As part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), the EHR Incentive Program (also known as Meaningful Use) will sunset and be replaced with the Advancing Care Information (ACI) performance category under the new Quality Payment Program.
The Advancing Care Information category is weighted as 25% of the final score. Eligible clinicians (ECs) will need to meet five required measures for a minimum of 90 days. These include:
- Security Risk Analysis – Addressing the security of electronic protected health information (ePHI), including: encryption, implementing security updates and correcting identified security deficiencies.
- e-Prescribing – At least one permissible prescription written by the EC is queried for a drug formulary and transmitted electronically using Certified EHR Technology (CEHRT).
- Provide Patient Access – For at least one unique patient seen by the EC:
- The patient (or patient-authorized representative) is provided timely access to view online, download, and transmit his or her health information; and
- The EC ensures the patient’s health information (PHI) is available for the patient (or patient-authorized representative) to access using any application of their choice that is configured to meet the technical specifications of the Application Programing Interface (API) in the EC’s certified EHR technology.
- Send Summary of Care – For at least one transition of care or referral, the EC that transitions or refers their patient to another setting of care or health care provider:
- Creates a summary of care record using certified EHR technology; and
- Electronically exchanges the summary of care record.
- Request/Accept Summary of Care – For at least one transition of care or referral received or patient encounter in which the EC has never before encountered the patient, the EC receives or retrieves and incorporates into the patient’s record an electronic summary of care document.
ECs may earn additional credit if they choose to submit additional measures. These include:
- Report Public Health and Clinical Data Registry Reporting measures
- Use certified EHR technology to report quality improvement activities from the improvement activities performance category
Don’t have Certified EHR Technology (CEHRT)?
MIPS eligible clinicians that do not have CEHRT may have their score reweighted for the following reasons:
- They apply for reweighting citing one of three specified reasons:
- Insufficient Internet Connectivity
- Extreme and Uncontrollable Circumstances
- Lack of Control over the Availability of CEHRT
These ECs must submit an application for CMS to reweight the ACI performance category to 0%.
- They are one of the following ECs that qualify for an automatic reweighting:
- Physician Assistants
- Hospital-based clinicians
- Nurse Practitioners
- Certified Registered Nurse Anesthetists
- Clinical Nurse Specialists
- Clinicians who lack face-to-face interactions with patients
These ECs can still choose to report, and if data is submitted, CMS will score their performance and weight their ACI performance accordingly.
For these two groups of ECs, CMS will reweight the category to 0% and assign the 25% to the Quality performance category to give participants the potential to earn up to 100 points in the MIPS Final Score.
For additional information and an in-depth description of the Advancing Care Information Performance Category Measures and Scores, follow these links:
- CMS Advancing Care Information Performance Category Fact Sheet
- CMS Advancing Care Information Website
How do ECs report?
MIPS ECs will be able to report ACI measures and objectives if they have:
- Technology certified to the 2015 Edition, or
- A combination of 2014 and 2015 certified technology Editions
For 2017, ECs can report ACI transition measures and objectives if they have:
- A certified 2015 technology Edition, or
- A certified 2014 technology Edition, or
- A combination of the 2014 and 2015 certified technologies Editions.
If you’re uncertain about the certification of your EHR, visit HealthIT.gov and use their tool to determine your EHR certification year through vendor and module selection.
What if I Don’t have the CEHRT to report ACI Measures and Objectives?
If you are an eligible provider, you may be able to submit a Hardship form. If approved, the exemption is only valid for one payment year and you will need to submit a new application for additional years. Follow these links for Hardship Instructions and Applications:
- CMS Payment Adjustments & Hardship Information
- Medicare EHR Incentive Program Hardship Exception Instructions
- Medicare EHR Incentive Program Hardship Exception Application
The deadline for submitting Hardship forms for 2017 ECs Transitioning to MIPS if you’ve never successfully attested to Meaningful Use and based on the 2016 EHR reporting period is October 1, 2017.
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