMS Final Rule outlines the following mandatory criteria for an Eligible Hospital EH to be considered for the Connecticut Medicaid EHR Incentive Program The Department also requires that EHs be enrolled as a Medical Assistance provider without sanctions or exclusions Hospitals that are not enrolled will need to enroll with Medical Assistance prior to applying for the Department s EHR Incentive Program and must meet program requirements including meeting Medical Assistance patient volume thresholds To qualify for an incentive payment under the Medicaid EHR Incentive Payment Program an Eligible Hospital must have a minimum 10 Medicaid patient volume threshold Children s hospitals do not have a patient volume threshold Note HUSKY B patients who in CMS terms are defined as members of a Children s Health Insurance Program CHIP do not count toward the Medicaid patient volume criteria EHs for the Medical Assistance program in Connecticut include acute care critical access and children s hospitals Hospitals are eligible for both Medicaid and Medicare incentive payments except for children s hospitals and cancer hospitals which are only eligible for Medicaid incentive payments There are specific sets of CMS Certification Numbers CCN that correspond to EHs which are listed

Eligible Hospital User Manual - Connecticut Medical Assistance

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