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Background

The New Jersey Innovation Institute’s (NJII) Medicaid Provider Program (MPP) expansion is being funded through a grant from the New Jersey Department of Human Services, Division of Medical Assistance and Health Services that was awarded in October, 2017.  The program funds up to 1,250 providers in achieving the Medicaid Promoting Interoperability Program (Formerly known as the EHR Incentive Program).

The program builds upon an initial grant from the Office of National Coordinator that was awarded to New Jersey Innovation Institute (formerly NJ-HITECH) in 2010, from the U.S. Department of Health and Human Services.

The Purpose of the Promoting Interoperability Program

The PI program requires that providers demonstrate they are using certified Electronic Health Record (EHR) technology in ways that measurably improve healthcare quality and efficiency.

It is the set of standards defined by the Centers for Medicare and Medicaid Services (CMS) Incentive Programs that governs the use of Electronic Health Records (EHRs) and allows eligible providers and hospitals to earn incentive payments by meeting specific criteria.

The Goal of the PI Program

The PI program was created to promote the utilization of Electronic Health Records (EHRs) as a way to improve health care in the United States. EHRs provide many benefits for providers and their patients including:

  • Complete and accurate information to provide the best possible care. With EHRs, providers will know more about their patients and their health histories before walking into the examination room
  • Better access to and sharing of information. EHRs facilitate greater access to the information providers need to diagnose health problems earlier and improve the health outcomes of their patients. EHRs also allow information to be shared more easily among doctors’ offices and hospitals, and across health systems, leading to better coordination of care
  • Patient empowerment and participation. EHRs help empower patients to take a more active role in their health and in the health of their families. Patients can receive electronic copies of their medical records and share their health information securely.

Legislation and Regulations

New Jersey Medicaid and its Medicaid Managed Care Organization partners have teamed up with the Regional Extension Center, New Jersey Innovations Institute (formerly the New Jersey Health Information Technology Extension Center) to offer free consulting and other services to assist providers in becoming eligible for Medicaid Promoting Interoperability Program payments. For more information on this partnership, click here.

On November 14, 2016, CMS published the 2017 OPPS/ASC final rule with comment period, which impacts the Medicare and Medicaid EHR Incentive Programs through revisions to the objectives and measures for eligible hospitals, CAHs and dual-eligible hospitals who attest to CMS as well as the 2016 and 2017 EHR reporting period and reporting requirements. The changes increase flexibility, lower the reporting burden for providers, and focus on the exchange of health information and using technology to support patient care.

To access the 2017 Modified Stage 2 program requirements and information finalized in the OPPS/ASC final rule with comment period specific to eligible hospitals, CAHs and dual-eligible hospitals click here.

To access the Stage 3 program requirements and information finalized in the OPPS/ASC final rule with comment period specific to eligible hospitals, CAHs and dual-eligible hospitals click here.

All PI measures are based on encounters that occurred at locations where certified EHR technology is implemented. At least 50% of a provider’s total patient encounters must occur at locations where there is “Certified Electronic Health Record Technology” in order to be eligible for the Medicaid EHR Incentive Program incentives. Additionally, at least 80% of the attesting providers’ patients in the EHR Reporting Period must be included in the provider’s or group practices’ EHR system in order to be eligible for New Jersey Medicaid PI Program payments.

The last year to begin participation in the Medicaid PI Program was CY2016.

New Jersey Innovation Institute
NJIT 400 Fenster Hall
323 Dr Martin Luther King Jr Blvd
Newark, NJ 07102

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mu@njii.com
973-642-4055, Option 2