Merit-Based Incentive Payment System (MIPS) Promoting Interoperability Performance Category Measure 2018 Performance Period
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1 Merit-Based Incentive Payment System (MIPS) Promoting Interoperability Performance Category Measure 2018 Performance Period Objective: Measure: Measure ID: Public Health and Clinical Data Registry Reporting Immunization Registry Reporting The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data and receive immunization forecasts and histories from the public health immunization registry/immunization information system (IIS). PI_PHCDRR_1 Definition of Terms Active engagement The MIPS eligible clinician is in the process of moving towards sending "production data" to a public health agency or clinical data registry, or is sending production data to a public health agency (PHA) or clinical data registry (CDR). Active engagement may be demonstrated in one of the following ways: Option 1 Completed Registration to Submit Data: The MIPS eligible clinician registered to submit data with the PHA or, where applicable, the CDR to which the information is being submitted; registration was completed within 60 days after the start of the MIPS performance period; and the MIPS eligible clinician is awaiting an invitation from the PHA or CDR to begin testing and validation. This option allows MIPS eligible clinicians to meet the measure when the PHA or the CDR has limited resources to initiate the testing and validation process. MIPS eligible clinicians that have registered in previous years do not need to submit an additional registration to meet this requirement for each MIPS performance period. Option 2 Testing and Validation: The MIPS eligible clinician is in the process of testing and validation of the electronic submission of data. MIPS eligible clinicians must respond to requests from the PHA or, where applicable, the CDR within 30 days; failure to respond twice within a MIPS performance period would result in that MIPS eligible clinician not meeting the measure. 1
2 Option 3 Production: The MIPS eligible clinician has completed testing and validation of the electronic submission and is electronically submitting production data to the PHA or CDR. Production data Refers to data generated through clinical processes involving patient care, and it is used to distinguish between data and test data which may be submitted for the purposes of enrolling in and testing electronic data transfers. Reporting Requirements YES/NO The MIPS eligible clinician must attest YES to being in active engagement with a PHA to submit immunization data and receive immunization forecasts and histories from the public health immunization registry/immunization information system (IIS). Scoring Information BASE SCORE/PERFORMANCE SCORE/BONUS SCORE Required for the Base Score: No Percentage of Performance Score: 10% for reporting to a single registry Eligible for Bonus Score: Yes, 5% as long as credit not received under the performance score One-time bonus of 10% for MIPS eligible clinicians and groups who report using 2015 Edition CEHRT exclusively for the 2018 performance period and submit only Promoting Interoperability measures. Note: MIPS eligible clinicians must fulfill the requirements of base score measures to earn a base score in order to earn any score in the Promoting Interoperability performance category. In addition to the base score, MIPS eligible clinicians have the opportunity to earn additional credit through the submission of performance measures and a bonus measure and/or activity. Additional Information MIPS eligible clinicians can report the Promoting Interoperability objectives and measures if they have technology certified to the 2015 Edition, or a combination of technologies from the 2014 and 2015 Editions that support these measures. More information about Promoting Interoperability scoring is available on the QPP website. In order to meet this measure, the following information must be made available to patients electronically: 2
3 The patient must be able to access this information on demand, such as through a patient portal or personal health record (PHR) or by other online electronic means. We note that while a covered entity may be able to fully satisfy a patient's request for information through view, download or transmit (VDT), the measure does not replace the covered entity's responsibilities to meet the broader requirements under HIPAA to provide an individual, upon request, with access to PHI in a designated record set. Active engagement with a public health or clinical data registry or registries that is/are different from the agency or registry that a MIPS eligible clinician identified to earn a performance score will earn the MIPS eligible clinician a bonus of 5 percentage points. However, a MIPS eligible clinician cannot receive credit under both the performance score and bonus score for reporting to the same public health agency or registry. For the measure, a MIPS eligible clinician s health IT system may layer additional information on the immunization history, forecast, and still successfully meet this measure. Bi-directionality provides that certified health IT must be able to receive and display a consolidated immunization history and forecast in addition to sending the immunization record. MIPS eligible clinicians who have previously registered, tested, or begun ongoing submission of data to registry do not need to restart the process. When MIPS eligible clinicians choose to report as a group, data should be aggregated for all MIPS eligible clinicians under one Taxpayer Identification Number (TIN). This includes those MIPS eligible clinicians who may qualify for reweighting such as a significant hardship exception, hospital or ASC-based status, or in a specialty which is not required to report data to the Promoting Interoperability performance category. If these MIPS eligible clinicians choose to report as a part of a group practice, they will be scored on the Promoting Interoperability performance category like all other MIPS eligible clinicians. Regulatory References For further discussion, please see the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) final rule: 81 FR In order to meet this objective and measure, a MIPS eligible clinician must use the capabilities and standards of CEHRT at 45 CFR (f)(1), (f)(6) and (f)(7). Certification and Standards Criteria Below is the corresponding certification and standards criteria for electronic health record technology that supports achieving the meaningful use of this measure. 3
4 Certification Criteria* (f)(1) Public Health Transmission to Immunization Registries (i) Create immunization information for electronic transmission in accordance with: (A) The standard and applicable implementation specifications specified in (e)(4). (B) At a minimum, the version of the standard specified in (e)(3) for historical vaccines. (C) At a minimum, the version of the standard specified in (e)(4) for administered vaccines. (ii) Enable a user to request, access, and display a patient's evaluated immunization history and the immunization forecast from an immunization registry in accordance with the standard at (e)(4) (a)(3)(4) Logical Observation Identifiers Names and Codes (LOINC ) Database version 2.40, a universal code system for identifying laboratory and clinical observations produced by the Regenstrief Institute, Inc. (incorporated by reference in ) (c)(2)(3) Logical Observation Identifiers Names and Codes (LOINC ) Database version 2.52, a universal code system for identifying laboratory and clinical observations produced by the Regenstrief Institute, Inc. (incorporated by reference in ). *Depending on the type of certification issued to the EHR technology, it will also have been certified to the certification criterion adopted at 45 CFR (g)(1), (g)(2), or both, in order to assist in the calculation of this meaningful use measure. 4
5 Standards Criteria (e)(3) Electronic submission to immunization registries (e)(4) Electronic submission to immunization registries HL (incorporated by reference in ). Implementation specifications. HL Implementation Guide for Immunization Messaging, Release 1.4, (incorporated by reference in ). HL (incorporated by reference in ). Implementation specifications. HL Implementation Guide for Immunization Messaging, Release 1.5 (incorporated by reference in ) and HL7 Version Implementation Guide for Immunization Messaging (Release 1.5) Addendum, July 2015 (incorporated by reference in ) (a)(3) HL7 Implementation Guide for CDA Release 2: IHE Health Story Consolidation. The use of the unstructured document document-level template is prohibited (a) Applicability Statement for Secure Health Transport (g) The data and time recorded utilize a system clock that has been synchronized following (RFC 1305) Network Time Protocol, or (RFC 5905) Network Time Protocol Version 4. Additional certification and standards criteria may apply. Review the ONC 2015 Edition Final Rule for more information. 5
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