North Carolina Medicaid Incentive Payment System: NC-MIPS Presented to North Carolina Hospital Association October 25, 2011

NC-MIPS Provides a technology solution to facilitate the registration and attestation process for Eligible Professionals (EP) and Eligible Hospitals (EH) and provides validation features for the state. 25 October 20112

Up-Front Notes Links and contact information provided at end of presentation Please hold questions until end ◦ We’ll move quickly to allow time for questions

Attestation NC-MIPS System 25 October CMS Registration (NLR) Attestation Validation Payment Meaningful Use All payment years Payment year one only Payment year two and later + NC-MIPS Registration Participation Requirements Adopt, Implement, or Upgrade

Attestation NC-MIPS System 25 October CMS Registration (NLR) Attestation Validation Payment Meaningful Use All payment years Payment year one only Payment year two and later + Today’s Focus NC-MIPS Registration Participation Requirements Adopt, Implement, or Upgrade

NC-MIPS Registration North Carolina Medicaid Incentive Payment System 25 October 20116

NC-MIPS Registration Step 1: Hospital Registers with CMS ◦ After successful registration, NC is notified ◦ NC matches record supplied by CMS and sends ◦ Outreach may occur during matching 25 October Step 2: Obtain NCID Step 3: Setup Account ◦ Go to NC-MIPS Provider Portal’s Account Setup ◦ Enter CMS-supplied Registration Number, NPI, EIN, and MPN ◦ Enter NCID and password

NCID “NCID is the standard identity management and access service provided to state, local, business, and individual users. NCID provides a high degree of security and access control to real-time resources.” 25 October NCID is linked to account used for attestation NCID website link found on NC-MIPS portal account login page

NC-MIPS Attestation North Carolina Medicaid Incentive Payment System 25 October 20119

Attestations Hospital Step 1: Gather Necessary Information ◦ Patient Volume Information ◦ Payment Calculation Data Hospital Step 2: Complete, Submit, and Print ◦ Go through the attestation process in the portal Hospital Step 3: Sign and Return Printed Attestation ◦ Return signed attestation with supporting material ◦ Signature from officer of the corporation 25 October

Patient Volume Information Hospitals must meet 10% Medicaid patient volume threshold over 90-day period in prior Federal Fiscal Year NC Requested Data ◦ Total Medicaid Acute Care Inpatient Discharges ◦ Total Medicaid ED Visits ◦ Total Acute Care Inpatient Discharges ◦ Total ED Visits 25 October

Payment Calculation Data Pages Enter hospital’s fiscal year end month Baseline from most recent 12 month cost report ending prior to first day of program year’s Federal Fiscal Year ◦ Example: prior to 10/1/2010 for program year 2011 CMS is required for full year cost reports covering periods ending after 4/30/2011 Refer to the Payment Calculation Worksheet for additional details. 25 October

Payment Calculation Worksheet 25 October

Payment Calculation Worksheet (2) 25 October

Payment Calculation Worksheet (3) 25 October

Payment Calculation Worksheet (4) 25 October

Demonstration Click here to jump to the screen shots...

NC-MIPS Attestation Validation North Carolina Medicaid Incentive Payment System 25 October

NC-MIPS Attestation Validation Multiple checks are performed against the provider-entered attestation data ◦ If issues arise …  Outreach to overcome issue  Possible “not eligible” finding State findings ◦ If “eligible” – moves on to payment process ◦ If “not eligible” – notification is sent 25 October

NC-MIPS Payment North Carolina Medicaid Incentive Payment System 25 October

NC-MIPS Payment Payment Process Starts with DMA Approval ◦ NC-MIPS verifies ability to pay with CMS ◦ With CMS approval, payment request sent to MMIS ◦ If CMS does not approve…  Outreach to overcome issue  Possible denial letter ◦ MMIS makes payment during the next check write cycle ◦ After payment, MMIS notifies NC-MIPS 14 September

Wrap-Up North Carolina Medicaid Incentive Payment System 25 October

Useful Links DMA Electronic Health Record web page Has link to CMS site Link to EH Attestation Guide /Default/EH_Attestation_Guide.pdf /Default/EH_Attestation_Guide.pdf NCID web site 25 October

Contact Information 25 October CSC NC-MIPS Operations Specific processing questions or DMA NC-MIPS General program or policy questions Amelia Bryant, NCHA or

Questions & Answer 25 October

NC-MIPS EH Portal Pages

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