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Step 2: Create an SLR Account.

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Welcome to the State Level Registry (SLR) for the Medi-Cal Promoting Interoperability (PI) Program


The Medi-Cal PI Program is able to provide substantial financial incentives to health professionals and acute care hospitals to adopt, implement, upgrade and meaningfully use certified electronic health record technology. Professionals can receive up to $61,250 over 6 years and hospitals (depending on size) can receive up to $10-15 million over 4 years. As of June 2017, the program has distributed $1.4 billion in federal funding to over 22,000 health professionals and over 390 hospitals. The last year to begin the program was 2016, but previously enrolled professionals and hospitals may continue to receive incentive payments through 2021.


Important Program Changes due to the Coronavirus Pandemic

Despite having extended the deadline for 2019 MU attestations from March 31, 2020 to April 14, 2020, DHCS is aware that some providers may need additional time to submit 2019 attestations because of the COVID-19 crisis. For this reason, DHCS will consider extending the attestation deadline on a case-by-case basis for professionals whose 2019 attestations have been delayed because of the impact of the COVID-19 on their practices. Any professional wishing to request such an extension must make such a request to DHCS by sending an e-mail to Medi-Cal.EHR@dhcs.ca.gov by April 30, 2020. The request should specify the professional’s name and NPI and provide a brief explanation of why the COVID-19 has delayed the attestation. Extensions will be individually evaluated and will not exceed 6 weeks. Because of system limitations of the State Level Registry, professionals who have started a 2020 attestation or are in a group/clinic that has already begun attesting for 2020 will not be allowed to take advantage of this opportunity.
Beginning immediately, DHCS will accept e-signatures on attestations in lieu of physically-signed signatures. It is the responsibility of each practice organization to have controls in place to help assure that their staff use electronic signatures appropriately. If an electronic signature is provided for the eligible professional, the eligible professional must have approved its use. Documentation of this approval must be available for audit purposes.
DHCS realizes that the Coronavirus pandemic is an evolving crisis and will continue to adjust program policies as the need arises. We express our sincere appreciation for the vital work the healthcare community is doing throughout the State and the nation in this time of great need.

Important Information

2020 Attestations

Attestations for 2020 opened on April 15, 2020.
All providers will be able to use 90-day or longer reporting periods for both MU objectives and CQMs.
Attestations for the 2020 program year will be available for Stage 3 only.
Providers do not have to use 2015 CEHRT for the entire year, but must use 2015 CEHRT for the entire MU reporting period.
The 2020 prequalification list for clinics will not be available until July, 2020. However, DHCS plans to allow clinics to use an Interim 2020 prequalification list (based on the 2019 prequalification list) to initially register for 2020. However, payment will not be issued until eligibility is confirmed by the 2020 prequalification list or the clinic submits encounter data to prove eligibility.
The 2020 prequalification list for professionals is available to be accessed.


2019 Attestations

Attestations for 2019 will close on April 14, 2020. Providers experiencing technical problems that prevent attestation should open a ticket with the SLR Help Desk by this date. Having such a ticket open by this date may enable DHCS to grant an extension based on technical grounds. However, extensions for non-technical reasons will not be granted.
Attestations for the 2019 program year will be available for Stage 3 only.
All providers will have a minimum 90-day MU reporting period.
Providers do not have to use 2015 CEHRT for the entire year, but must use 2015 CEHRT for the entire MU reporting period.
Providers that have not reported MU previously will have a minimum 90-day CQM reporting period, and providers that have reported MU previously will have an entire calendar year CQM reporting period.
Only hospitals that successfully attested to MU in 2018 and have not completed their four years of eligibility are able to attest to MU for 2019.
Only professionals that successfully attested to AIU or MU in the past are able to attest to MU for 2019.
The 2019 clinic prequalification list is available and is also accessible on the DHCS website.
The 2019 prequalification list for professionals is available and is also accessible on the DHCS website.


MU Documentation Requirements

Beginning in the 2019 Program Year, DHCS requires that documentation supporting meaningful use (MU) attestations be uploaded into the State Level Registry (SLR) before a MU attestation can be reviewed and approved. This documentation should include a copy of the MU dashboard report including data for both objectives and CQMs produced by the electronic health record or an equivalent data source. The documentation should also include a copy of the Security Risk Analysis (SRA) or a signed letter describing the SRA. Click here for further information about the SRA documentation. Any upload button in the SLR can be used for this purpose. Upload buttons can be found at the bottom of every MU objective page.
Alternatively, documentation for individual professionals in a group/clinic can be uploaded into the group/clinic SLR account, as long as separate MU data is provided for each professional. In the case of a group/clinic, the SRA documentation does not have to be specific for each professional. Providers in a group/clinic should speak with their group/clinic representative regarding uploading MU documentation into the group/clinic SLR account.


Internet Explorer Browser Problem

Although the SLR will operate properly using Internet Explorer, the ONC CHPL website will not. For this reason, it is recommended that attestation be submitted in SLR using Edge, Chrome, Firefox or other more up to date browsers.


SLR Helpdesk Phone Number and e-mail Change

On October 1, 2019 the phone number and email for the SLR Helpdesk were changed to the following:
•  Phone (855) 649-7806
•  E-mail: CASLRSupport@us.ibm.com


Greenway Health EHR

In December 2018 Greenway notified users of its SuccessEHS, Intergy, and Prime Suite EHRs that some data reported for meaningful use (MU) attestations was incorrect. DHCS, following guidance from CMS, continued to accept MU attestations from Greenway EHR users with the understanding that Greenway would subsequently provide software updates that would allow users to submit corrected data for 2018. Updated software for the Intergy EHR became available from Greenway on August 16, 2019.
SuccessEHS users will be able to attest for 2019, but must use other certified electronic health record technology (CEHRT). DHCS expects Intergy and Prime Suite EHRs to be capable of correctly reporting MU data for 2019 attestations. However, providers should contact their Greenway representatives regarding the capabilities of their EHRs for 2019 attestations.


Audits

DHCS is required to conduct audits of hospitals and providers who receive EHR incentive payments for AIU or MU. Hospitals and providers should retain documentation supporting their attestations for at least seven years in case of an audit.
Hospitals: DHCS began auditing hospital AIU incentive payments in September 2015. The EHR audits are scheduled in the same manner as the Medi-Cal cost report audits. To the extent possible, the EHR audits will be combined with the cost report audits to minimize disruption to the hospital’s operations and staff.
Based on recent clarification and approval received from the Centers for Medicare and Medicaid Services (CMS), DHCS revises its EHR Incentive Program auditing standards as described below. These changes will apply both retroactively and going forward.
Administrative bed days are counted as acute inpatient bed days when calculating the Medicaid Share.
Psychiatric and rehabilitation bed days and discharges with care occurring in beds that would be paid under IPPS for Medicare patients are counted as acute inpatient bed days and discharges. Psychiatric and rehabilitation bed days and discharges with care occurring in beds that would not be paid under IPPS for Medicare patients are not counted as acute inpatient bed days or discharges.
DHCS has also clarified its auditing standards for Nursery Bed Days as follows.
Nursery bed days and discharges for sick children with care billed under codes 172-174 may be counted as acute inpatient bed days and discharges. In the past, only nursery bed days billed under code 174 could be counted as acute inpatient bed days or discharges.
Hospitals that have already been audited will, if appropriate, receive revised audit statements reflecting these changes. Hospitals with pending appeals should consult with their legal counsel regarding the relevance of these changes to their appeals.
Professionals: DHCS recently began auditing the meaningful use attestations of selected professionals.



California Technical Assistance Program (CTAP)--In November, 2015 the California Technical Assistance Program was launched with $37.5 million in federal and state funds. This program is designed to continue the work of the Regional Extension Center Program which has provided assistance to over 12,000 professionals in adopting, implementing, upgrading and meaningfully using certified electronic health record technology. The CTAP program is designed to deliver free services to assist an additional 7,500 professionals, with special emphasis on solo practitioners and specialists. The four CTAP organizations can be accessed by clicking on the links below..

Important Web Resources (all links open in new window)