State Of Connecticut Department Of Social Services-Books Pdf

STATE OF CONNECTICUT DEPARTMENT OF SOCIAL SERVICES
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State Medicaid Health Information Technology Plan November 2010 Page i. Table of Contents, Executive Summary 1, A Connecticut Background 3. A 1 State Demographics 3, A 1 1 Population 3, A 1 2 Geography 3. A 1 3 Income and Poverty 3, A 2 Health Care Environment in Connecticut 3. A 2 1 State of Health Indicators 3, A 2 2 Health Coverage 4. A 3 Overview of Medicaid in Connecticut 4, A 3 1 Connecticut s Medicaid Program 4.
A 3 2 Medicaid Budget 5, A 4 Overview of Current Project 5. A 4 1 Planning Activity Summary 5, A 4 2 Coordination with Other Federal Entities and Federally Funded. Entities Projects 7, B As Is HIT Landscape 9, B 1 State Organization of the Incentive Payment Program 9. B 1 1 DSS 9, B 1 2 Claims Administrator 9, B 2 Status of Statewide HIE initiatives 10. B 2 1 State Designated Entity HITE CT and activities to date 10. B 2 2 HIE Initiatives in Connecticut 11, B 3 Status of Medicaid HIT Initiatives 12.
B 3 1 E Prescribing 12, B 3 2 eHealthCT HIE Pilot 13. B 3 3 Comprehensive Active Medication Profile CAMP Pilot Project 14. B 4 DSS Relationship to the State Government HIT Coordinator 14. B 5 Status of Public Health HIE HIT Activities 15, B 5 1 State Immunization Registry of Connecticut 15. B 5 2 Electronic Death Registry System EDRS 15, B 5 3 Public Health Information Network PHIN 16. B 5 4 Maven and PHIN MS Configurations 16, B 5 5 Enhanced HIV AIDS Laboratory Reporting 17. B 5 6 Laboratory Information Management System LIMS 17. B 5 7 Environmental Public Health Tracking EPHT 19. B 6 Status of ePrescribing 19, State Medicaid Health Information Technology Plan November 2010 Page ii.
B 7 Status of Regional Extension Center in CT 20, B 8 Broadband Landscape 21. B 8 1 GIS Mapping Landscape 21, B 8 2 State Broadband Access and Network Capacity Expansion 21. B 9 U S Department of Veterans Affair and Indian Health Service Clinical. Facilities with EHRs 22, B 10 Status of Medicaid Eligible Providers and Hospitals and Adoption Likelihood 22. B 10 1 Statewide Adoption of EHRs 22, B 10 2 Estimating the Number of Eligible Hospitals Based on Patient. Volume Only 24, B 10 3 Estimating the Number of Eligible Providers Submitted Based on.
Medicaid Claims 26, B 11 Existing State Systems and Processes 27. B 11 1 Role of the MMIS System in the SMA s HIT E Environment 27. B 11 2 Provider Relations and Call Center 27, B 11 3 Current MITA 27. B 11 4 Appeals and Audit 27, B 11 5 Legal Environment 28. B 11 6 Reporting 28, C The State s To Be Landscape 29. C 1 Vision Goals and Objectives 29, C 1 1 Medicaid HIT Strategic Goals 29.
C 1 2 EHR Incentive Program Objectives 30, C 2 Governance 31. C 2 1 Scope and Principles 31, C 2 2 Key Governance Entities 32. C 2 3 Governance Roles Matrix High level Outline 32. C 2 4 Status of Governance Implementation 33, C 3 Future Medicaid System Architecture 35. C 3 1 Architecture Overview 35, C 3 2 Business Architecture 37. C 3 3 Information Architecture 37, C 3 3 1 interChange MMIS 37.
C 3 3 2 Data Warehouse 38, C 3 3 3 Connecticut Statewide HIE 38. C 3 4 Technology Architecture 40, C 3 5 MITA Compliance 41. C 3 6 Privacy and Security 41, C 4 Coordination with the Statewide HIE 41. State Medicaid Health Information Technology Plan November 2010 Page iii. D Activities Necessary to Administer and Oversee the EHR Incentive. Program 43, D 1 Program Organization 43, D 1 1 Proposed Staffing 43. D 2 Provider Eligibility 45, D 2 1 Eligibility Methodology 45.
D 2 2 Verifying Provider and Hospital Qualifications 46. D 2 3 Verifying Provider Hospital Based Status 46, D 2 4 Medicare versus Medicaid 46. D 3 Attestation Verification Mechanisms 47, D 3 1 Provider Attestations 47. D 3 2 Data Sources to Corroborate Patient Volume 47. D 3 3 Adopt Implement or Upgrade 48, D 3 4 Verifying Meaningful Use 48. D 3 5 Proposed Changes to the Meaningful Use Definition 49. D 3 6 Verifying Use of Certified Electronic Health Record Technology 49. D 3 7 Collecting Meaningful Use Data 49, D 4 Incentive Payment Processing 49. D 4 1 EHR Incentive Payment Calculation Approach 49. D 4 2 EHR Incentive Payment Frequency 50, D 4 3 Assignment of Payment 51.
D 5 Appeals Process 51, D 5 1 Program Eligibility 51. D 5 2 Payment Amount 52, D 5 3 Adopt Implement Upgrade 52. D 5 4 Meaningful Use 52, D 5 5 Appeals Staffing 52. D 6 Provider Support Activities 53, D 6 1 Outreach and Education 53. D 6 2 Coordination with the Regional Extension Center eHealthCT 53. D 6 3 Connecticut Medicaid Webpage Enhancements 53. D 6 4 Communication Tools 54, D 6 5 Help Desk Support Plan 55.
D 7 Financial Reporting 55, D 8 IT Systems Changes Needed and Associated Timeframe 55. E The State s Audit Strategy 57, E 1 Pre payment 57. E 2 Post Payment 57, E 3 Corrective Action 58, State Medicaid Health Information Technology Plan November 2010 Page iv. E 4 Fraud and Abuse Identification Remedies and Recoupment 58. F The State s HIT Roadmap 59, F 1 Roadmap Narrative 59. F 2 Risk Analysis 62, F 3 Long Term Plan for Health Outcome Analytics 65.
F 4 Metrics and Measurement of EHR Adoption 67, F 5 Annual Benchmarks 69. F 5 1 Annual Benchmarks for Strategic Objectives 69. F 5 2 Annual Benchmarks for Audit and Oversight 71. G Appendices 73, G 1 Acronyms and Definition of Terms 73. G 2 Health Care Services Provided by the State 82, G 3 Connecticut interChange MMIS Description 84. G 4 Program Activities and Schedule 87, G 5 Connecticut HIT Initiatives Master Project Plan 91. G 6 MAPIR High Level Scope for Connecticut Integration Activities 92. G 7 References 97, List of Figures, Figure 1 Percent of Connecticut Physicians using Technologies in their Practice 23.
Figure 2 National HIT Adoption by Office based Physicians in the United States 24. Figure 3 EHR Adoption by Office based Physicians in the United States 2001 2007 24. Figure 4 Governance Roles Matrix 33, Figure 5 SMHP Solution Architecture 36. Figure 6 Connecticut Medicaid Systems 37, Figure 7 Overview of the Major Information Flows 38. Figure 8 Statewide Health Information Exchange 39, Figure 9 HIT Evolution in the Next Five Years 59. Figure 10 The State s HIT Roadmap 61, Figure 11 Performance Framework Connecting HIT Outcomes 65. Figure 12 Moving Data to Action 67, State Medicaid Health Information Technology Plan November 2010 Page v.
List of Tables, Table 1 State of Health Connecticut and the U S 3. Table 2 Health Insurance Coverage in Connecticut and the Unites States 4. Table 3 Statewide ePrescriptions Refill Requests and Refill Responses Jan Sep. Table 4 Acute Care and Children s Hospitals in Connecticut 25. Table 5 Summation of Eligble Provider Analysis 26, Table 6 Medicaid HIT Strategic Goals for Connecticut 29. Table 7 Internal State Stakeholders 33, Table 8 External Stakeholders 34. Table 9 EHR Incentive Program Staffing 43, Table 10 Data Sources to Corroborate Hospital Patient Volume 47. Table 11 A I U Attestation Documentattion 48, Table 12 Data Sources to Determine Incentive Payments 50.
Table 13 Three Year Payout Schedule for Hospitals 51. Table 14 Risk Analysis Table Legend 62, Table 15 Risk Analysis Table 62. Table 16 Health Outcome Analytics Goals 66, Table 17 Incentive Program Implementation Performance Measures 68. Table 18 Annual Benchmarks for Strategic Objectives 69. Table 19 Annual Benchmarks for Audit and Oversight 71. Table 20 Program Activities and Schedule 87, Table 21 Eligible Providers and Associated Entities 96. State Medicaid Health Information Technology Plan November 2010 Page 1. Executive Summary, On February 17 2009 the American Recovery and Reinvestment Act of 2009 ARRA was. signed into law and established the framework of financial incentives to stimulate growth and. improve the health of the nation s economy and health care system ARRA defined specific. roles and incentives for the U S Department of Health and Human Services HHS and its. partner State Medicaid Agencies SMA in improving the nation s health care through the. Meaningful Use of Electronic Health Record EHR technologies i Two titles in ARRA Title. XIII Division A Health Information Technology and Title IV Division B Medicare and Medicaid. Health Information Technology comprise the Health Information Technology for Economic and. Clinical Health HITECH Act which provides unprecedented opportunities for states to plan. design and support providers in meaningfully using EHRs and Health Information Exchanges. HIEs to improve the health care quality and cost efficiency of its residents. To help guide State Medicaid Agencies planning efforts the Center for Medicaid and State. Operations CMSO within the Centers for Medicare, and Medicaid Services CMS issued a letter to state.
Medicaid directors on September 1 2009 The letter, provided initial guidance on section 4201 of ARRA Pub. L 111 5 which requires all SMAs to develop a State. Medicaid Health Information Technology Plan SMHP, and to establish a Medicaid EHR incentive payment. Meaningful Use, program to provide incentives for Eligible Professionals Adopt Implement Upgrade. Certified EHRs, EPs and hospitals to adopt and meaningfully use. EHRs to improve the health of its residents and quality. and efficiency of the health care system This guidance Eligibility. specifically required the submission of the Planning. Advance Planning Document P APD to obtain prior State Medicaid HIT Plan SMHP. approval and to secure 90 Federal financial, participation for the planning activities for the SMHP the Source CMS her Incentive Program Briefing EHR Incentive Program.
SMHP which outlines the approach to implement the EHR Final Rule Medicaid Provisions July 19 2010. incentive program and an Implementation Advance Planning Document I APD to request. enhanced funding for the administration of the project and the 100 federal funding of the. incentive payments themselves, On July 13 2010 CMS and the Office of the National Coordinator for Health Information. Technology ONC announced two complementary final rules to implement the EHR Incentive. Program under HITECH Act The CMS regulations specify the objectives that providers must. achieve to qualify for incentive payments States will be initiating their incentive programs on a. rolling basis subject to CMS approval of their State Medicaid HIT Plans which detail how each. state will implement and oversee the incentive programs The ONC regulations specify the. technical capabilities that EHR technology must have to be certified for Meaningful Use and to. support providers in achieving the Meaningful Use objectives. On August 17 2010 CMS issued a second letter to the state Medicaid directors providing more. detailed guidance to the Medicaid agencies regarding the implementation of Section 4201 of. ARRA Pub L 111 5 and CMS recently published regulations at 42 CFR Part 495 Subpart D. The letter also set stated CMS expectations relating to the activities and potential uses of 90. Federal Financial Participation FFP administrative matching funds 90 10 funds In order to. qualify for the 90 10 funds a state must at a minimum demonstrate to the satisfaction of the. Secretary compliance with three requirements, Administration of Medicaid incentive payments to Medicaid EPs and eligible hospitals. State Medicaid Health Information Technology Plan November 2010 Page 2. Oversight of the Medicaid EHR Incentive Program including routine tracking of. Meaningful Use attestations and reporting mechanisms and. Pursuit of initiatives that encourage the adoption of certified EHR technology for the. promotion of health care quality and the electronic exchange of health information. Connecticut Department of Social Services DSS staff have reviewed the final rules the State. Medicaid Directors letters and have actively participated in the CMS All States calls to. strengthen the State s understanding regarding the intent of the rule language and to ensure the. State s ability to successfully develop an EHR Incentive Program that meets the needs of. Connecticut and is in alignment with the rule, Connecticut s SMHP will provide CMS with an understanding of the activities the DSS expects. to undertake over the next five years as the Department implements Section 4201 Medicaid. provisions of the American Recovery and Reinvestment Act Specifically Connecticut s SMHP. constitutes a roadmap of how DSS expects to encourage administer and monitor incentive. payments to eligible providers EPs and hospitals The State s SMHP will detail the. components necessary to ensure that incentive program applicants that are able to demonstrate. eligibility receive timely and accurate incentive payments without duplication The SMHP for. Connecticut addresses how the Department will work with and support the statewide HIE. initiative The SMHP includes efforts that DSS will employ to work effectively with the Regional. Extension Center REC to promote EHR adoption and Meaningful Use. This SMHP is a collaborative effort that includes key DSS stakeholder in the EHR Incentive. Program the Department of Public Health the State Government HIT Coordinator the Regional. Extension Center and the Department of Information Technology. State Medicaid Health Information Technology Plan November 2010 Page 3. A Connecticut Background, A 1 State Demographics, A 1 1 Population. STATE OF CONNECTICUT DEPARTMENT OF SOCIAL SERVICES State Medicaid Health Information Technology Plan For the Health Information Technology Implementation

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