Section 1200-13-18-.06 - ELECTRONIC HEALTH RECORD INCENTIVE PROGRAM (EHR-IP)(1) An approved provider of TennCare services, upon receipt of a notice of action, may appeal the following issues related to the EHR-IP: (a) Denial of an incentive payment;(b) Incentive payment amount;(c) Determination of eligibility for an incentive payment, including but not limited to measurement of patient volume;(d) Determination of efforts to adopt, implement or upgrade to certified EHR technology during the first year of the EHR-IP or meaningful use of certified EHR technology in subsequent years;(e) Whether the provider is hospital-based;(f) Whether the provider is practicing predominantly in an FQHC or RHC;(g) Whether a hospital qualifies as an acute care or children's hospital; or,(h) Whether the provider is already participating in the Medicare incentive program or in the Medicaid incentive program of another state and therefore is ineligible for duplicate TennCare incentive program payments.(2) Each notice of action sent to a provider of a determination of any matter listed in paragraph (1) shall contain the following:(a) The contact information to reach an individual knowledgeable about the EHR-IP who is authorized to discuss the determination with which the provider disagrees;(b) The manner by which the provider may submit additional information to support his disagreement with the determination; and(c) A statement that the provider has the right to appeal the determination with which he disagrees and the manner in which an appeal must be filed.(3) Any appeal of a notice of action shall be conducted according to rule .01 of this chapter.Tenn. Comp. R. & Regs. 1200-13-18-.06
Emergency rule filed February 18, 2011; effective through August 17, 2011. Original rule filed May 18, 2011; effective August 16, 2011.Statutory Authority: T.C.A. §§ 4-5-202, 71-5-105 and 71-5-109.