D.C. Mun. Regs. tit. 29, r. 29-8900

Current through Register Vol. 71, No. 49, December 6, 2024

Rule 29-8900 - PROVIDER ELIGIBILITY

8900.1

The Department of Health Care Finance (DHCF) shall administer the Medicaid Electronic Health Record Incentive Payment Program (MEIP), which provides incentive payments to certain eligible providers participating in the District of Columbia Medicaid program as they adopt, implement, upgrade, or demonstrate meaningful use of certified Electronic Health Record (EHR) technology.

8900.2

The following providers shall be eligible for participation in MEIP:

(a) Eligible professionals as identified in Subsection 8900.3; and

(b) Eligible hospitals as identified in Subsection 8900.5.

8900.3

An eligible professional shall be one (1) of the following:

(a) A physician licensed in accordance with the District of Columbia Health Occupations Revision Act of 1985, effective March 25, 1986 (D.C. Law 6-99; D.C. Official Code §§ 3-1201et seq. (2007 Repl. & 2012 Supp.));

(b) A dentist licensed to engage in the practice of dentistry as defined by § 102(5) of the District of Columbia Health Occupations Revision Act of 1985, effective March 25, 1986 (D.C. Law 6-99; D.C. Official Code §§ 3-1201et seq. (2007 Repl. & 2012 Supp.));

(c) A certified nurse midwife licensed as an advanced practice registered nurse pursuant to the District of Columbia Health Occupations Revision Act of 1985, effective March 25, 1986 (D.C. Law 6-99; D.C. Official Code §§ 3-1201et seq. (2007 Repl. & 2012 Supp.)), and certified by the American Midwifery Certification Board (AMCB);

(d) A nurse practitioner licensed as an advanced practice registered nurse pursuant to the District of Columbia Health Occupations Revision Act of 1985, effective March 25, 1986 (D.C. Law 6-99; D.C. Official Code §§ 3-1201et seq. (2007 Repl. & 2012 Supp.)); or

(e) A physician's assistant, licensed in accordance with the District of Columbia Health Occupations Revision Act of 1985, effective March 25, 1986 (D.C. Law 6-99; D.C. Official Code §§ 3-1201et seq. (2007 Repl. & 2012 Supp.)), who practices in a Federally Qualified Health Center (FQHC).

8900.4

Consistent with the requirements of Subsection 8900.3, an eligible professional shall not be hospital-based, unless the professional's eligibility for incentive payments is based on practice at a FQHC.

8900.5

An eligible hospital shall be one (1) of the following:

(a) An acute care hospital located in the District of Columbia; or

(b) A children's hospital located in the District of Columbia.

8900.6

For each year of MEIP participation, an eligible provider shall meet all of the following requirements:

(a) Have no current or pending sanction identified by the United States Department of Health and Human Services, Office of Inspector General or the District of Columbia list of excluded providers;

(b) Declare the intent to participate by electronically registering with the CMS using the Medicare and Medicaid electronic health record incentive program registration and attestation website;

(c) Use the District of Columbia State Level Registry to attest to the provider's qualifications to receive the incentive payment; and submit an electronic copy of a signed attestation form at http://dc.arraincentive.com;

(d) Meet Medicaid patient volume requirements consistent with the requirements of Section 8901, "Methodology for Volume Requirements", and the District of Columbia State Medicaid Health Information Technology Plan (SMHP);

(e) Submit a Certified Health IT Product List (CHPL) Product Number; and

(f) Declare, if applicable, the intent to reassign incentive payments to a third party subject to the requirements of 42 C.F.R. § 495.10(f).

8900.7

For the first year of MEIP participation, an eligible provider shall meet the requirements of Subsection 8900.6 and meet one (1) of the following conditions:

(a) Demonstrate and attest to adopting, implementing or upgrading EHR technology as defined in 42 C.F.R. § 495.302 that has been certified by the Office of the National Coordinator for Health Information Technology; or

(b) Demonstrate that it is a meaningful EHR user as defined in 42 C.F.R. § 495.4.

8900.8

An eligible provider that demonstrates and attests to adopting, implementing or upgrading EHR technology in accordance with Subsection 8900.7 shall report which certified EHR technology they have adopted, implemented or upgraded to and provide supporting documentation (e.g., purchase receipts or other proof of good faith payment between purchaser and seller, or proof of binding contract) in a manner specified by DHCF.

8900.9

In the second, third, fourth, fifth, and sixth year of MEIP participation, an eligible provider shall satisfy all of the following criteria:

(a) Meet the requirements of Subsection 8900.6;

(b) Demonstrate that it is a meaningful EHR user as defined in 42 C.F.R. § 495.4; and

(c) Use certified EHR technology interoperable with the system designated by the District to report clinical quality measures.

D.C. Mun. Regs. tit. 29, r. 29-8900

Final Rulemaking published at 61 DCR 237 (January 10, 2014)

Authority: An Act to enable the District of Columbia to receive Federal financial assistance under Title XIX of the Social Security Act for a medical assistance program, and for other purposes, approved December 27, 1967 (81 Stat.744; D.C. Official Code § 1-307.02 (2013 Supp.)), and Section 6(6) of the Department of Health Care Finance Establishment Act of 2007, effective February 27, 2008 (D.C. Law 17-109; D.C. Official Code § 7-771.05(6) (2012 Repl.)).