Promoting Interoperability (PI) Program

The Centers for Medicare & Medicaid Services (CMS) has renamed the EHR Incentive Programs to the Promoting Interoperability (PI) Program to continue the agency’s focus on improving patients’ access to health information and reducing the time and cost required of providers to comply with the programs’ requirements.

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HFS logoILHITREC has an ongoing partnership with the Illinois Department of Healthcare and Family Services (HFS) to implement the Promoting Interoperability (PI) Medicaid Program (Illinois EHR Medicaid Incentive Payment Program) which provides incentive payments to eligible providers and hospitals as they demonstrate meaningful use of certified EHR technology.

ILHITREC offers remote and onsite registration, attestation and Meaningful Use services at no cost to qualified Medicaid providers through a contract with the HFS as part of the Medicaid Promoting Interoperability Program.  ILHITREC provides the most coordinated, up-to-date information by working closely with federal and state departments, state and regional consortiums, and other key networks and agencies and delivering direct technical assistance, education and training to providers and practices statewide.

Below are key topics, education and resources for Medicaid meaningful use participants.

    2019 Medicaid Meaningful Use Requirements: Stage 3

In the 2019 Program Year, eligible providers will be required to use Stage 3 Meaningful Use. The following pages will provide more details on 2019 Stage 3 reporting.

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     Calculating Patient Volume

One key aspect of eligibility is patient volume. To qualify for an incentive payment under the Illinois EHR Medicaid Incentive Payment Program, an eligible professional must meet one of the following criteria for Medicaid patient volume:

  • Have a minimum 30% Medicaid patient volume
  • Have a minimum 20% Medicaid patient volume, and be a pediatrician

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     Medicaid Meaningful Use Audits

The EHR Incentive Program Medicaid Audits for the State of Illinois will be conducted by the Department of Healthcare and Family Services, Office of the Inspector General, Bureau of Medicaid Integrity. Any EP attesting to, and receiving an EHR incentive payment through the Illinois Medicaid EHR Incentive Program is subject to an audit.

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     Objective 1: Protect Patient Information

Conducting or reviewing a security risk analysis to meet the standards of Health Insurance Portability and Accountability Act of 1996 (HIPAA) Security Rule is included in the meaningful use requirements of the Medicare and Medicaid EHR Incentive Programs. Eligible professionals must conduct or review a security risk analysis for each EHR reporting period to ensure the privacy and security of their patients’ protected health information.

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     Objective 2: E-Prescribing

E-Prescribing is a prescriber's ability to electronically send an accurate, error-free and understandable prescription directly to a pharmacy from the point-of-care, and is considered an important element in improving the quality of patient care.

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     Objective 3: Clinical Decision Support (CDS)

Clinical quality measures (CQMs) are tools that help measure and track the quality of health care services that eligible professionals (EPs), eligible hospitals (EHs), and critical access hospitals (CAHs) provide. Measuring and reporting CQMs helps to ensure that our health care system is delivering effective, safe, efficient, patient-centered, equitable, and timely care. The following pages will provide more details on CQM and eCQM reporting.

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     Objective 4: Computerized Provider Order Entry (CPOE) Meds/Labs/Rads

Computerized provider order entry (CPOE) refers to the process of providers entering and sending treatment instructions – including medication, laboratory, and radiology orders – via a computer application rather than paper, fax, or telephone.

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     Objective 5: Patient Electronic Access to Health Information with Patient Education (Patient Engagement /Patient Portals)

The purpose of this objective is to provide patients the ability to view online, download, and transmit their health information within 4 business days of the information being available to the EP. This could include providing patients with instructions on how to access their health information, the website address they must visit for online access, a unique and registered username or password, instructions on how to create a login, or any other instructions, tools, or materials that patients need in order to view, download, or transmit their information.

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     Objective 6: Coordination of Care through Patient Engagement

Increasing patient engagement in their health care can be an important factor to consider in patient health. In the Coordination of Care through Patient Engagement Objective, EPs are required to use certified electronic health record technology (CEHRT) to engage with patients or their authorized representatives about the patient’s care.

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     Objective 7: Health Information Exchange (HIE)

An EP who transitions their patients to another setting of care, or refers their patient to another provider, needs to provide a summary of care record for each transition of care or referral. Transition of Care refers to moving a patient from one care setting to another, as ordered by the EP. This section provides further detail and resources for understanding this meaningful use objective.

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     Objective 8: Public Health Reporting and Specialized Registries

An EP should be in active engagement with a public health agency to submit electronic public health data from CEHRT, except where prohibited and in accordance with applicable law and practice.

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Resources

Important Medicaid Attestation Deadlines in 2019

Medicaid Promoting Interoperability Program Eligible Professionals Objectives and Measures for 2019

EHR Incentive Program Toolkit (PDF)

Stages of Promoting Interoperability Program - Meaningful Use (PDF)

Aligning MIPS PI & Medicaid PI (PDF)

Comparing Stage 2 and Stage 3 for 2019 (PDF)

Illinois Promoting Interoperability Program for Medicaid