The Centers for Medicare and Medicaid Services has published its final guidance to state Medicaid directors on what they can expect from the federal government in terms of funding support for their health IT activities, clearing the way for them to start-up programs for the adoption and meaningful use of electronic health records.
In a letter published Aug. 17, CMS laid out three minimum requirements that states have to meet in order to qualify for a 90 percent federal financial participation (FFP) match for any state administrative expenses tied to EHR activities.
States are already guaranteed a 100 percent FFP for incentive payments to eligible Medicaid providers to adopt and meaningfully use EHRs under ARRA.
To get the 90 percent FFP match, states must:
- Get approval of design, development and set-up of any systems and processes they need to administer the EHR incentive program effectively.
- Oversee the program adequately, ensuring that it meets all statutory and regulatory requirements and is started up in a way to minimize the potential for fraud, waste and abuse.
- Actively pursue initiatives that encourage the adoption of certified EHR technology and health information exchange.
However, CMS officials are urging states to be creative in how they use all their available Medicaid funding. For example, money provided for Medicaid Management Information Systems (MMIS) could be also be used for HITECH Act EHR incentive programs, they said.
"We think that, if you can do somethings with MMIS funding related to HITECH then you should go ahead and do it," Rick Friedman, the director of the CMS division of state systems, told the audience at a session at the MMIS 2010 conference held in Portland, Ore., this week.
"We think those should be integrated, as they introduce quality measures into the program and help bring providers into meaningful use," he said.
Friedman also reminded the audience that CMS desires all future MMIS development to hew toward the Medicaid Information Technology Architecture (MITA), which CMS is pushing as a standardized framework that all states can use to help improve their Medicaid systems development and health care management.
Jessica Kahn, CMS' technical director for Health IT, told the same MMIS 2010 session that these efforts have strong backing from the administration.
"The Office of Management and Budget has finally seen the light [on allocation of costs] and is willing to work with us on that," she said. "The states have the responsibility to come up with the details, and then we will work with each state," on cost allocations.
However, she urged states not to wait until all the details have been worked out before ramping up their EHR incentive programs. In fact, the letter to state Medicaid directors specifically says that CMS expects that states will take an incremental approach.
"Don't wait until you have all of the answers," she told the conference audience.
