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The committee met to consider the following agenda items.
 
State and Federal Developments (Melanie Williams, Director e-Health Coordinator,HHSC)

  • HB 2641 – addresses HIE; made it explicit certain health reporting programs now have permission to address extending Medicaid reimbursement until September 2019
  • SB 195 – info for prescription drug monitoring program; recently transferred to pharmacy board
  • SB 200 – could potentially abolish the Medicaid Health Information Exchange Advisory Committee; the committee has requested that support be given to keep the advisory committee intact and prevent its dissolution
    • A rulemaking process must be created for re-established advisory committees; rules must be developed by March 1, 2016; all re-established advisory committees meetings must be live streamed and provide online access to meeting materials
  • US House approved 21st Century Cures Act
  • HIE IAPD – requested $4,596,413 from Medicaid HIE 901/10 CMS funding to support 3 strategies
  • ONC “Advanced Interoperable HIT Services to Support HIE FAO” – awards grants to 10-12 states to provide training to integrate HIE into existing workflows; total of $28 million available; $1-3 million per award

 
Health and Human Services HIE

  • The OeHC is engaged in Data Asset Inventory and Interoperability Planning effort with the office of the CDO
    • Defines the interoperability plan as enterprise-level, and the scope of the first year plan to document the “as-is” environment
    • The plan will include Enterprise Data Inventory Information and Capability Analysis
    • A draft of the Enterprise Interoperability Plan is due to HIE Advisory Committee by December 31, 2015

 
Statewide HIE Activities (Tony Gilman, CEO, Texas Health Services Authority)

  • HIETexas Statewide HIE 2015 Metrics
    • Query (Pull) – 3,539 physicians active; 68 hospitals active; 551 other providers active; 17,023 patient record queries
    • Direct (Push) – 3,507 physicians active; 79 hospitals active; 168 other providers active; 23,461 direct transactions
  • Rural White Space Request for Application
    • THSA re-released RFA in January to award $300,00 to fund four B&O plans in Texas White Space
    • THSA has contracted with Healthcare Access San Antonio to complete a West Texas HIE readiness assessment; may explore other options to support West Texas connectivity with CommonWell Health Alliance

 
Electronic Health Record Incentive Program and Meaningful Use (Deb Norris, Project Manager, CHIP Division)

  • June 2015 Metrics
    • $753.5 million in HER incentives paid; 332 Eligible Hospitals; 8,472 Eligible Professionals; 284 EHs paid for at least one year of meaningful use; 3,288 EPs paid for at least one year of meaningful use
    • EP attest deadline – 1,000 EPs attested in the last 3 weeks prior to deadline; 32% of EPs attesting in 2014 used the Flex Rule; 69% of EPs attested to full implementation of 2014 CEHRT; 56% of EPs scheduled for Stage 2 attested to Stage 2; 44% of EPs scheduled for Stage 2 attested to Stage 1 using the Flex Rule
  • Medicaid Enrollment – providers must be enrolled in Medicaid to participate in HER Inventive Program; providers must submit Medicaid enrollment application by December 31 of the program year
  • 2015 MU Modifications Proposed Rule
    • Proposed rule aims to align Stages 1 and 2 with proposed Stage 3
    • Allows 90 day MU reporting period for all program participants in 2015
    • Aligns hospital reporting to the calendar year instead of federal fiscal year
    • Removes MU measures that are redundant or topped out
    • Removes distinction between “Core” and “Menu” measures; all retained measures are from Stage 2 and are required
    • EPs who are scheduled for Stage 1 in 2015can take exclusions/alternates for some measures that were part of Stage 2 only
    • In 2016, all EPs, regardless of stage, must meet the Stage 2 measures
  • PH reporting – proposes to align with Stage 3 version of PH objectives for 2015-17
    • Clinical data registry reporting included in PH objective; allows reporting to multiple CDRS to meet required number of measures in the objective
    • Patient engagement – VDT measure changed from 5% of patients to 1 patient must VDT his health info during reporting period
    • Secure electronic messaging – changed from 5% of patients must send secure message to “functionality must be enabled”
    • No Medicare attestations allowed for 2015 until January 1, 2016
    • PY 2015 attestation deadline to avoid Medicare payment penalties is February 29, 2016 for EPs and EHs
    • CMS expects to issue final rule in late summer/early fall
    • HHSC plans to extend PY 2015 Medicaid incentive attestation deadline to March 31, 2016 for EPs/EHs

 
Texas Medicaid Health IT – Outreach

  • Barrier Survey – Preliminary Survey Findings
    • Barrier Survey Response Rates – NLR 15%; AIU 12.9%; MU 30%; Total 18.9%
    • Barrier Survey Practice Size Factor –
      • NLR – 46% 1-5 providers; 6% 6-50 providers; 48% 51+ providers
      • AIU – 70% 1-5 providers; 18% 6-50 providers; 12% 51+ providers
      • MU – 53% 1-5 providers; 12% 6-50 providers; 35% 51+ providers
  • HER-IP Enrollment
    • Medicaid EP can skip attestation years
    • 2016 is final year to enter into Medicaid HER Incentive Program by attesting for AIU
    • According to surveys, 96% NLR plan to attest for AIU by 2015
    • 2011-15 AIU to MU1 is 47%
  • 47% of HER-IP enrollees have achieved MU
  • The Barrier Survey identified MU measures for outreach to strategize aid attestation
  • Outreach strategies need to shift sustainability – providers who are continuous adapt faster

 
Update on International Classification of Disease, 10th Ed. (ICD-10) for Compliance Date – October 1, 2015 (Carol Vasquez, Project Manager, HHSC)

  • The ICD-10-CM final rule adopts new diagnosis and procedure coding (ICD-10-PCS); these codes will replace ICD-9-CM)
  • The final rule compliance date is October 1, 2015
  • Implementing a full remediation solution enables support for ICD -9/ICD-10 codes, based on DOS and/or date of discharge
  • No need to capture submitted data vs. processed data
  • Bills to watch
    • HR 2652 – 24 month grace period for coding mistakes due to transition to ICD-10; HHS Secretary must assist providers in their implementation; study effects of ICD-10 on providers and physicians by Comptroller General must be released April 1, 2016
    • HR 2247 – 18 month transitional period after 10/1/15 compliance date prohibits denials for minor coding mistakes
    • HR 2126 – prohibits HHS Secretary from replacing ICD-9 with ICD-10

 
 
Patient Matching in Health Information Exchanges (Katherine Lusk, MHSM, RHIA)

  • Problems
    • HIE interoperability current manual clean up is not financially sustainable; no national patient identifier; incomplete information with treatment; inaccurate information with treatment; potential privacy breach
  • Resolving Problems
    • Utilize data captured with other business functions for linking; increase data attributes; capture/store data in standard format; eliminate free text except name; use standard naming convention practices
  • Recommendations
    • Utilizing an incremental adoption, phased approach that is patient centered and vendor neutral
    • Adopt standard definitions
    • Adopt standard naming conventions