1. New Jersey Medicaid EHR Incentive Program Hospital Overview

2. Presentation Summary Medicaid EHR Incentive Program Overview
Eligibility
Adopt, Implement, Upgrade, and Meaningful Use Definitions
Payment Calculation and Schedule
Registration and Attestation
Questions and Answers

3. Program Overview

4. Program Overview
The Medicaid EHR Incentive Program will provide incentive payments to eligible hospitals as they adopt, implement, or upgrade certified EHR technology in their first year of participation and demonstrate meaningful use for two additional years.

5. Program Overview
Incentive payments to hospitals will begin being distributed in January – February
The last year a Medicaid eligible hospital may begin the program is 2016.
Hospital payments will vary by facility based on hospital size and Medicaid concentration
Hospitals may receive payments from BOTH the Medicare and Medicaid EHR Incentive Programs

6. Eligibility

7. Eligibility Acute Care Hospitals Children’s Hospitals
General hospitals, cancer hospitals and critical access hospitals
Average length of patient stay of 25 days or fewer
CMS Certification Number (CCN) with the last four digits in the series 0001 – 0879 and
10% Medicaid Patient Volume based on encounters
Children’s Hospitals
CCN with last four digits in the series 3300 – 3399
No patient volume requirement

8. Eligibility: Medicaid Encounter
A hospital encounter occurs only in a hospital’s inpatient department, or emergency department on any one day
One Medicaid encounter is tallied:
For each inpatient discharge IF Medicaid paid for any part of the patient’s stay, and
For each emergency department visit (no more than one per patient per day), IF Medicaid paid for any part of that ER visit.

9. Patient Volume Calculation
Medicaid Encounter count for a selected 90 day period divided by
Total inpatient discharges + emergency room visits for the same period
If the total is greater than 10%, the hospital is eligible for a Medicaid EHR Incentive Payment
New Jersey Medicaid recommends that hospitals use their Medicare or Medicaid cost reports for all calculations.

10. Adopt, Implement, Upgrade and Meaningful Use

11. Adopt, Implement or Upgrade (AIU)
Hospitals must demonstrate one of these to receive a Year 1 incentive payment:
Adopt – Acquire, purchase, or secure access to certified EHR technology
Implement - Install or commence utilization of certified EHR technology
Upgrade - Expand the available functionality of certified EHR technology

12. Adopt, Implement or Upgrade (AIU)
Documentation proving AIU should be uploaded into the attestation system, and should include the following:
Identification of the EHR technology being adopted or already in use
Signed contract or financial record indicating the purchase, acquisition or lease of certified EHR technology

13. Meaningful Use
Hospitals must demonstrate meaningful use to receive Year 2 and 3 incentive payments
Meaningful Use Includes:
Compliance with all 14 ONC “Core” Meaningful Use objectives
Compliance with 5 of the 10 “Menu Set” Meaningful Use objectives
All meaningful use attestations will be subject to audits performed by CMS

14. Payment Calculation and Schedule

15. Payment Calculation Basics
Payment is calculated once and will be distributed over three years:
50% Year 1, 40% Year 2, 10% year 3
Complex formula based on projected hospital discharge growth rates and Medicaid patient volume
EHR Incentive Program Payment System will perform the calculation
More detail on the calculation formula is available at

16. Payment Calculation: Information Needed
Total acute inpatient discharges for the last 4 completed hospital fiscal years
Total acute inpatient bed days for the entire hospital fiscal year completed in the most recently completed federal fiscal year
Acute inpatient bed days which Medicaid (Title XIX only, fee-for-service or managed care) paid a share of for the same hospital fiscal year
Excluding Medicaid/Medicare dual eligible days

17. Payment Calculation: Information Needed
Total charges for the hospital fiscal year completed in the most recently completed federal fiscal year
Total Charity Care charges for the hospital fiscal year completed in the most recently completed hospital fiscal year

18. Payment Calculation: Additional Points
Recommended Data Sources:
Medicare Cost Reports
Medicaid Cost Reports
Financial Statements or Accounting Records
Six page description of the payment calculation process is available at

19. Registration and Attestation

20. Registration and Attestation Timeline
November 7, 2011 – National Level Repository registrations launched
December 2011 – EHR Incentive Program Attestation System launches
January/February 2012 – Initial EHR Incentive Program payments distributed

21. National Level Registration
CMS Administered Process with state verification
Verifies that hospital meets the basic eligibility criteria for the Medicaid EHR Incentive Program
Opened for the New Jersey Medicaid EHR Incentive Program on 11/7/11

22. National Level Registration
Hospitals that already registered as dually-eligible for the Medicaid and Medicare programs have already completed this process
Hospitals that have never registered can go to ehrincentives.cms.gov to begin the process
Registration User Guide is available at

23. National Level Registration
Information Needed to Complete the Process:
Name of the eligible hospital
National Provider Identifier (NPI)
Provider Enrollment, Chain, and Ownership System (PECOS) Provider Number
CCN (CMS Certification Number)
Business address and phone number
Valid address
Taxpayer Identification Number (TIN)

24. State Level Attestation
Begins once NLR Registration is successfully completed
Allows hospitals to enter their Medicaid patient volume information, upload AIU documentation, and enter information needed for payment calculation
Application will be available within the provider portal section of
All information entered will be subject to audit that could result in recoupment

25. State Level Attestation
Information Needed to Complete Attestation:
Medicaid Provider ID
90 day period for patient volume calculation
Medicaid Fee-for-Service and Managed Care encounters for the selected 90 day period
Total encounters for the selected 90 day period
Any out-of-state Medicaid fee-for-service or managed care patient encounters
Total discharges for the four most recently completed hospital fiscal years

26. State Level Attestation
Information Needed to Complete Attestation:
Medicaid fee-for-service and managed care acute inpatient bed days for the most recently completed hospital fiscal year
Total acute inpatient bed days for the most recently completed hospital fiscal year
Total Hospital Charges (including Charity Care charges)
Charity Care Charges
CMS EHR Certification Number

27. State Level Attestation
Additional Attestation Information:
Once all information is entered, hospitals will have 72 hours to change any information included in the attestation
The attestation system will verify all Medicaid information entered against information available in NJMMIS
New Jersey Medicaid recommends using Medicare cost reports to complete the attestation process. The lines that should be used are available at

28. Additional Information
EHR Incentive Program Website
NJMMIS Provider Services
, Option 7
Have your Medicaid Provider ID number
Program address