Medicare and Medicaid Attestation June 19, 2012

1. Medicare and Medicaid AttestationJune 19, 2012 Presented by Jesus F. Ruiz, CPA

2. Medicare EHR Attestation Basics Federal Fiscal Year (FFY) ending 09/30/2013 is the final year Hospitals will be eligible for full EHR incentive payments. Medicare EHR attestation must begin and end within the same Federal Fiscal Year.

3. Facilities that first attested Medicare Meaningful Use (MU) in FFY 2011 will attest according to the following schedule: FFY Ending 9/30/11 – Stage 1 - 90day attestation period. FFY Ending 9/30/12 – Stage 1 – full year attestation. FFY Ending 9/30/13 – Stage 1 – full year attestation. FFY Ending 9/30/14 – Stage 2 – full year attestation.

4. Facilities that attest Medicare Meaningful Use (MU) in FFY 2012 will attest according to the following schedule: FFY Ending 9/30/12 – Stage 1 - 90day attestation period. FFY Ending 9/30/13 – Stage 1 – full year attestation. FFY Ending 9/30/14 – Stage 2 – full year attestation. FFY Ending 9/30/15 – Stage 2 – full year attestation.

5. Upcoming important dates pertaining to the EHR Incentive payment program: • July 3, 2012– Last day for eligible hospitals to begin their 90-day reporting period to demonstrate meaningful use for the Medicare EHR Incentive Program. • September 30, 2012 – Last day of the federal fiscal year. Reporting year ends for eligible hospitals and CAHs. • October 3, 2012 – Last day for eligible professionals to begin their 90-day reporting period for calendar year 2012 for the Medicare EHR Incentive Program. • November 30, 2012 – Last day for eligible hospitals and critical access hospitals to register and attest to receive an Incentive Payment for FY 2012 under the Medicare EHR Incentive Program. • December 31, 2012 – Reporting year ends for eligible professionals. • February 28, 2013 – Last day for eligible professionals to register and attest to receive an Incentive Payment for calendar year (CY) 2012.

6. Medicare EHR payments are comprised of two components Initial Payment made at the time of attestation. This is only an interim payment subject to Medicare Settlement. Final Payment made as a settlement based on a finalized (NPR) cost report.

7. Initial Payment PPS Hospitals – Payment made by the payment contractor 4-8 weeks after attestation. CAH – Payment made by the payment contractor 4-8 weeks after FI/MAC validation for CAH. CAH - Although the allowable amounts are calculated by the FI/MAC, the EHR incentive payments will be made by a single payment contractor. Payments will be made in the same manner the CAH receives their other Medicare payments (i.e., EFT or check)   The Initial payment is based on the latest as filed cost report. May be based on CMS 2552-96 or CMS 2552-10 cost report

8. Final Payment Final payment or settlement is based on the Medicare Cost Report that begins during the payment year and will be reconciled to the actual amounts at final settlement of that cost report. Only CMS 2552-10 will be used for final settlement. Due to the change in cost report facilities that are not proactive may have to pay a portion of their initial payment back.

9. Requirements for Attestation • Registered for participation in Medicare EHR incentive payment program. • User of EHR certified technology. • Obtained CMS EHR Certification ID #. • Completed the 90 attestation period. • Have written record of attestation period compliance.

10. Preparation http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/index.html?redirect=/ehrincentiveprograms/ http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Attestation.html

11. Attestation https://ehrincentives.cms.gov/hitech/login.action

12. Questions?