Meaningful Use Attestation Review for Hospitals

1. Meaningful Use AttestationReview for Hospitals “That when the sea was calm all boats alike show'd mastership in floating;” W. Shakespeare, The Tragedy of Coriolanus

2. Goals • Problems, Risks • Common Issues • Recommendations • Q & A

3. Problems & Risks • Failing MU attestation • Significant implications – financial, legal, operational • Remediation challenging, time consuming • Meeting MU objectives “all or none” • MU requirements complex • CMS & ONC Final Rules (CFR) > 300 pages • MU specification sheets frequently refer to CFR • Ancillary references often combine EH & EP information • Mobius strip versus learning curve

4. Problems & Risks • Approval Process • MU data = Honor System • Eligibility confirmation – CCN, OIGExclusions, PECOS #, etc. • Medicare Administrative Contractor review; CAH submit expenses • Payment File Development Contractor • Audits • Process not well defined under HITECH • Attestation + Payment ≠ Withstand Audit • CMS entitled to recoup payment

5. Common Issues • Misunderstanding of Core & Menu objectives • Objectives requiring a YES/NO response (silent failures) • Core Obj. #13 - “Capability to exchange key clinical information..” • Menu Obj. #8 - “Capability to submit electronic data to immunization registries...” • Borderline metrics • CPOE, Problem List • Work flow adjustments, bylaws • Underestimate time & resources needed • 90 day reporting period = last quarter of FFY = zero margin • CQMs, manual abstraction

6. Common Issues • Failure to utilize team approach • Combination of clinical, IT & administrative • Personnel changes • Payment • CAH – attest, submit expenses to MAC • Administrative housekeeping – TIN, CCN, PECOS, etc. • Vendors • MU reporting – suboptimal, time-consuming • Bolt on functionality

7. Recommendations - generalized • Review all Stage 1 MU specification sheets • Exclusions, Definitions • Additional Information – the “fine print” • Resolve issues before hitting SUBMIT. • Use worksheet provided by CMS • Hospital_Attestation_Worksheet.pdf • http://www.cms.gov/EHRIncentivePrograms/Downloads/ • Do practice attestation • http://cms.gov/apps/ehr

8. Recommendations - generalized • Print and retain copies of MU & CQM reports • must retain copies for six (6) years • Incorrect attestation • Acuity level - ? transcription error, multiple mistakes, etc. • Fix the problem – “good faith” • Leverage your resources – internal, external • EHR Information Center 1-888-734-6433, TTY 1-888-734-6563.7:30 AM – 6:30 PM (Central Time) Monday through Friday

9. Q & A ? Barry Little, M.D. Physician Advisor Kentucky Regional Extension Center 859+323-3092 barry.little@uky.edu