[{"state":"Alabama","policy_lever":"Accountable Care Arrangements","activity_status":"Proposed","activity_description":"Alabama Medicaid Agency (AMA) proposes to create funding pools under the Demonstration that support the development, transition and maintenance of a coordinated care delivery system through the regional care organizations (RCOs), and to provide a mechanism for investments in delivery system reform. The funding pools will have three distinct components for which federal financial participation is requested: (1) funding for designated state health programs (DSHP), (2) transition payments to RCOs, hospitals, and other eligible providers to cover costs associated with transitioning to the RCO model, and (3) a delivery system reform incentive payment (DSRIP) program for RCOs, hospitals, and other eligible providers that will better align provider payment with the value of care.","source":"Section 1115 Demonstration Proposal Alabama Medicaid Transformation","source_url":"http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/al/al-medicaid-transformation-pa.pdf"},{"state":"Alabama","policy_lever":"Medicaid State Plan Amendments (SPA)","activity_status":"Actual","activity_description":"Alabama's Medicaid Health Home SPA targets individuals with a single behavioral health issue, two chronic conditions; or one chronic condition and the risk of developing another from the following list of conditions: Mental Health Condition, Substance Use Disorder, Asthma, Diabetes, Heart Disease, Transplants, Cardiovascular Disease, Chronic Obstructive Pulmonary Disease, Cancer, HIV and Sickle Cell Anemia.  Alabama utilizes MMIS and the Care Management Information System to identify patients meeting health home criteria. The state currently requires an integrated medical record but not an electronic continuity of care record. Alabama also uses web-based tools, a HIPAA-client portal, home monitoring (Real-time Medical Electronic Data Exchange (RMEDETM) system and an interactive voice response system (IVR). The state is planning to implement use of \"One Health Record\" [the state's HIE] when national standards are finalized. Once One Health Record is operational the state will consider possible sharing of consent forms and encouragement of all providers types (SA, CMHCs and ADPH) to connect to One Health Record.  Building off the work of Q-Tool, the infrastructure for One Health RecordTM and the infrastructure for Meaningful Use will be utilized for the Patient 1st Program, including a HIPAA-client portal that enables providers to view paid claims data submitted for an enrollee by any provider. The portal will provide access to hospital emergency department services claims data, specific preferred drug lists (PDL), prescription information for an individual enrollee, information regarding whether a prescription meets requirement for Medicaid payment. Providers will be able to transmit a prescription electronically to the enrollee's pharmacy of choice, review laboratory data and determine medication adherence information. Enhancements under consideration specifically address the opportunity for a unified web-based assessment tool, particularly related to mental health and substance use.","source":"Medicaid Approved Health Home State Plan Amendments: (Filter by State; Search term= Health Home) AL 14-001 Approval Date 3-04-15.","source_url":"http://www.medicaid.gov/state-resource-center/medicaid-state-plan-amendments/medicaid-state-plan-amendments.html"},{"state":"Alabama","policy_lever":"Medicaid Waivers and Demonstrations","activity_status":"Proposed","activity_description":"The State of Alabama Medicaid Agency (AMA) is seeking approval of a Section 1115 Demonstration Project to implement versions of CMS accountable care organizations, regional care organizations (RCOs), to improve care coordination and outcomes and ensure the long-term sustainability of Alabama?s Medicaid program. Providers affiliated with RCOs will be expected to use the standardized continuity of care record, which will be a component of the providers? certified electronic health record. If the provider does not have a certified electronic health record, the health information exchange will accommodate a variety of interchange formats via a software based bridge. Ultimately, real-time access to data will support providers in predicting, planning for, and intervening when necessary in a beneficiary?s case management plan.","source":"Section 1115 Demonstration Proposal Alabama Medicaid Transformation","source_url":"http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/al/al-medicaid-transformation-pa.pdf"},{"state":"Alabama","policy_lever":"State Appropriated Funds","activity_status":"Proposed","activity_description":"Alabama Medicaid Agency (AMA) proposes to create funding pools under the Demonstration that support the development, transition and maintenance of a coordinated care delivery system through the regional care organizations (RCOs), and to provide a mechanism for investments in delivery system reform. The funding pools will have three distinct components for which federal financial participation is requested: (1) funding for designated state health programs (DSHP), (2) transition payments to RCOs, hospitals, and other eligible providers to cover costs associated with transitioning to the RCO model, and (3) a delivery system reform incentive payment (DSRIP) program for RCOs, hospitals, and other eligible providers that will better align provider payment with the value of care.","source":"Section 1115 Demonstration Proposal Alabama Medicaid Transformation","source_url":"http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/al/al-medicaid-transformation-pa.pdf"},{"state":"Alabama","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"Alabama's Medicaid Health Home SPA targets individuals with a single behavioral health issue, two chronic conditions; or one chronic condition and the risk of developing another from the following list of conditions: Mental Health Condition, Substance Use Disorder, Asthma, Diabetes, Heart Disease, Transplants, Cardiovascular Disease, Chronic Obstructive Pulmonary Disease, Cancer, HIV and Sickle Cell Anemia.  Alabama utilizes MMIS and the Care Management Information System to identify patients meeting health home criteria. The state currently requires an integrated medical record but not an electronic continuity of care record. Alabama also uses web-based tools, a HIPAA-client portal, home monitoring (Real-time Medical Electronic Data Exchange (RMEDETM) system and an interactive voice response system (IVR). The state is planning to implement use of \"One Health Record\" [the state's HIE] when national standards are finalized. Once One Health Record is operational the state will consider possible sharing of consent forms and encouragement of all providers types (SA, CMHCs and ADPH) to connect to One Health Record.  Building off the work of Q-Tool, the infrastructure for One Health RecordTM and the infrastructure for Meaningful Use will be utilized for the Patient 1st Program, including a HIPAA-client portal that enables providers to view paid claims data submitted for an enrollee by any provider. The portal will provide access to hospital emergency department services claims data, specific preferred drug lists (PDL), prescription information for an individual enrollee, information regarding whether a prescription meets requirement for Medicaid payment. Providers will be able to transmit a prescription electronically to the enrollee's pharmacy of choice, review laboratory data and determine medication adherence information. Enhancements under consideration specifically address the opportunity for a unified web-based assessment tool, particularly related to mental health and substance use.","source":"Medicaid Approved Health Home State Plan Amendments (Filter by State; Search term= Health Home)    AL 14-001 Approval Date 3-04-15.","source_url":"http://www.medicaid.gov/state-resource-center/medicaid-state-plan-amendments/medicaid-state-plan-amendments.html"},{"state":"Alabama","policy_lever":"Accountable Care Arrangements","activity_status":"Proposed","activity_description":"The State of Alabama Medicaid Agency (AMA) is seeking approval of a Section 1115 Demonstration Project to implement versions of CMS accountable care organizations, regional care organizations (RCOs), to improve care coordination and outcomes and ensure the long-term sustainability of Alabama?s Medicaid program. Providers affiliated with RCOs will be expected to use the standardized continuity of care record, which will be a component of the providers? certified electronic health record. If the provider does not have a certified electronic health record, the health information exchange will accommodate a variety of interchange formats via a software based bridge. Ultimately, real-time access to data will support providers in predicting, planning for, and intervening when necessary in a beneficiary?s case management plan.","source":"Section 1115 Demonstration Proposal Alabama Medicaid Transformation","source_url":"http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/al/al-medicaid-transformation-pa.pdf"},{"state":"Alaska","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Proposed","activity_description":"In May 2014, Alaska DHSS, the Alaska Primary Care Association, and the Alaska Mental Health Trust Authority launched the Alaska Patient-Centered Medical Home Initiative (AK-PCMH-I), a patient-centered medical home pilot focused on achieving better health outcomes and patient experience for rural and frontier populations. These pilots are expected to expand the use of EHRs and collaboration among Alaskan providers on behalf of their clients.","source":"Alaska Patient Centered Medical Home Initiative","source_url":"https://www.pcpcc.org/initiative/alaska-patient-centered-medical-home-initiative-ak-pcmh-I"},{"state":"Alaska","policy_lever":"All Payer Claims Database (APCD) Policies","activity_status":"Proposed","activity_description":"In 2011 the State performed a study of the feasibility of implementing an All-Payer Claims Database (APCD) in Alaska. Alaska will work with the Health Care Commission and other stakeholders to seek methods to include Medicare, Medicaid, Commercial payers, and self-insured companies in the APCD.  Following two years of study, the Alaska Health Care Commission recommended in its 2013 Annual Report to the governor and legislature that the State of Alaska establish an APCD to support health care price and quality transparency, payment reform, and strengthening the health information infrastructure.","source":"Policy Brief:  All-Payer Claims Database","source_url":"http://dhss.alaska.gov/ahcc/Documents/2014ReportAPPENDIX%20B.pdf"},{"state":"Alaska","policy_lever":"eCQM Reporting","activity_status":"Proposed","activity_description":"Alaska has proposed in its most recently approved Implementation Advanced Planning Document with Centers for Medicare & Medicaid Services to establish the ability for providers to report clinical quality measures electronically via Alaska's HIE","source":"Alaska's CMS approved IAPD","source_url":""},{"state":"Alaska","policy_lever":"State Privacy and Security Policies","activity_status":"Actual","activity_description":"The State of Alaska participated in the HISPC project, working with 33 states on privacy and security issues related to the exchange of health information. This effort helped form the basis for the State legislation (Senate Bill 133, now AS 18.23.310) that established the Alaska HIE.   The policies and agreements developed under HISPC continue to be refined to meet ARRA requirements for HIE and meaningful use of EHRs. Ongoing efforts include:  ? Working with legislators on standardizing Alaska laws regarding privacy/confidentiality ? Drafting sample language for uniform medical records statutes and regulations ? Enacting laws and regulations in support of HIE and EHRs, exploring the possibility of immunity or statutory limitation on liability, such as a cap on damages for the HIE ? Reviewing and, when necessary, enacting state laws regarding the privacy and security ? Identifying applicable legal exceptions and safe harbors from fraud and abuse liability for providers","source":"2011 Alaska Statutes: Sec. 18.23.310. Confidentiality and security of information","source_url":"http://law.justia.com/codes/alaska/2011/title18/chapter18-23/sec-18-23-310"},{"state":"Alaska","policy_lever":"Public Health Surveillance","activity_status":"Actual","activity_description":"Alaska's public health measure reporting for immunization registry reporting, syndromic surveillance and reportable laboratory reporting is being conducted by utilizing Alaska's HIE. Alaska is requiring all providers submit the Public Health measure data via Alaska's HIE which is then transmitted to Alaska's Department of Health & Social Services, Division of Public Health via a VPN connection between the State and the HIE","source":"Alaska's CMS approved IAPD","source_url":""},{"state":"Alaska","policy_lever":"Rate Setting and Rate Review","activity_status":"Actual","activity_description":"The DHSS is currently in the process of developing new rate model pilots that will be piloted in late 2013. These models change the Medicaid delivery system from a service based model to one that will be tied to providers? quality and performance measures and will require the tracking of recipients across the health care delivery system, including behavioral health.","source":"The Healthy Alaskan Plan","source_url":"http://dhss.alaska.gov/HealthyAlaska/Documents/Healthy_Alaska_Plan_FINAL.pdf"},{"state":"Alaska","policy_lever":"State Insurance Commission (Commissioner) Policies","activity_status":"Proposed","activity_description":"The Health Care Commission recommended that the State encourage ?full participation? in the Hospital Discharge Database by each of Alaska?s hospitals. The information in the Hospital Discharge database is used to support needs assessment, policy development, planning, program evaluation, and tracking of health status. The current participation in the database is voluntary and includes inpatient discharge data from 10-17 of the State?s 25 Acute Care and Critical Access hospitals. Alaska is considering mandating participation in this database.","source":"Transforming Health Care in Alaska: Alaska's Hospital Discharge Database","source_url":"http://dhss.alaska.gov/ahcc/Documents/meetings/201303/HospitalDischargeDatabasePolicyBrief.pdf"},{"state":"Arizona","policy_lever":"Federal or State Grants","activity_status":"Actual","activity_description":"Under the ONC HIE Cooperative agreement Program: The Arizona Strategic Enterprise Technology Office (ASET) used grant funds to encourage HIE participation and care transformation through the Unconnected Providers Program, focusing on those not eligible for the EHR Incentive Program  (e.g., Long-term and Behavioral health). ASET  created a second grant program to accelerate HIE for health care organizations and payers that were  working to make clinical data more available to their providers. The grant supported organizations that were creating, developing, or maturing their IT environment to increase data exchange to adapt to change in reimbursement methods or to help providers meet meaningful use requirements.    The AHCCCS Program was awarded in April 2015 a CMS State Innovation Model (SIM) Planning Grant that will address improving care coordination through behavioral health and physical health integration, correctional health, and American Indian Health Population health.   Arizona Health-e Connection has applied for two Federal grants in Q1 2015; The ONC HIE Interoperability Grant and the Practice Transformation Network (PTNs) section of the Transforming Clinical Practice Initiative (TCPI) grant. AzHeC has not received any notice of award at this time.","source":"Arizona Health Information Exchange (HIE) Program Sustainability Plan, 2013","source_url":"https://aset.az.gov/sites/default/files/files/ARIZONA%20Response%20-%20PIN%20002%20-%20Program%20Sustainability%20Plan%20-%202013%20Submission%20-%20Final%20-%2005-29-2013.pdf"},{"state":"Arizona","policy_lever":"Federal or State Grants","activity_status":"Actual","activity_description":"In March, 2014, CMS awarded planning grants to nine qualified states to test quality measurement tools and demonstrate e-health in Medicaid community-based long term services and supports (LTSS). The grant program, known as TEFT, is designed to field test an experience survey and a set of functional assessment items, demonstrate personal health records, and create a standard electronic LTSS record. The state grantees will have an opportunity to extend the grant period to a total of four years. With the total grant program nearing $42 million, this is the first time the Centers for Medicare & Medicaid Services (CMS) is promoting the use of health information technology in the community-based LTSS system.","source":"TEFT Info CMS","source_url":"http://www.medicaid.gov/medicaid-chip-program-information/by-topics/delivery-systems/grant-programs/teft-program.html"},{"state":"Arizona","policy_lever":"Medicaid Waivers and Demonstrations","activity_status":"Proposed","activity_description":"The Arizona Health Care Cost Containment System (AHCCCS) administers Medicaid to approximately 1.64 million members largely through a managed care delivery system. The 1115 Waiver refers to section 1115 of the Social Security Act (SSA). States must comply with Title XIX (Medicaid) and Title XXI (Children's Health Insurance Program) of the SSA. Since Arizona began providing Medicaid on October 1, 1982, AHCCCS has been exempt from specific provisions of the SSA, pursuant to an 1115 Research and Demonstration Waiver.","source":"Link to AHCCCS Waiver Page","source_url":"http://www.azahcccs.gov/reporting/federal/waiver.aspx"},{"state":"Arizona","policy_lever":"State Privacy and Security Policies","activity_status":"Actual","activity_description":"AZ passed two legislative packages that removed existing statutory barriers to HIE in 2011 and 2012. This included:  An \"opt-out\"  consent policy where patients may choose not to have their health information shared with others through an HIO. Healthcare providers participating in the HIO are required to have a notification and opt-out process, and a consent policy that is reflective of Arizona clinicians and consumers (HB2620).  Patients are also allowed to: request a copy of their health information that is available through the HIO, able to request that incorrect health information about them be amended; the right to request a list of individuals who have viewed their information through the HIO for a period of at least 3 years prior to the patient's request and the right to be notified in case of a breach at the HIO that affects the patients individually identifiable health information. (HB 2369) modifies and enhances state statutes that allow for the electronic prescribing of controlled substances and restricts the HIO from using de-identified health information for research. There was also clarification to the  Notice of Health Information Practices to patients about choosing not to share their health information.","source":"Arizona Healthe Connection website","source_url":"http://www.azhec.org/?page=Policy_Development"},{"state":"Arizona","policy_lever":"State Purchasing/Contracting of Health Care Services","activity_status":"Actual","activity_description":"Through contract between the state Medicaid program (AHCCCS) and its Acute Care Health plans, AHCCCS requires the Acute Care Managed Care Health Plans to join the statewide  HIE called The Network. Over the next year the Network will work to onboard the Regional Behavioral Health Contractors to the HIE. In addition AHCCCS has two different contracts in place with AzHeC/The Network. The HIE Subsidy program uses HITECH funds to incentivize Medicaid high volume Hospitals, FQHCS and Rural Health Centers to join The Network.  The program subsidizes  the one time HIE onboarding fees of eligible Network participants who complete bidirectional connectivity with The Network. AHCCCS has a separate contract with the Regional Extension Center to provide education and outreach for Eligible Professionals in the EHRS Incentive Program.     AHCCCS is working with The Network and the Public Health agency to establish a MU reporting portal.","source":"State Medicaid HIT Plan (SMHP)","source_url":"http://www.azahcccs.gov/HIT/downloads/MedicaidHealthInformationTechnologyPlan_SMHP.pdf"},{"state":"Arizona","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Proposed","activity_description":"The Arizona Health Care Cost Containment System (AHCCCS) administers Medicaid to approximately 1.64 million members largely through a managed care delivery system. The 1115 Waiver refers to section 1115 of the Social Security Act (SSA). States must comply with Title XIX (Medicaid) and Title XXI (Children's Health Insurance Program) of the SSA. Since Arizona began providing Medicaid on October 1, 1982, AHCCCS has been exempt from specific provisions of the SSA, pursuant to an 1115 Research and Demonstration Waiver.","source":"Link to AHCCCS Waiver Page","source_url":"http://www.azahcccs.gov/reporting/federal/waiver.aspx"},{"state":"Arkansas","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Proposed","activity_description":"The Arkansas Legislature passed SB133 on March 25, 2015, which is now Act 887 of 2015. It allows telemedicine practitioners to be licensed as doctors in Arkansas, provided they have a pre-existing in-person relationship with their patient. Exceptions are made to this in cases of life-or-death emergency or in cases where the provider is ?simply providing information of a generic nature.? The bill also excludes store-and-forward technology, and abortions via telemedicine.","source":"Act 887 of 2015","source_url":"http://www.arkleg.state.ar.us/assembly/2015/2015R/Acts/Act887.pdf"},{"state":"Arkansas","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"Arkansas participates in the CMS Comprehensive Primary Care (CPC) initiative. The CPC initiative is a four-year multi-payer initiative designed to strengthen primary care. The initiative is testing whether provision of comprehensive primary care functions at each practice site ? supported by multi-payer payment reform, the continuous use of data to guide improvement, and meaningful use of health information technology ? can achieve improved care, better health for populations, and lower costs, and can inform future Medicare and Medicaid policy.","source":"CMS Comprehensive Primary Care Initiative","source_url":"http://innovation.cms.gov/initiatives/Comprehensive-Primary-Care-Initiative/"},{"state":"Arkansas","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"Arkansas?s Health Care Payment Improvement Initiative (AHCPII) began as a state effort and has subsequently been rolled into the state's SIM grant efforts.   The components of AHCPII that have been rolled out are PCMH (Patient Centered Medical Home) and Retrospective Episodes of Care (EOC).  One of the activities tracked for PCMH practice support is:  - Join SHARE and be able to access inpatient discharge and transfer information.  Practices must document compliance by written report to DMS via the provider portal.  SHARE is the State Health Alliance for Records Exchange which is administered by the Arkansas Office of Health Information Technology (OHIT).  The state?s PCMH program is a multi-payer initiative with participation from several additional commercial carriers and self-insured entities. Arkansas Blue Cross Blue Shield, Qualchoice, and Centene are required to support the program as a function of their participation in the Healthcare Independence Program. The program requires that all carriers are offering qualified health plans (QHPs) on Arkansas?s insurance exchange marketplace participate in the PCMH program. Additionally, the state and public school employee plan is also participating in the PCMH program. This additional multi-payer support reinforces the incentives for practices to meeting the PCMH activities related to EHR adoption, joining SHARE, and striving to gain other HIT/HIE ? related efficiencies as a result of the program.","source":"Arkansas Payment Improvement Initiative:","source_url":"http://www.paymentinitiative.org/Pages/default.aspx"},{"state":"Arkansas","policy_lever":"All Payer Claims Database (APCD) Policies","activity_status":"Actual","activity_description":"The Arkansas Legislature passed SB956 on April 1, 2015, which is now Act 1233. It creates the Healthcare Transparency Initiative and provides authority to collect healthcare information from insurance carriers and other entities. The Act calls for the creation of a database including ongoing all-payer claims database projects funded through the State Insurance Department.  The database will receive and store data from a submitting entity relating to medical, dental, and pharmaceutical and other insurance claims information, unique identifiers, and geographic and demographic information for covered individuals.","source":"Act 1233","source_url":"http://www.arkleg.state.ar.us/assembly/2015/2015R/Acts/Act1233.pdf"},{"state":"Arkansas","policy_lever":"HIE Advisory Council / Oversight Board","activity_status":"Actual","activity_description":"The Public School Health Services Advisory Committee has been created to study the medical needs of students and develop guidelines which include documentation and communications through health information technology; A member of the OHIT will participate on the Committee.","source":"Act 935 of 2015","source_url":"http://www.arkleg.state.ar.us/assembly/2015/2015R/Acts/Act935.pdf"},{"state":"Arkansas","policy_lever":"Medicaid Waivers and Demonstrations","activity_status":"Actual","activity_description":"In 2013, the Health Care Independence Program 1115(a) Demonstration Waiver was approved by CMS.  In 2014, CMS approved a Request for Amended Special Terms and Conditions.  The Amended Special Terms and Conditions contains the following language:  XVI. HEALTH INFORMATION TECHNOLOGY AND PREMIUM ASSISTANCE 91. Health Information Technology (Health IT). The State will use HIT to link services and core providers across the continuum of care to the greatest extent possible. The State is expected to achieve minimum standards in foundational areas of HIT and to develop its own goals for the transformational areas of HIT use. a. Health IT: Arkansas must have plans for health IT adoption for providers. This will include creating a pathway (and/or a plan) to adoption of certified EHR technology and the ability to exchange data through the State?s health information exchanges. If providers do not currently have this technology, there must be a plan in place to encourage adoption, especially for those providers eligible for the Medicare and Medicaid EHR Incentive Program. b. The State must participate in all efforts to ensure that all regions (e.g., counties or other municipalities) have coverage by a health information exchange. Federal funding for developing HIE infrastructure may be available, per State Medicaid Director letter #11-004, to the extent that allowable costs are properly allocated among payers. The State must ensure that all new systems pathways efficiently prepare for 2014 eligibility and enrollment changes.  c. All requirements must also align with Arkansas? State Medicaid HIT Plan and other planning efforts such as the ONC HIE Operational Plan.","source":"CMS?s Approval (dated December 31, 2014) of the Request for Amended Special Terms and Conditions for the Arkansas Health Care Independence Program (dated September 15, 2014):","source_url":""},{"state":"Arkansas","policy_lever":"State Privacy and Security Policies","activity_status":"Actual","activity_description":"OHIT has established technical, privacy and security, and clinical user groups that are working on ways to encourage Participants using SHARE to increase and expand their y and use of SHARE.","source":"Information provided by Jan Bartlett.","source_url":""},{"state":"Arkansas","policy_lever":"State Appropriated Funds","activity_status":"Actual","activity_description":"Act 869 of 2015 appropriated $9.4 Million for the Office of Health Information Technology (OHIT) and for the State Health Alliance for Records Exchange (SHARE) for personal services, operating expenses, grants, and matching funds of the Office of Health Information Technology - State Operations for the fiscal year ending June 30, 2016.","source":"Act 891 of 2011 created the Office of Health Information Technology","source_url":"http://www.arkleg.state.ar.us/assembly/2011/2011R/Acts/Act891.pdf"},{"state":"Arkansas","policy_lever":"State Appropriated Funds","activity_status":"Actual","activity_description":"Act 130 of 2015 provided $3 Million in general improvement funds for personal services and operating expenses of the Office of Health Information Technology (OHIT), for the State Health Alliance for Records Exchange (SHARE), and for grants to rural or critical access hospitals.   Act 662 of 2015 provided $3 Million in state general improvement funds for grants for personal services, operating expenses, professional  fees and services, and debt service expenses for increasing the adoption of  electronic health records to improve patient care and outcomes, reducing the  cost of care to patient and state, and improving the efficiency of the health  information exchange.","source":"Act 130 of 2015","source_url":"http://www.arkleg.state.ar.us/assembly/2015/2015R/Acts/Act130.pdf"},{"state":"Arkansas","policy_lever":"State Appropriated Funds","activity_status":"Actual","activity_description":"The state has partnered with the Employee Benefits Division of the Arkansas Dept of Finance and Administration \"to encourage the use of State Health Alliance for Records Exchange (SHARE) with all of its affiliated providers.\"","source":"AR HIT Strategic and Operational Plan Profile, 2011","source_url":"http://healthit.gov/sites/default/files/ar-plan-summary_updated-2011-12-21-2.pdf"},{"state":"Arkansas","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"In 2013, the Health Care Independence Program 1115(a) Demonstration Waiver was approved by CMS.  In 2014, CMS approved a Request for Amended Special Terms and Conditions.  The Amended Special Terms and Conditions contains the following language:  XVI. HEALTH INFORMATION TECHNOLOGY AND PREMIUM ASSISTANCE 91. Health Information Technology (Health IT). The State will use HIT to link services and core providers across the continuum of care to the greatest extent possible. The State is expected to achieve minimum standards in foundational areas of HIT and to develop its own goals for the transformational areas of HIT use. a. Health IT: Arkansas must have plans for health IT adoption for providers. This will include creating a pathway (and/or a plan) to adoption of certified EHR technology and the ability to exchange data through the State?s health information exchanges. If providers do not currently have this technology, there must be a plan in place to encourage adoption, especially for those providers eligible for the Medicare and Medicaid EHR Incentive Program. b. The State must participate in all efforts to ensure that all regions (e.g., counties or other municipalities) have coverage by a health information exchange. Federal funding for developing HIE infrastructure may be available, per State Medicaid Director letter #11-004, to the extent that allowable costs are properly allocated among payers. The State must ensure that all new systems pathways efficiently prepare for 2014 eligibility and enrollment changes.  c. All requirements must also align with Arkansas? State Medicaid HIT Plan and other planning efforts such as the ONC HIE Operational Plan.","source":"CMS?s Approval (dated December 31, 2014) of the Request for Amended Special Terms and Conditions for the Arkansas Health Care Independence Program (dated September 15, 2014):","source_url":""},{"state":"California","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"Managed Medi-Cal Long-Term Supports and Services (LTSS), for which all Medi-Cal beneficiaries, including dual eligible beneficiaries, are required to join a Medi-Cal managed care health plan to receive their Medi-Cal benefits, including LTSS and Medicare wrap-around benefits.","source":"Coordinated Care Initiative Overview","source_url":"http://www.dhcs.ca.gov/provgovpart/Documents/Duals/TBL/CCI_Fact_Sheet.pdf"},{"state":"California","policy_lever":"Demonstrations to Integrate Care for Dually Eligible Beneficiaries","activity_status":"Actual","activity_description":"Cal MediConnect Program, a voluntary three-year demonstration for dual eligible beneficiaries to receive coordinated medical, behavioral health, long-term institutional, and home-and community-based services  through a single organized delivery system in eight counties.  The program specifically identifies requirements related to information exchange that will support improved services and care models, specifically between mental health services and medical services.","source":"CalDual: An Overview of CA's Coordinated Care Initiative","source_url":"http://www.calduals.org/background/ca_duals_demo/"},{"state":"California","policy_lever":"Medicaid Waivers and Demonstrations","activity_status":"Actual","activity_description":"California Bridge to Reform Demonstration:  Transition into Mandatory Managed Care and Enrollment Strategies. DHCS is working with CMS and managed care plans to support smooth transitions using available information, including linking beneficiaries to providers, for the purposes of assigning members to providers and for ongoing care coordination and/or disease management, using claims data and/or other available data sources, such as EHRs and HIE as a source of clinical data on SPD enrollees.","source":"California Bridge to Reform Demonstration","source_url":"http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ca/ca-bridge-to-health-reform-ca.pdf"},{"state":"California","policy_lever":"Medicaid Waivers and Demonstrations","activity_status":"Actual","activity_description":"California Bridge to Reform Demonstration:  Delivery System Reform Incentive Payments included expectations and requirements for participating hospitals to use EHRs in the context of registry functions to assess patient care and outcomes for a number quality improvement measures.","source":"California Bridge to Reform Demonstration","source_url":"http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ca/ca-bridge-to-health-reform-ca.pdf"},{"state":"California","policy_lever":"Public Health Surveillance","activity_status":"Actual","activity_description":"The ARRA-funded Immunization (IZ) Gateway serves as a single point of entry for submitting immunization data and enables providers and hospitals to meet meaningful use requirements.","source":"","source_url":"http://cairweb.org/imp2/"},{"state":"California","policy_lever":"State Appropriated Funds","activity_status":"Actual","activity_description":"California added section 130255 to the Health and Safety Code (H&SC) in 2010, which created the Health Information Technology and Exchange Fund. The Fund is a special state fund for the purpose of holding any public and private funds awarded, contributed, and earned to be dedicated toward the continued support for programs and activities that continue to advance California?s health information exchange efforts. California section 130255 also allowed the state to create an advisory board.","source":"Health and Safety Code","source_url":"http://www.leginfo.ca.gov/cgi-bin/displaycode?section=hsc&group=130001-131000&file=130250-130255"},{"state":"Colorado","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"Colorado is one of the recipients of the CMS funded Comprehensive Primary Care (CPC) initiative. As of June 2013, the total practices enrolled in the CPCI program in CO are 74 totaling 369 providers in the state. To succeed in the program, practices will need to incorporate health IT, including EHRs and HIE into their workflow.","source":"CMS Comprehensive Primary Care Initiative","source_url":"http://innovation.cms.gov/initiatives/Comprehensive-Primary-Care-Initiative/"},{"state":"Colorado","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"As signed by the Governor on 3/20/2015, as of?January 1, 2016, the Health Care Delivery Via Telemedicine Statewide?bill removes previous population restrictions. However, Colorado patients remain unable to receive care over the telephone to meet state requirements for mandated payment under this bill. Plans cannot impose an annual or lifetime dollar maximum that applies separately to telemedicine services (previously defined as residing in a county with 150,000 or fewer residents) and precludes a health benefit plan from requiring in-person care delivery when telemedicine is appropriate, regardless of the geographic location of the health care provider and the recipient of care. In addition, carriers must reimburse providers who deliver care through telemedicine on the same basis that the carrier is responsible for coverage of services delivered in person and cannot charge deductible, copayment, or coinsurance amounts that are not equally imposed on all terms and services covered under the health benefit plan.","source":"House Bill 15-1029: Health Care Delivery Via Telemedicine Statewide","source_url":"http://www.legispeak.com/bill/2015/hb15-1029"},{"state":"Colorado","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"In 2010 Colorado Health Department began enrolling Medicaid clients into the Accountable Care Collaborative (ACC).? The program is designed around 7 Regional Care Collaborative Organizations (RCCOs) that were opened for competitive bid and awarded to state-based health care provider and payer organizations. Governor John Hickenlooper signed House Bill 12-1281 into law on June 4, 2012 providing optional expansion of the ACC program.?The law provides RCCOs the opportunity to propose further payment / delivery system reforms. These activities coalesce to promote PCMH model, require strong referral networks and seamless transition of care, and in the future may require integration of long-term, home-based, and behavioral health care settings.","source":"State of Colorado House Bill 12-1281","source_url":"http://www.leg.state.co.us/clics/clics2012a/csl.nsf/fsbillcont3/28EE8C6A74A0719887257981007F12EC/$FILE/1281_01.pdf"},{"state":"Colorado","policy_lever":"All Payer Claims Database (APCD) Policies","activity_status":"Actual","activity_description":"Colorado?s All Payer Claims Database (APCD) legislation (Colorado House Bill 10-1330) went into effect in late summer 2010. The legislation set out a number of required actions and milestones. CIVHC was appointed the Administrator of the APCD and, through its work with an appointed APCD Advisory Committee, has successfully met its statutory milestones on or before deadlines.","source":"House Bill 10-1330","source_url":"http://www.leg.state.co.us/CLICS/CLICS2010A/csl.nsf/fsbillcont3/7772EFE1E998E627872576B700617FA4?Open&file=1330_enr.pdf"},{"state":"Colorado","policy_lever":"State Designation of Exchange Entity","activity_status":"Actual","activity_description":"Senate Bill 11-200 - May 2011, the Colorado General Assembly passed Senate Bill 11-200 to establish the Colorado Health Benefits Exchange (COHBE) as a public entity. The implementation phase of COHBE includes both technological implementation and business implementation, spanning activities as varied as developing and testing computer infrastructure, to policy development, outreach, and plan management.","source":"Senate Bill 11-200","source_url":"http://www.coloradohealthinstitute.org/key-issues/detail/legislation-and-policy/cohbe-revisited-the-next-steps-for-colorados-insurance-exchange"},{"state":"Colorado","policy_lever":"Episode of Care Risk-Sharing","activity_status":"Actual","activity_description":"Effective for dates of service on or after July 1, 2011, all Medicaid claims for hospital readmissions in which a client is readmitted to the same hospital within 48 hours of discharge, will be denied unless the readmission is completely unrelated to the first admission. This change means that the hospital will receive payment only one time for what is essentially one episode of care.?This change will requires information exchange with other community providers, particularly information such as functional status, mental health diagnoses, and history of infection in the most frail and vulnerable patients.?Currently, the hospital readmissions policy only applies to patients who return to the same hospital within 48 hours of discharge.? With better connectivity across systems and more opportunity for information exchange, such a policy could be extended to apply to any readmission regardless of hospital facility.","source":"CO HCPF Provider Bulletin, Oct 2010","source_url":"https://www.colorado.gov/pacific/sites/default/files/Bulletin_1010_B1000289_0.pdf"},{"state":"Colorado","policy_lever":"Federal or State Grants","activity_status":"Actual","activity_description":"In March, 2014, CMS awarded planning grants to nine qualified states to test quality measurement tools and demonstrate e-health in Medicaid community-based long term services and supports (LTSS). The grant program, known as TEFT, is designed to field test an experience survey and a set of functional assessment items, demonstrate personal health records, and create a standard electronic LTSS record. The state grantees will have an opportunity to extend the grant period to a total of four years. With the total grant program nearing $42 million, this is the first time the Centers for Medicare & Medicaid Services (CMS) is promoting the use of health information technology in the community-based LTSS system.","source":"TEFT Info CMS","source_url":"http://www.medicaid.gov/medicaid-chip-program-information/by-topics/delivery-systems/grant-programs/teft-program.html"},{"state":"Colorado","policy_lever":"HIE Advisory Council / Oversight Board","activity_status":"Actual","activity_description":"HB 14-1323 prohibits state or local government from accessing an individual?s medical record without the individual?s consent. The bill also creates the Government Access to Personal Medical Information Task Force, which will make recommendations on the access, use and distribution of personal medical information by state and local governments.","source":"HB 14-1323","source_url":"http://www.leg.state.co.us/clics/clics2014a/csl.nsf/fsbillcont2/0E5F22E151FB1B9987257C3000070918/$FILE/1323_enr.pdf"},{"state":"Colorado","policy_lever":"HIE Advisory Council / Oversight Board","activity_status":"Actual","activity_description":"Executive Order 2015-001, signed March 18, 2015, established a State Innovation Model (SIM) Office, which in conjunction with State Model Advisory Board, will develop a state health care innovation plan that will integrate physical and behavioral health services in a way that most primary- and specialty-care physicians? offices do not do. Colorado will use $65 million in federal grant money to achieve its aims.","source":"Executive Order 2015-004","source_url":"https://www.colorado.gov/pacific/sites/default/files/atoms/files/B%202015-004%20BELC_0.pdf"},{"state":"Colorado","policy_lever":"Provider Licensure","activity_status":"Actual","activity_description":"HB 12-1052 - Requires collection of accurate and up-to-date health care professional data on a statewide basis in order to determine the medically underserved areas of the state and to accurately guide the education and training needs for health care professionals in this state. CO is using this licensing data base with additional data points plus coordinated governance to build a provider index with additional data elements to create a golden standard for provider data. Data generators can be data users and retrieve additional data elements from the collective health professional data tables. Examples of data generators include but are not limited to licensing data, APCD data, HIE provider data, health insurance exchange data, Medicaid provider data, and HPSA data.","source":"HB 12-1052","source_url":"http://www.leg.state.co.us/clics/clics2012a/csl.nsf/fsbillcont2/D64782352F2BC6B387257981007DDE2A/$FILE/1052_enr.pdf"},{"state":"Colorado","policy_lever":"Prescription Drug Monitoring Programs (PDMP)","activity_status":"Actual","activity_description":"HB 14-1283, signed into law May 21, 2014, modified the states PDMP. Some of the modifications included, allowing \"push notices\" to both prescribers and pharmacists, mandatory PDMP registration for pharmacists and DEA registered prescribers, direct access to PDMP by CO Department of Public Health & Environment, and permission authority for federally owned and operated pharmacies to submit controlled substance data into the PDMP. \"Colorado plans to use this to leverage PDMP and HIE integration\", said Kate Kiefert, State HIT Coordinator.","source":"HB 14-1283","source_url":"http://openstates.org/co/bills/2014A/HB14-1283/"},{"state":"Colorado","policy_lever":"State Privacy and Security Policies","activity_status":"Actual","activity_description":"Behavioral Health Information Exchange - The Colorado Division of Behavioral Health Code of Colorado Regulations (2 CCR 502-2) includes a confidentiality stipulation that states written consent must be acquired and held on file for one year to share certain client information (and renewed for additional one year periods). This regulation affects situations where a covered behavioral health organization provides outbound formation to an HIE. This does not limit receiving data available through the HIE, such as labs, hospital discharge information, imaging results, care summaries, etc.","source":"2 CCR 502-2","source_url":"http://www.sos.state.co.us/CCR/DisplayRule.do?action=ruleinfo&ruleId=2157&deptID=9&agencyID=70&deptName=500,2500%20Department%20of%20Human%20Services&agencyName=502%20Division%20of%20Mental%20Health&seriesNum=2%20CCR%20502-1"},{"state":"Colorado","policy_lever":"Public Health Surveillance","activity_status":"Actual","activity_description":"Colorado HIO and Health Department have implemented three pilot implementations to support exchange between health care providers and the public health department.? The three pilots are Electronic Lab Reporting, Immunization Reporting, and Newborn Screening Orders & Results Delivery. The HIO and Health Department are also partnering to pilot population health data sharing into the Cancer Registry and for syndromic surveillance data.?The State has not yet mandated electronic reporting or public health messaging as a matter of policy, but there is an increasing trend and preference toward that approach in light of MU2 requirements.","source":"CORHIO e-Newsletter Update","source_url":"http://www.corhio.org/news/2012/1/11/143-providers-to-benefit-from-streamlined-public-health-reporting-through-hie"},{"state":"Colorado","policy_lever":"State Designation of Exchange Entity","activity_status":"Actual","activity_description":"Executive Order 08-009, signed April 3, 2009, Designating the Colorado Regional Health Information Organization as Colorado's Qualified State-Designated Entity to lead efforts to expand the use of  health information across Colorado to meet state and federal goals for improving health and health care.","source":"Executive Order 08-009","source_url":""},{"state":"Colorado","policy_lever":"Accountable Care Arrangements","activity_status":"Actual","activity_description":"In 2010 Colorado Health Department began enrolling Medicaid clients into the Accountable Care Collaborative (ACC).? The program is designed around 7 Regional Care Collaborative Organizations (RCCOs) that were opened for competitive bid and awarded to state-based health care provider and payer organizations. Governor John Hickenlooper signed House Bill 12-1281 into law on June 4, 2012 providing optional expansion of the ACC program.?The law provides RCCOs the opportunity to propose further payment / delivery system reforms. These activities coalesce to promote PCMH model, require strong referral networks and seamless transition of care, and in the future may require integration of long-term, home-based, and behavioral health care settings.","source":"State of Colorado House Bill 12-1281","source_url":"http://www.leg.state.co.us/clics/clics2012a/csl.nsf/fsbillcont3/28EE8C6A74A0719887257981007F12EC/$FILE/1281_01.pdf"},{"state":"Connecticut","policy_lever":"Medicaid State Plan Amendments (SPA)","activity_status":"Proposed","activity_description":"The Affordable Care Act of 2010, Section 2703, created an optional Medicaid State Plan benefit for states to establish Health Homes to coordinate care for people with Medicaid who have chronic conditions by adding Section 2703 of the Social Security Act. Health Homes providers will integrate and coordinate all primary, acute, behavioral health, and long-term services and supports to treat the whole person.","source":"Kate McEvoy, Director, Division of Health Services (Medicaid Director)","source_url":""},{"state":"Connecticut","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"CT Department of Social Services administers a PCMH program in which practices are eligible for enhanced fees contingent on NCQA Level II or III recognition and performance incentive payments based on measure performance.  Inter-operability is not specifically required, however, the NCQA standards reflect capabilities that are supported by inter-operability.","source":"Husky Health CT","source_url":"http://www.huskyhealthct.org/providers/pcmh.html"},{"state":"Connecticut","policy_lever":"All Payer Claims Database (APCD) Policies","activity_status":"Actual","activity_description":"The Connecticut APCD was established in 2012. With the passage of Public Act 13-247, the Connecticut General Assembly authorized Access Health CT (Connecticut?s health insurance exchange) to ?(A) Oversee the planning, implementation and administration of the all-payer claims database program for the purpose of collecting, assessing and reporting health care information relating to safety, quality, cost-effectiveness, access and efficiency for all levels of health care; (B) ensure that data received from reporting entities is securely collected, compiled and stored in accordance with state and federal law; and (C) conduct audits of data submitted by reporting entities in order to verify its accuracy.? PA 13-247 further directs Access Health CT to ?(A) Utilize data in the all-payer claims database to provide health care consumers in the state with information concerning the cost and quality of health care services that allows such consumers to make economically sound and medically appropriate health care decisions; and (B) make data in the all-payer claims database available to any state agency, insurer, employer, health care provider, consumer of health care services or researcher for the purpose of allowing such person or entity to review such data as it relates to health care utilization, costs or quality of health care services. Such disclosure shall be made in accordance with subdivision (2) of subsection (b) of section 38a-1090 of the general statutes, as amended by this act. The exchange may set a fee to be charged to each person or entity requesting access to data stored in the all-payer claims database.?","source":"Connecticut APCD Council","source_url":"http://apcdcouncil.org/state/connecticut"},{"state":"Connecticut","policy_lever":"Federal or State Grants","activity_status":"Actual","activity_description":"In March, 2014, CMS awarded planning grants to nine qualified states to test quality measurement tools and demonstrate e-health in Medicaid community-based long term services and supports (LTSS). The grant program, known as TEFT, is designed to field test an experience survey and a set of functional assessment items, demonstrate personal health records, and create a standard electronic LTSS record. The state grantees will have an opportunity to extend the grant period to a total of four years. With the total grant program nearing $42 million, this is the first time the Centers for Medicare & Medicaid Services (CMS) is promoting the use of health information technology in the community-based LTSS system.","source":"TEFT Info CMS","source_url":"http://www.medicaid.gov/medicaid-chip-program-information/by-topics/delivery-systems/grant-programs/teft-program.html"},{"state":"Connecticut","policy_lever":"Medicare and Medicaid EHR Incentive Program (Meaningful Use)","activity_status":"Actual","activity_description":"The Medicare and Medicaid EHR Incentive Programs provide financial incentives for the ?meaningful use? of certified EHR technology. To receive an EHR incentive payment, providers have to show that they are ?meaningfully using? their certified EHR technology by meeting certain measurement thresholds that range from recording patient information as structured data to exchanging summary care records.","source":"Minakshi Tikoo, HIT Coordinator","source_url":""},{"state":"Connecticut","policy_lever":"Private Grants/Contracts","activity_status":"Proposed","activity_description":"CT Department of Social Services applies for a state plan amendment, which would establish a reimbursement mechanism to support e-consultation between primary care providers in FQHC settings and physician specialist at UConn Health, an academic medical center. Substantial support for the demonstration project is being provided by a private foundation.","source":"Kate McEvoy, Director, Division of Health Services (Medicaid Director) as source","source_url":""},{"state":"Connecticut","policy_lever":"State Appropriated Funds","activity_status":"Actual","activity_description":"The Administration strongly believes that improving and expanding the state?s use of technology is vital to creating a state government that is more transparent, accountable, efficient and effective in delivering services and meeting its responsibilities to all of its constituents. The administration's commitment to enhancing the state's effective use of technology is evidenced, in part, by the establishment of the Information Technology Capital Investment Program (Sec 2a of Public Act 12-189) with an authorizations of $50M in FY13-14 and current authorizations in FY14-16 of $50M and $50M (Public Act 13-239).","source":"","source_url":"http://www.ct.gov/opm/cwp/view.asp?Q=511606"},{"state":"Connecticut","policy_lever":"State Purchasing/Contracting of Health IT Infrastructure (non-Medicaid)","activity_status":"Actual","activity_description":"Connecticut Department of Mental Health and Addiction Services (DMHAS) is implementing a complete Electronic Health Record (EHR) to replace the paper charts and current electronic documentation tools used in both Inpatient and Outpatient State-operated facilities. DMHAS has contracted with FEi Systems of Columbia, Maryland to host and maintain the use of the WITS (Web Infrastructure for Treatment Systems) EHR application.  The WITS application is currently used by 29 other State and County entities. The EHR implementation follows a multi-year phased approach.  ? Phase 1: Completed in August 2014; Admission, Discharge, Transfer, Service Entry and documentation, Bed Management, National Outcome Measure data collection, Co-occurring screens, Crisis, Jail Diversion and Forensic evaluations, and Billing ? Phase 2: July-September 2015; Evaluation and Management notes, Mental Status Exams, Vitals, Medication Lists, Allergy  and Plan of Care (Treatment Plans);  ? Phase 3: December 2015; Other Clinical Documentation ? Phase 4: January 2016; Pharmacy Systems for 4 State-operated facilities ? Phase 5: July 2016; Computerized Physician Order Entry and receipt of lab results  WITS is an ONC certified system.  The vendor does support ?Direct? for messaging and will support the interface with a specified Health Information Exchange.  New values being added, such as allergies or medications, will utilize standardized values (SNOMED-CT) for inter-operability and sharing of data.  The vendor will use Clinical Documentation Architecture (CDA) for sharing of information with other entities.","source":"Dan Olshansky (DMHAS)","source_url":""},{"state":"Connecticut","policy_lever":"Federal or State Grants","activity_status":"Actual","activity_description":"The Centers for Medicare & Medicaid Services (CMS) is promoting the use of health information technology within the community based Long Term Services and Supports system. This year CMS announced awards for the TEFT (Testing Experience and Functional Tools)grant to introduce health IT into this population. The TEFT grant is designed to field test an experience of care survey and a set of functional assessment items, as well as demonstrate the use of personal health records, and finally to contribute to the creation of a standard electronic long term services and supports record, all of which Connecticut will be participating in. Connecticut is one of only nine(9) states to be admitted participation in the program, and one of only six (6) states awarded funding to administer all four components of the grant. The expected outcomes of the TEFT grant program include the creation of national measures and valuable feedback on how health information technology can be implemented in this portion of the Medicaid system, to best serve the LTSS population.","source":"","source_url":"http://www.ct.gov/dss/lib/dss/hit/teftoverview.pdf"},{"state":"Connecticut","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Proposed","activity_description":"The Affordable Care Act of 2010, Section 2703, created an optional Medicaid State Plan benefit for states to establish Health Homes to coordinate care for people with Medicaid who have chronic conditions by adding Section 2703 of the Social Security Act. Health Homes providers will integrate and coordinate all primary, acute, behavioral health, and long-term services and supports to treat the whole person.","source":"Kate McEvoy, Director, Division of Health Services (Medicaid Director)","source_url":""},{"state":"Delaware","policy_lever":"Qualified Health Plan Requirement (Health Insurance Exchange)","activity_status":"Actual","activity_description":"\"All issuers participating in the state health insurance marketplace are required to participate in and utilize DHIN data use services and claims data submission services,\" according to the Delaware Department of Insurance Issuer QHP Submission Guide.","source":"Delaware Department of Insurance Issuer QHP Submission Guide, 2015","source_url":"http://www.delawareinsurance.gov/health-reform/DE-Issuer-QHP-Submission-Guide.pdf"},{"state":"Delaware","policy_lever":"State Appropriated Funds","activity_status":"Actual","activity_description":"DHIN receives state funds: 35% of their budget is State funds totaling $12.1 million in appropriations through fiscal year 2012.","source":"DHIN Funding","source_url":"http://www.dhin.org/about/dhin-funding"},{"state":"Delaware","policy_lever":"State Designation of Exchange Entity","activity_status":"Actual","activity_description":"Public instrumentality to the state: In Jan 2011, the DHIN became a public instrumentality to the state.  With this designation, DHIN is required to report bi-annually to the state on their business plan and sustainability strategies, while benefiting from state funding when appropriated for operational uses.  Another benefit of this designation is more agility in contracting and hiring. There is only one other entity in DE that has this designation.","source":"DHIN HIE Strategic and Operational Plan Profile","source_url":"http://healthit.gov/sites/default/files/de-plan-summary_updated-2012-03-141.pdf"},{"state":"District of Columbia","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Proposed","activity_description":"In July 2013 the DC city council mandated certain telemedicine services. Medicaid officials hope to publish proposed rules by summer 2015 and finalize them by fall 2015.","source":"Telemedicine Reimbursement Act","source_url":"http://disb.dc.gov/sites/default/files/dc/sites/disb/release_content/attachments/2-7-13-REINTRODUCED-Telemedicine-Reimbursement%20Act-Bill%2020-50-DISB%20Testimony.pdf"},{"state":"District of Columbia","policy_lever":"State Appropriated Funds","activity_status":"Actual","activity_description":"Made available grants to help community health centers to develop EHR systems: D.C. B 2 ?(B) Of the remainder of the grant, $2.2 million in fiscal year 2007 and $2.8 in fiscal year 2009, shall be used to develop an electronic health record system for community health centers to promote higher quality of care, improved coordination of services among providers, and more accurate reporting of health statistics to the Department of Health; provided, that of the $2.2 million allocated for fiscal year 2007, $200,000 shall be used to support information technology needs for District of Columbia public and charter school nurse suites.?","source":"NCSL Health Information Technology 2007 and 2008 State Legislation","source_url":"http://www.ncsl.org/print/health/forum/hit_enacted.pdf"},{"state":"Florida","policy_lever":"Federal or State Grants","activity_status":"Actual","activity_description":"The Medicaid and SCHIP agencies in Florida and Illinois are using the Children's Health Insurance Program Reauthorization Act (CHIPRA) grant to improve health outcomes for children by enhancing access to information for use by providers, consumers, and state agencies.  HIE is one component of the grant funded activities.","source":"AHRQ CHIPRA Quality Demonstration Project Overview","source_url":"http://www.ahrq.gov/policymakers/chipra/demoeval/demostates/fl.html"},{"state":"Florida","policy_lever":"Medicaid Waivers and Demonstrations","activity_status":"Actual","activity_description":"FL Medicaid worked with CMS to add to their Medicaid waiver a condition to hospitals that wish to receive low-income pool (LIP) funding (which includes disproportionate share hospital funds DSH) that providers must \"participate in Florida Event Notification program.\"","source":"FHIN","source_url":"http://www.fhin.net/committeesAndCouncils/docs/hiecc/Aug1514/tabC/ENSLIP.pdf"},{"state":"Florida","policy_lever":"Medicaid Waivers and Demonstrations","activity_status":"Proposed","activity_description":"The State submitted a request to renew its Section 1115 Demonstration Program, Florida MEDS AD, which provides Medicaid eligibility for individuals who are disabled or age 65 or over, and who are also eligible for and receiving Medicaid-covered institutional care services, hospice services, or home and community-based services; and whose incomes do not exceed 88 percent of the federal poverty level and whose assets do not exceed $5,000 for individuals or $6,000 for couples.   The program create a process by which a primary care provider, a clinical reviewer, or a field pharmacist can refer a patient for a more intensive MTM (medications therapy management) review; or to a program that incorporates  proven disease management modalities:  ? a thorough patient evaluation  ? an inter-disciplinary team of providers ? use of electronic medical record technology ? deployment of home health technology (i.e., telehealth) ? access to community-based support services that are sensitive to population needs and local systems of care.","source":"Medicaid Section 1115 Demonstration Program","source_url":"http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/fl/MEDS-AD/fl-fl-meds-ad-demo-program-01012014-12312016.pdf"},{"state":"Florida","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Proposed","activity_description":"The State submitted a request to renew its Section 1115 Demonstration Program, Florida MEDS AD, which provides Medicaid eligibility for individuals who are disabled or age 65 or over, and who are also eligible for and receiving Medicaid-covered institutional care services, hospice services, or home and community-based services; and whose incomes do not exceed 88 percent of the federal poverty level and whose assets do not exceed $5,000 for individuals or $6,000 for couples.   The program create a process by which a primary care provider, a clinical reviewer, or a field pharmacist can refer a patient for a more intensive MTM (medications therapy management) review; or to a program that incorporates  proven disease management modalities:  ? a thorough patient evaluation  ? an inter-disciplinary team of providers ? use of electronic medical record technology ? deployment of home health technology (i.e., telehealth) ? access to community-based support services that are sensitive to population needs and local systems of care.","source":"Medicaid Section 1115 Demonstration Program","source_url":"http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/fl/MEDS-AD/fl-fl-meds-ad-demo-program-01012014-12312016.pdf"},{"state":"Georgia","policy_lever":"Federal or State Grants","activity_status":"Actual","activity_description":"In March, 2014, CMS awarded planning grants to nine qualified states to test quality measurement tools and demonstrate e-health in Medicaid community-based long term services and supports (LTSS). The grant program, known as TEFT, is designed to field test an experience survey and a set of functional assessment items, demonstrate personal health records, and create a standard electronic LTSS record. The state grantees will have an opportunity to extend the grant period to a total of four years. With the total grant program nearing $42 million, this is the first time the Centers for Medicare & Medicaid Services (CMS) is promoting the use of health information technology in the community-based LTSS system.","source":"TEFT Info CMS","source_url":"http://www.medicaid.gov/medicaid-chip-program-information/by-topics/delivery-systems/grant-programs/teft-program.html"},{"state":"Georgia","policy_lever":"Federal or State Grants","activity_status":"Actual","activity_description":"GaHIN Capacity Building Grant program was developed to support the statewide network by on-boarding and connecting various healthcare organizations, state agencies, and service area health information exchange. The grant program will build capacity for HIE, increase connectivity and flow of patient information, and facilitate interoperability.","source":"GaHIN Capacity Building Grant Program Notice of Direct Award","source_url":"https://dch.georgia.gov/sites/dch.georgia.gov/files/related_files/document/Capacity_Building-Notice_of_Direct_Award-GRAChie.pdf"},{"state":"Idaho","policy_lever":"Medicaid State Plan Amendments (SPA)","activity_status":"Actual","activity_description":"Idaho's Medicaid Health Home SPA targets individuals with chronic conditions of (1) SPMI or SED; (2) Diabetes and asthma; or (3) those who have either diabetes or asthma and are at risk for another chronic condition. Participating providers must report quality measures through a web portal. Idaho Medicaid staff have facilitated communications between providers and provided limited technical assistance to facilitate accurate provider reporting from EMR's. Providers are encouraged to use the Idaho Health Data Exchange (IHDE) to develop partnerships that maximize the use of HIT across providers (i.e. hospitals). Idaho has developed initial and final HIT requirements. Designated providers must meet the initial HIT requirement to implement a Health Home. In addition, providers must provide a plan to achieve the final requirement within twenty-four months of program initiation in order to be approved as a Health Home provider.  The initial standards (months 1-3) require designated providers to make use of available HIT for the following processes:     1. Have a structured information system in place to populate a disease management database.     2. Have a structured information system for tracking and managing the patients with chronic diseases.   The final standards require that designated providers use HIT for the following processes:     1. Have a systematic process to follow-up on tests, treatments, services, and referrals which is incorporated into the patient's care plan;     2. Utilize HIT allowing the patient health information and care plan to be accessible and allow for population management and identification of gaps in care including preventive services; and     3. Is required to make use of available HIT and access members' data through the IHDE to conduct all processes, as feasible.","source":"Medicaid Approved Health Home State Plan Amendments (Filter by State; Search term= Health Home)  ID 12-0009 Approval Date 11/21/2012","source_url":"http://www.medicaid.gov/state-resource-center/medicaid-state-plan-amendments/medicaid-state-plan-amendments.html"},{"state":"Idaho","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"Idaho's Medicaid Health Home SPA targets individuals with chronic conditions of (1) SPMI or SED; (2) Diabetes and asthma; or (3) those who have either diabetes or asthma and are at risk for another chronic condition. Participating providers must report quality measures through a web portal. Idaho Medicaid staff have facilitated communications between providers and provided limited technical assistance to facilitate accurate provider reporting from EMR's. Providers are encouraged to use the Idaho Health Data Exchange (IHDE) to develop partnerships that maximize the use of HIT across providers (i.e. hospitals). Idaho has developed initial and final HIT requirements. Designated providers must meet the initial HIT requirement to implement a Health Home. In addition, providers must provide a plan to achieve the final requirement within twenty-four months of program initiation in order to be approved as a Health Home provider.  The initial standards (months 1-3) require designated providers to make use of available HIT for the following processes:     1. Have a structured information system in place to populate a disease management database.     2. Have a structured information system for tracking and managing the patients with chronic diseases.   The final standards require that designated providers use HIT for the following processes:     1. Have a systematic process to follow-up on tests, treatments, services, and referrals which is incorporated into the patient's care plan;     2. Utilize HIT allowing the patient health information and care plan to be accessible and allow for population management and identification of gaps in care including preventive services; and     3. Is required to make use of available HIT and access members' data through the IHDE to conduct all processes, as feasible.","source":"Medicaid Approved Health Home State Plan Amendments(Filter by State; Search term= Health Home)  ID 12-0009 Approval Date 11/21/2012","source_url":"http://www.medicaid.gov/state-resource-center/medicaid-state-plan-amendments/medicaid-state-plan-amendments.html"},{"state":"Illinois","policy_lever":"Medicaid Waivers and Demonstrations","activity_status":"Proposed","activity_description":"The state will invest $26 million annually in incentive-based payments for performance on specific metrics achieved by current Illinois GME programs in designated medical specialties. In year 1 and 2: 25% of funds will be set aside for written curricula in population medicine based on practice in primary/general outpatient settings. The curriculum must contain competencies in the areas of population medicine: preventive care, the use of information technology for managing clinic patients, appropriate management of patient transitions of care, inter-professional team-based care and patient-centered decision making.","source":"Illinois 1115 Waiver Proposal","source_url":"http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/il/il-path-transformation-pa.pdf"},{"state":"Illinois","policy_lever":"State Privacy and Security Policies","activity_status":"Actual","activity_description":"On March 8, 2013, the Illinois House of Representatives unanimously approved a bill (HB1017) to amend the Mental Health Confidentiality Act. The bill provides for the use of health information exchange (HIE) for the exchange of patient mental health records, while granting patients individual choice (opt-out) regarding the disclosure by the HIE of such records. Public Act 98-0378 was signed on August 16, 2013.","source":"Illinois House Bill 1017","source_url":"http://www.ilga.gov/legislation/BillStatus.asp?GAID=12&GA=99&DocNum=1017&DocTypeID=HB&SessionID=85&LegID=71462&SpecSess=&Session="},{"state":"Illinois","policy_lever":"Public Health Surveillance","activity_status":"Actual","activity_description":"The ILHIE technical core services implementation includes support for a single interface to the Public Health Node, which will facilitate the electronic reporting of data directly from provider EHRs to the Department. Existing point-to-point interfaces for electronic public health reporting will gradually be phased out in favor of the single interface approach, providing a long-term incentive to adopt EHR and acquire HIE service.","source":"The ILHIE is currently supporting 84 connections with access to 184 provider facilities","source_url":"http://www.illinois.gov/sites/ilhie/Documents/Who%20Is%20Connected%20to%20the%20ILHIE%20%28as%20of%203-23-15%29.pdf"},{"state":"Illinois","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Proposed","activity_description":"The state will invest $26 million annually in incentive-based payments for performance on specific metrics achieved by current Illinois GME programs in designated medical specialties. In year 1 and 2: 25% of funds will be set aside for written curricula in population medicine based on practice in primary/general outpatient settings. The curriculum must contain competencies in the areas of population medicine: preventive care, the use of information technology for managing clinic patients, appropriate management of patient transitions of care, inter-professional team-based care and patient-centered decision making.","source":"Illinois 1115 Waiver Proposal","source_url":"http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/il/il-path-transformation-pa.pdf"},{"state":"Iowa","policy_lever":"Accountable Care Arrangements","activity_status":"Actual","activity_description":"Iowa has established ACO agreements to manage the new Iowa Wellness Plan population as of January 1, 2014.  Medicaid has 5 ACO agreements in place with major healthcare system and as noted above.  ACOs must have a participating agreements with the IHIN, must use HIT to securely exchange information and participate in the exchange of ADT data.","source":"Iowa Department of Human Services","source_url":"https://dhs.iowa.gov/sites/default/files/470-5218.pdf"},{"state":"Iowa","policy_lever":"eCQM Reporting","activity_status":"Actual","activity_description":"Iowa Medicaid aligned their ACO quality measurement system with the dominant private payers in Iowa.  Both payers track ACO quality using a composite score called the Value Index Score (VIS).  The VIS measures primary care providers on up to 16 different measures that focus on whole-person, system transforming activities.  A strong VIS score provides the delivery system with processes necessary to lower the total cost of care.  The VIS is a claims based quality measurement tool system which has no reporting burden on providers, while at the same time a dashboard refreshed monthly with dynamic reporting allows providers access to data previously not available.","source":"Iowa Department of Human Services","source_url":"http://dhs.iowa.gov/ime/about/iowa-health-and-wellness-plan/ACO-VIS"},{"state":"Iowa","policy_lever":"Federal or State Grants","activity_status":"Actual","activity_description":"Iowa is one of 11 states award an Round 2 SIM Test grant.  The state must implement activities that support improved population health, transformed healthcare delivery and lower total cost of care.  To support HIT and interoperability, the SIM proposal focuses on requiring the delivery system to connect and use the statewide HIE, known as the IHIN, use, analyze and share data to improve care coordination.  By providing the delivery system with a state-wide event notification system, this data can be used to 1. Receive timely information from systems outside of their own internal delivery systems; 2. Coordinate transitions of care with entities outside of their own system; and, 3. Improve health outcomes of individual patients that have the potential to both improve overall population health and lower potentially avoidable events.","source":"Iowa Department of Human Services: Iowa's Project Narrative, page 20 and 21","source_url":"http://dhs.iowa.gov/sites/default/files/SIM_Testing_Iowa_Project_Narrative.pdf"},{"state":"Iowa","policy_lever":"HIE Advisory Council / Oversight Board","activity_status":"Actual","activity_description":"Legislation was created and passed recognizing the eHealth executive council and advisory committee.  This body is used to determine and approve state related HIE activities.","source":"Iowa Legislation Documents","source_url":"https://www.legis.iowa.gov/docs/code/2015/135.156.pdf"},{"state":"Iowa","policy_lever":"Medicare and Medicaid EHR Incentive Program (Meaningful Use)","activity_status":"Actual","activity_description":"Iowa implemented the Medicaid EHR Incentive Payment Program with a rollout date of January 3, 2011. The Iowa Medicaid Enterprise coordinated outreach efforts with the Regional Extension Center and Iowa Department of Public Health as well as the eHealth Advisory Council to assist eligible provider's and hospital's participation in the program. Iowa has made over $118 M in Medicaid EHR incentive payments to Iowa providers and hospitals.","source":"Iowa Department of Human Services","source_url":"http://dhs.iowa.gov/ime/providers/tools-trainings-and-services/medicaid-initiatives/EHRincentives"},{"state":"Iowa","policy_lever":"Medicaid State Plan Amendments (SPA)","activity_status":"Actual","activity_description":"Iowa's Medicaid Health Home SPA (1 of 2) targets individuals with two chronic conditions or one chronic condition and at risk for another, including BMI over 85% for the pediatric population.   Iowa e-health is implementing a state-wide health exchange in CY2012.  Iowa Medicaid Enterprise) will support the effort to make the exchange available to health home providers. The HIT team will monitor the rate of adoption and meaningful use of EHRs within the Iowa Medicaid provider community. To operate a health home, the following relate to Health IT: (demonstrate use of population management tool (patient registry); demonstrate evidence of EHR and plan to meaningfully use HIT; connect to statewide health information network; encourage email, text messaging; patient portals and other technology to communicate with patients. Providers will maintain an electronic system with standard/protocols for tracking patient referrals, and using the Health Information Network (HIN) to exchange health records.  Use of the EHR will assist with maintaining a comprehensive medication list and allow providers access to evidence based decisions and assist with referral protocols.","source":"Medicaid Approved Health Home State Plan Amendments: (Filter by State; Search term= Health Home)  IA 14-002 Approval Date 4/03/14","source_url":"http://www.medicaid.gov/state-resource-center/medicaid-state-plan-amendments/medicaid-state-plan-amendments.html"},{"state":"Iowa","policy_lever":"Medicaid Waivers and Demonstrations","activity_status":"Expired","activity_description":"Medical homes in the IowaCare Medical Home Pilot must: Implement and/or utilize Health Information Technology (HIT); a. Demonstrate evidence of acquisition, installation and adoption of an electronic health record (EHR) system. b. Establish a plan for meaningful use of health information exchange (HIE) in accordance with the Federal Register requirement. c. Report chronic conditions ?registry data? once the IME registry guidelines are established. An assumption can be made that the guidelines will adopt the PQRI/Meaningful Use data format.","source":"IowaCare Amendment to Section 1115 Demonstration","source_url":"http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ia/ia-care-ca.pdf"},{"state":"Iowa","policy_lever":"Medicaid Waivers and Demonstrations","activity_status":"Expired","activity_description":"The state of Iowa shall work to meet the following benchmarks during the extension period:  Increase the adoption and meaningful use of Electronic Health Records (EHR) and Health Information Exchange (HIE) by primary network providers in the demonstration. All primary network providers will either have an EHR, or will have a plan and timeframe for adopting an EHR.","source":"IowaCare Amendment to Section 1115 Demonstration","source_url":"http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ia/ia-care-ca.pdf"},{"state":"Iowa","policy_lever":"State Privacy and Security Policies","activity_status":"Actual","activity_description":"Iowa e-Health has used resources provided through the Iowa Attorney General?s Office to create a Participation Agreement and related documents, including the IHIN Privacy Policies and IHIN Security Policies.","source":"Iowa e-Health Privacy & Security","source_url":"http://www.iowaehealth.org/patient/privacy-security/"},{"state":"Iowa","policy_lever":"Private Grants/Contracts","activity_status":"Actual","activity_description":"Some states started leveraging the rise of ACOs to bolster their HIE infrastructure, and vice versa. In Iowa, Wellmark has twelve ACO contracts, each of which will require a system for sharing data internally.","source":"Iowa Department of Human Services","source_url":"https://dhs.iowa.gov/sites/default/files/470-5218.pdf"},{"state":"Iowa","policy_lever":"Public Health Surveillance","activity_status":"Actual","activity_description":"The IHIN has built capability for electronic submission of both cancer registry data and state reportable disease lab results. Both of these services utilize standard file layouts.  In order to use either of these services there must be a signed Participation Agreement.","source":"Iowa Health","source_url":"http://iowaehealth.org/provider/resources/meaningful-use/"},{"state":"Iowa","policy_lever":"State Purchasing/Contracting of Health Care Services","activity_status":"Proposed","activity_description":"Awarded MCOs shall interface with the IHIN,  promote the use of HIT, and agree to align with State led HIT initiatives as they develop.","source":"Iowa Department of Human Services: RFP MED-16-009 Attachment 1 (SOW) Incorporating Amendment 1, 03-26-15.docx","source_url":"http://bidopportunities.iowa.gov/?pgname=viewrfp&rfp_id=11140"},{"state":"Iowa","policy_lever":"State Purchasing/Contracting of Health IT Infrastructure (non-Medicaid)","activity_status":"Proposed","activity_description":"One activity of the State's SIM project is to establish a state-wide event notification system.  Iowa is starting with ADT files from Iowa hospitals and sending notifications to care teams when a patient has a ED Discharge, an Inpatient Admission or an Inpatient Discharge.  The SIM project is funding the infrastructure and will be piloting the project with Medicaid data, however, the design is to be multipayer with the ability to allow any payer's population to take advantage of the notification system.","source":"Iowa Department of Human Services: Iowa's Project Narrative, page 20 and 21","source_url":"http://dhs.iowa.gov/sites/default/files/SIM_Testing_Iowa_Project_Narrative.pdf"},{"state":"Iowa","policy_lever":"State-level Legal Protections","activity_status":"Actual","activity_description":"To promote patient safety and to provide a safe harbor for providers, Iowa law provides that a healthcare professional or hospital who uses health information accessed through the IHIN for treatment purposes is exempt from any other state law that would otherwise prevent access to that information.   New legislation was just passed by the house and senate and will soon be sent to the governor. This new legislation will expand these protections to payment and healthcare operations.","source":"Iowa Code Section 135.156E(13) (2012)","source_url":"https://www.legis.iowa.gov/docs/code/135.156E.pdf"},{"state":"Iowa","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"Iowa's Medicaid Health Home SPA (1 of 2) targets individuals with two chronic conditions or one chronic condition and at risk for another, including BMI over 85% for the pediatric population.   Iowa e-health is implementing a state-wide health exchange in CY2012.  Iowa Medicaid Enterprise) will support the effort to make the exchange available to health home providers. The HIT team will monitor the rate of adoption and meaningful use of EHRs within the Iowa Medicaid provider community. To operate a health home, the following relate to Health IT: (demonstrate use of population management tool (patient registry); demonstrate evidence of EHR and plan to meaningfully use HIT; connect to statewide health information network; encourage email, text messaging; patient portals and other technology to communicate with patients. Providers will maintain an electronic system with standard/protocols for tracking patient referrals, and using the Health Information Network (HIN) to exchange health records.  Use of the EHR will assist with maintaining a comprehensive medication list and allow providers access to evidence based decisions and assist with referral protocols.","source":"Medicaid Approved Health Home State Plan Amendments  (Filter by State; Search term= Health Home)  IA 14-002 Approval Date 4/03/14","source_url":"http://www.medicaid.gov/state-resource-center/medicaid-state-plan-amendments/medicaid-state-plan-amendments.html"},{"state":"Iowa","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Expired","activity_description":"Medical homes in the IowaCare Medical Home Pilot must: Implement and/or utilize Health Information Technology (HIT); a. Demonstrate evidence of acquisition, installation and adoption of an electronic health record (EHR) system. b. Establish a plan for meaningful use of health information exchange (HIE) in accordance with the Federal Register requirement. c. Report chronic conditions ?registry data? once the IME registry guidelines are established. An assumption can be made that the guidelines will adopt the PQRI/Meaningful Use data format.","source":"IowaCare Amendment to Section 1115 Demonstration","source_url":"http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ia/ia-care-ca.pdf"},{"state":"Iowa","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Expired","activity_description":"The state of Iowa shall work to meet the following benchmarks during the extension period:  Increase the adoption and meaningful use of Electronic Health Records (EHR) and Health Information Exchange (HIE) by primary network providers in the demonstration. All primary network providers will either have an EHR, or will have a plan and timeframe for adopting an EHR.","source":"IowaCare Amendment to Section 1115 Demonstration","source_url":"http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ia/ia-care-ca.pdf"},{"state":"Kentucky","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"CMS Comprehensive Primary Care Initiative participants are encouraged to connect to the statewide HIE (SHARE) to exchange clinical information (ONC SOP Update 2013).","source":"CMS Comprehensive Primary Care Initiative","source_url":"http://innovation.cms.gov/initiatives/Comprehensive-Primary-Care-Initiative/"},{"state":"Kentucky","policy_lever":"Federal or State Grants","activity_status":"Actual","activity_description":"In March, 2014, CMS awarded planning grants to nine qualified states to test quality measurement tools and demonstrate e-health in Medicaid community-based long term services and supports (LTSS). The grant program, known as TEFT, is designed to field test an experience survey and a set of functional assessment items, demonstrate personal health records, and create a standard electronic LTSS record. The state grantees will have an opportunity to extend the grant period to a total of four years. With the total grant program nearing $42 million, this is the first time the Centers for Medicare & Medicaid Services (CMS) is promoting the use of health information technology in the community-based LTSS system.","source":"TEFT Info CMS","source_url":"http://www.medicaid.gov/medicaid-chip-program-information/by-topics/delivery-systems/grant-programs/teft-program.html"},{"state":"Kentucky","policy_lever":"Medicare and Medicaid EHR Incentive Program (Meaningful Use)","activity_status":"Actual","activity_description":"KHIE collaborates closely with the State's Medicaid Incentive Program. Providers must connect to the HIE in order to attest to the public health objectives within meaningful use.","source":"","source_url":"http://chfs.ky.gov/dms/ehr.htm"},{"state":"Kentucky","policy_lever":"Public Health Surveillance","activity_status":"Actual","activity_description":"KY has mandated that providers electronically report diseases via KHIE.","source":"","source_url":"http://www.lrc.ky.gov/kar/902/002/020.htm"},{"state":"Kentucky","policy_lever":"Public Health Surveillance","activity_status":"Actual","activity_description":"Kentucky CHFS is pursuing an enterprise network that would be a backbone for the Public Health Reporting and Surveillance systems, MMIS, APCD, HBE, and HIE","source":"KY Strategic and Operational Plan Profile","source_url":"http://khie.ky.gov/SiteCollectionDocuments/KY%20Plan%20Summary%2003%2008%2011%20pdf.pdf"},{"state":"Kentucky","policy_lever":"State Designation of Exchange Entity","activity_status":"Actual","activity_description":"The Commonwealth of Kentucky has designated Kentucky Health Information Exchange as the Public Health Authority (PHA) for  Public Health Reporting for Syndromic Surveillance (SS), Electronic Laboratory Reporting (ELR), Cancer Case and Immunization Registry (IR) reporting.","source":"","source_url":"http://chfs.ky.gov/NR/rdonlyres/1158A0F3-B33E-44F5-B774-6A7B9D53D493/0/KY_SMHP_v3_10072011.pdf"},{"state":"Kentucky","policy_lever":"State HIE / HISP Accreditation, Certification, Registration, or Qualification","activity_status":"Actual","activity_description":"KY has a Direct Trust Accredited HISP in place that supports care transitions for providers.","source":"","source_url":"http://khie.ky.gov/tech/Pages/toc.aspx"},{"state":"Kentucky","policy_lever":"All Payer Claims Database (APCD) Policies","activity_status":"Actual","activity_description":"Kentucky CHFS is pursuing an enterprise network that would be a backbone for the Public Health Reporting and Surveillance systems, MMIS, APCD, HBE, and HIE","source":"KY Strategic and Operational Plan Profile","source_url":"http://khie.ky.gov/SiteCollectionDocuments/KY%20Plan%20Summary%2003%2008%2011%20pdf.pdf"},{"state":"Maine","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"The demonstration program pays a monthly care management fee for beneficiaries receiving primary care from advanced primary care (APC) practices. The care management fee is intended to cover care coordination, improved access, patient education and other services to support chronically ill patients. Additionally, each participating State will have mechanisms to offer APC practices community support and linkages to State health promotion and disease prevention initiatives. Five states (Maine, Michigan, New York, Rhode Island, Vermont) accepted the offer and will continue participation in this demonstration through 2016.","source":"CMS Multi-Payer Advanced Primary Care Practice","source_url":"http://innovation.cms.gov/initiatives/Multi-Payer-Advanced-Primary-Care-Practice/"},{"state":"Maine","policy_lever":"Medicaid State Plan Amendments (SPA)","activity_status":"Actual","activity_description":"Core principles of PCMH treatment include treatment by providers who demonstrate leadership in PCMH delivery of care, a team based approach to care, practice integrated care management, enhanced access to care, behavioral-physical health integration, inclusion of patients and families in treatment, a connection to the community, integration of health information technology, and a commitment to reducing unnecessary healthcare spending, reducing waste, and improving cost-effective use of health care services","source":"ME Medicaid State Plan Amendment","source_url":"http://www.medicaid.gov/State-resource-center/Medicaid-State-Plan-Amendments/Downloads/ME/ME-09-018-Att.pdf"},{"state":"Maine","policy_lever":"Medicaid State Plan Amendments (SPA)","activity_status":"Actual","activity_description":"Maine's Medicaid Health Home SPA (1 of 2) targets individuals with two chronic conditions or one chronic condition and at risk for another.  The State of Maine requires all Health Homes to use EHR technology. Many of the providers are participating in the MaineCare HIT incentive program, including 100% of the state's FQHC's that are becoming health homes. HealthInfoNet (Maine's statewide health information exchange) has live connecti0ns to over 80% of Maine hospitals.  Secure messaging using HNIN/Direct Project standards are available to CCTs (Community Care Teams) for secure exchange of patient information. Sharing of care plans at point of transition will be accomplished either through the exchange of documents, via Direct, or through care summary information shared between EHRs. The Health Home (HH) practice will provide the care plan to the beneficiaries at the time of each visit as a \"visit summary\" generated out of the EHR.  HH will use EHR technology to provide individual and population healthcare to the MaineCare population being served. Provider EHR's will capture discreet clinical data that will be used in generating performance reports.  HH will be added to the prioritization list of ambulatory practices that will be on-boarded to the statewide HIE, HealthInfoNet.  Subject to the receipt of grant funding, the HIE is also developing and implementing a patient portal, which would be operational in the second half of 2013. HH teams will participate in a provider learning collaborative whose focus will be evidence based practice, including incorporating HIT into patient care. For those CCTs that do not have access to an EHR, they will communicate with the PCMH practice through the use of HIN Direct secure messaging standards; the HH practice will then enter that communication into the EMR. When possible, HH practice teams and CCTs will be encouraged to access patient information using HealthInfoNet.","source":"Medicaid Approved Health Home State Plan Amendments (Filter by State; Search term= Health Home)  ME 12-004 Approval Date 1/22/2013","source_url":"http://www.medicaid.gov/state-resource-center/medicaid-state-plan-amendments/medicaid-state-plan-amendments.html"},{"state":"Maine","policy_lever":"Medicaid State Plan Amendments (SPA)","activity_status":"Actual","activity_description":"Maine's Medicaid Health Home SPA (2 of 2) targets SPMI (Serious and Persistent Mental Illness) and children with serious emotional disturbance (SED). All enhanced primary care practices will have certified EHR systems with secure messaging. Certain Behavioral Health Home Organizations are eligible to receive funding through Maine's Innovation Model Initiative for the development and implementation of EHRs. Over 24 months all BHHO will be expected to have implemented certified EHR systems.  BHHO will be expected to share health information including care planning documents to and from other treating providers/organizations and across the team of BHH professionals. This will be according to capacity of the BHHO and described in  the MOA between the BHHO and the enhanced primary care practice. MaineCare will make available to BHH providers utilization data from MaineCare to assist in identification of high needs/high cost members and as a tool to scan for and act upon any gaps in care.","source":"Medicaid Approved Health Home State Plan Amendments (Filter by State; Search term= Health Home)  ME 14-001 Approval Date 12/17/2014","source_url":"http://www.medicaid.gov/state-resource-center/medicaid-state-plan-amendments/medicaid-state-plan-amendments.html"},{"state":"Maine","policy_lever":"Private Grants/Contracts","activity_status":"Ended","activity_description":"HealthInfoNet was awarded a 2-year Payment Reform Grant from the Maine Health Access foundation in 2011 to:  ? Establish a clinical data warehouse system to support payment reform initiatives leveraging the existing treatment-based health information exchange to address the aggregate data needs of hospitals and provider systems across the State. ? Determine the feasibility of linking clinical data with claims data from the Maine Health Data Organization (MHDO). This has been a long-time commitment by HealthInfoNet and was described in the approved SOP. The linking of the two data sets will build on Maine?s leadership in using data to promote better health outcomes.","source":"HealthInfoNet Press Release","source_url":"http://www.hinfonet.org/news-events/news/healthinfonet-receives-grant-link-maine%E2%80%99s-health-exchange-statewide-claims-database"},{"state":"Maine","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"Core principles of PCMH treatment include treatment by providers who demonstrate leadership in PCMH delivery of care, a team based approach to care, practice integrated care management, enhanced access to care, behavioral-physical health integration, inclusion of patients and families in treatment, a connection to the community, integration of health information technology, and a commitment to reducing unnecessary healthcare spending, reducing waste, and improving cost-effective use of health care services","source":"ME Medicaid State Plan Amendment","source_url":"http://www.medicaid.gov/State-resource-center/Medicaid-State-Plan-Amendments/Downloads/ME/ME-09-018-Att.pdf"},{"state":"Maine","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"Maine's Medicaid Health Home SPA (1 of 2) targets individuals with two chronic conditions or one chronic condition and at risk for another.  The State of Maine requires all Health Homes to use EHR technology. Many of the providers are participating in the MaineCare HIT incentive program, including 100% of the state's FQHC's that are becoming health homes. HealthInfoNet (Maine's statewide health information exchange) has live connecti0ns to over 80% of Maine hospitals.  Secure messaging using HNIN/Direct Project standards are available to CCTs (Community Care Teams) for secure exchange of patient information. Sharing of care plans at point of transition will be accomplished either through the exchange of documents, via Direct, or through care summary information shared between EHRs. The Health Home (HH) practice will provide the care plan to the beneficiaries at the time of each visit as a \"visit summary\" generated out of the EHR.  HH will use EHR technology to provide individual and population healthcare to the MaineCare population being served. Provider EHR's will capture discreet clinical data that will be used in generating performance reports.  HH will be added to the prioritization list of ambulatory practices that will be on-boarded to the statewide HIE, HealthInfoNet.  Subject to the receipt of grant funding, the HIE is also developing and implementing a patient portal, which would be operational in the second half of 2013. HH teams will participate in a provider learning collaborative whose focus will be evidence based practice, including incorporating HIT into patient care. For those CCTs that do not have access to an EHR, they will communicate with the PCMH practice through the use of HIN Direct secure messaging standards; the HH practice will then enter that communication into the EMR. When possible, HH practice teams and CCTs will be encouraged to access patient information using HealthInfoNet.","source":"Medicaid Approved Health Home State Plan Amendments (Filter by State; Search term= Health Home)  ME 12-004 Approval Date 1/22/2013","source_url":"http://www.medicaid.gov/state-resource-center/medicaid-state-plan-amendments/medicaid-state-plan-amendments.html"},{"state":"Maine","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"Maine's Medicaid Health Home SPA (2 of 2) targets SPMI (Serious and Persistent Mental Illness) and children with serious emotional disturbance (SED). All enhanced primary care practices will have certified EHR systems with secure messaging. Certain Behavioral Health Home Organizations are eligible to receive funding through Maine's Innovation Model Initiative for the development and implementation of EHRs. Over 24 months all BHHO will be expected to have implemented certified EHR systems.  BHHO will be expected to share health information including care planning documents to and from other treating providers/organizations and across the team of BHH professionals. This will be according to capacity of the BHHO and described in  the MOA between the BHHO and the enhanced primary care practice. MaineCare will make available to BHH providers utilization data from MaineCare to assist in identification of high needs/high cost members and as a tool to scan for and act upon any gaps in care.","source":"Medicaid Approved Health Home State Plan Amendments  (Filter by State; Search term= Health Home)  ME 14-001 Approval Date 12/17/2014","source_url":"http://www.medicaid.gov/state-resource-center/medicaid-state-plan-amendments/medicaid-state-plan-amendments.html"},{"state":"Maryland","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"EHR adoption and use is a core component of advanced care delivery models.  In the State?s pilot multi-payor patient centered medical home program participating practices were required to have a certified EHR and use services available through the State-Designated HIE.","source":"Maryland PCMH Practice Evaluation","source_url":"http://mhcc.maryland.gov/mhcc/pages/plr/plr_pcmh/documents/PCMH_Practice_Evaluation.pdf"},{"state":"Maryland","policy_lever":"All Payer Claims Database (APCD) Policies","activity_status":"Actual","activity_description":"Master patient indexing services for the All Payor Claims database, relying the MPI to enable insights into member churn between QHPs and Medicaid plans as member eligibility status changes over time;","source":"CRISP Provider Data Services MESC Conference Presentation","source_url":"http://www.mesconference.org/wp-content/uploads/2013/09/Tuesday_Provider-Data_Afzal-Moodley2.pdf"},{"state":"Maryland","policy_lever":"Federal or State Grants","activity_status":"Actual","activity_description":"In March, 2014, CMS awarded planning grants to nine qualified states to test quality measurement tools and demonstrate e-health in Medicaid community-based long term services and supports (LTSS). The grant program, known as TEFT, is designed to field test an experience survey and a set of functional assessment items, demonstrate personal health records, and create a standard electronic LTSS record. The state grantees will have an opportunity to extend the grant period to a total of four years. With the total grant program nearing $42 million, this is the first time the Centers for Medicare & Medicaid Services (CMS) is promoting the use of health information technology in the community-based LTSS system.","source":"TEFT Info CMS","source_url":"http://www.medicaid.gov/medicaid-chip-program-information/by-topics/delivery-systems/grant-programs/teft-program.html"},{"state":"Maryland","policy_lever":"HIE Advisory Council / Oversight Board","activity_status":"Actual","activity_description":"On May 19, 2011, House Bill 784, Medical Records ? Health Information Exchanges (HB 784) was signed into law.  This law stipulates that the Maryland Health Care Commission (MHCC) will adopt regulations for the privacy and security of protected information exchanged through all HIEs in the state.  The MHCC assembled an HIE Policy Board (Policy Board), an advisory group, in 2009 to: 1) maximize the benefit of HIE for health care consumers and providers, 2) mitigate potential privacy and security concerns for consumers, 3) promote consumer control over the use of and access to consumer health information, to the extent technically feasible, 4) support current law, 5) minimize overall costs to the health care system, and 6) facilitate public health and appropriate research uses. The HIE Policy Board advise MHCC staff on the policies regarding the privacy and security of protected health information exchanged through an HIE operating in the State.  The MHCC uses these policies in developing HIE regulations.","source":"MHCC HIE Policy Board Overview","source_url":"http://mhcc.maryland.gov/mhcc/Pages/home/workgroups/workgroups_hie_policyboard.aspx"},{"state":"Maryland","policy_lever":"Medicaid State Plan Amendments (SPA)","activity_status":"Actual","activity_description":"Health Homes for individuals with chronic conditions will augment the State's broader efforts to integrate somatic and behavioral health services. The program will target populations with behavioral health needs who are at high risk for additional chronic conditions, including those with serious persistent mental illness, serious emotional disturbance, and opioid substance use disorders. Health Homes will offer participants enhanced care coordination services from providers with whom they regularly receive care, including psychiatric rehabilitation programs, mobile treatment service providers, and opioid treatment programs.  This is a community-based approach, not a residential program.  Health Homes are designed to enhance person-centered care, empowering participants to manage and prevent chronic conditions in order to improve health outcomes, while reducing avoidable hospital encounters.  Health Homes will provide six core services, as follows: Comprehensive Care Management; Care Coordination; Health Promotion; Comprehensive Transitional Care; Individual and Family Support; and Referral to Community and Social Support.  Several forms of health information technology aid Health Homes in serving their participants.  This includes real time hospital encounter alerts and pharmacy use data from the State-Designated Health Information Exchange, as well as an eMedicaid online portal that acts as an enrollment, reporting, and tracking mechanism.","source":"Medicaid Approved Health Home State Plan Amendments","source_url":"http://www.medicaid.gov/State-Resource-Center/Medicaid-State-Technical-Assistance/Health-Homes-Technical-Assistance/Approved-Health-Home-State-Plan-Amendments.html"},{"state":"Maryland","policy_lever":"Prescription Drug Monitoring Programs (PDMP)","activity_status":"Proposed","activity_description":"Maryland?s Department of Health and Mental Hygiene (DHMH) has partnered with the State-Designated HIE to implement the State?s PDMP infrastructure to ensure that controlled dangerous substance (CDS) data are incorporated into a single source of external clinical data for providers (rather than a standalone PDMP portal).  Scheduled drug information is available to pharmacists and other treating health care providers will be made available through a web-based portal.","source":"Health Information Designs PDMP FAQ","source_url":"http://www.hidesigns.com/mdpdmp/frequently-asked-questions.html"},{"state":"Maryland","policy_lever":"State Privacy and Security Policies","activity_status":"Actual","activity_description":"MD H 806 Requires certain regulations for protected health information obtained or released through a health information exchange to govern the access, use maintenance, disclosure, and re-disclosure of protected health information as required by State and federal law.","source":"Affordable Care Act Legislative Database","source_url":"http://www.ncsl.org/research/health/new-health-reform-database.aspx"},{"state":"Maryland","policy_lever":"Public Health Surveillance","activity_status":"Proposed","activity_description":"HIE will facilitate certain legally authorized public health uses, such as reportable labs and immunization reporting to public health agencies.","source":"Overview of MU Stage 2 Public Health Reporting & For Obtaining Financial Subsidies for Connectivity when Connecting through CRISP","source_url":"https://mmcp.dhmh.maryland.gov/ehr/SiteAssets/SitePages/Home/PH_MU_Stage2_Notice%20to%20Hospitals_12.12.13.pdf"},{"state":"Maryland","policy_lever":"Qualified Health Plan Requirement (Health Insurance Exchange)","activity_status":"Actual","activity_description":"CRISP has partnered with the Maryland HBE to provide the following services: 1) provider information management, a verified provider demographics source (fed by the HBE Qualified Health Plans) to enable HBE customers to search for plans by providers in the network.","source":"CRISP Provider Data Services MESC Conference Presentation","source_url":"http://www.mesconference.org/wp-content/uploads/2013/09/Tuesday_Provider-Data_Afzal-Moodley2.pdf"},{"state":"Maryland","policy_lever":"Rate Setting and Rate Review","activity_status":"Actual","activity_description":"COMAR 10.37.07.03. Effective December 1, 2011, each hospital under the jurisdiction of the [Health Services Cost Review Commission (HSCRC)] shall electronically connect to the State-Designated HIE to enable the Commission to fully measure hospital-specific performance on readmissions using the HIE?s MPI.","source":"","source_url":"http://www.dsd.state.md.us/comar/comarhtml/10/10.37.07.03.htm"},{"state":"Maryland","policy_lever":"State Designation of Exchange Entity","activity_status":"Actual","activity_description":"Maryland law required the MHCC to designate a statewide HIE.  A competitive process was established to identify a multi-stakeholder group that would become a State-Designated HIE.  State-Designation is valid for a three-year time period.  See Appendix B for Md. Code Ann., Health-Gen. ?19-143 Annotated Code of Maryland.","source":"MD Code Ann., Health-General ? 19-143","source_url":"http://mhcc.maryland.gov/mhcc/pages/hit/hit_hie/hit_hie.aspx"},{"state":"Maryland","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"Health Homes for individuals with chronic conditions will augment the State's broader efforts to integrate somatic and behavioral health services. The program will target populations with behavioral health needs who are at high risk for additional chronic conditions, including those with serious persistent mental illness, serious emotional disturbance, and opioid substance use disorders. Health Homes will offer participants enhanced care coordination services from providers with whom they regularly receive care, including psychiatric rehabilitation programs, mobile treatment service providers, and opioid treatment programs.  This is a community-based approach, not a residential program.  Health Homes are designed to enhance person-centered care, empowering participants to manage and prevent chronic conditions in order to improve health outcomes, while reducing avoidable hospital encounters.  Health Homes will provide six core services, as follows: Comprehensive Care Management; Care Coordination; Health Promotion; Comprehensive Transitional Care; Individual and Family Support; and Referral to Community and Social Support.  Several forms of health information technology aid Health Homes in serving their participants.  This includes real time hospital encounter alerts and pharmacy use data from the State-Designated Health Information Exchange, as well as an eMedicaid online portal that acts as an enrollment, reporting, and tracking mechanism.","source":"Medicaid Approved Health Home State Plan Amendments","source_url":"http://www.medicaid.gov/State-Resource-Center/Medicaid-State-Technical-Assistance/Health-Homes-Technical-Assistance/Approved-Health-Home-State-Plan-Amendments.html"},{"state":"Maryland","policy_lever":"HIE Connection or Interoperability Mandate","activity_status":"Actual","activity_description":"COMAR 10.37.07.03. Effective December 1, 2011, each hospital under the jurisdiction of the [Health Services Cost Review Commission (HSCRC)] shall electronically connect to the State-Designated HIE to enable the Commission to fully measure hospital-specific performance on readmissions using the HIE?s MPI.","source":"","source_url":"http://www.dsd.state.md.us/comar/comarhtml/10/10.37.07.03.htm"},{"state":"Massachusetts","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"MassHealth (Medicaid) Policies: Various MassHealth initiatives such as Primary Care Payment Reform (PCPR) require providers to exchange clinical patient data which helps drive HIway adoption.","source":"MA State Innovation Model Operational Plan, 2013","source_url":"http://www.mass.gov/eohhs/docs/eohhs/state-innovation/ma-sim-operational-plan.pdf"},{"state":"Massachusetts","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"Payment reform initiatives, mandated by Chapter 224, such as the creation of ACOs and other integrated care models, will also require clinical coordination and help drive adoption.","source":"Summary of Chapter 224 of the Acts of 2012","source_url":"http://bluecrossmafoundation.org/sites/default/files/download/publication/Chapter%20224%20summary_1.pdf"},{"state":"Massachusetts","policy_lever":"All Payer Claims Database (APCD) Policies","activity_status":"Actual","activity_description":"MA FY15 Final Budget: Among other things, appropriates $4 million for the center for health information and analysis, for the development, operation and maintenance of an all-payer claims database.","source":"MA FY15 Final Budget (see section 4100-0061)","source_url":"https://malegislature.gov/Budget/FinalBudget/2015"},{"state":"Massachusetts","policy_lever":"Federal or State Grants","activity_status":"Actual","activity_description":"The Infrastructure and Capacity Building (ICB) grant program, funded by MassHealth, provides state funding for hospitals and community health centers across the state to help establish integrated delivery systems that provide more effective and cost?efficient care to patients in need.  All grant participants are also required to submit a plan to connect and use the Mass HIway, Massachusetts? Health Information Exchange.","source":"","source_url":"http://www.mass.gov/eohhs/docs/eohhs/strategic-plan/ehs-performance-report-fy14.pdf"},{"state":"Massachusetts","policy_lever":"Federal or State Grants","activity_status":"Proposed","activity_description":"The State Innovation Model Program for Massachusetts, sponsored by CMS, is developing a program that would  provide funding to provide technical assistance to support the connection of  Long Term Care and Behavioral Health providers to the Mass HIway.","source":"","source_url":"http://www.mass.gov/eohhs/docs/eohhs/state-innovation/ma-sim-operational-plan.pdf"},{"state":"Massachusetts","policy_lever":"Federal or State Grants","activity_status":"Actual","activity_description":"Established through the Commonwealth?s landmark cost containment law, Chapter 224 of the Acts of 2012, The Community Hospital Acceleration, Revitalization, and Transformation or (CHART) initiative is a grant program that will make phased investments for certain Massachusetts community hospitals to enhance their delivery of efficient, effective care. One goal of the program is to promote care coordination, integration, and delivery transformation and advance electronic health records adoption and information exchange among providers. Currently, all program applicants must state their commitment to beginning or maintaining participation in the Mass HIway.","source":"","source_url":"http://www.mass.gov/anf/budget-taxes-and-procurement/oversight-agencies/health-policy-commission/chart/"},{"state":"Massachusetts","policy_lever":"HIE Advisory Council / Oversight Board","activity_status":"Actual","activity_description":"Governance and Focus: Ch. 224 expanded the Health IT Council to broaden its representation across the healthcare community and added significantly to the breadth of experience and knowledge on the Council. The Council is the oversight body for the health information exchange.","source":"Summary of Chapter 224 of the Acts of 2012","source_url":"http://bluecrossmafoundation.org/sites/default/files/download/publication/Chapter%20224%20summary_1.pdf"},{"state":"Massachusetts","policy_lever":"Provider Licensure","activity_status":"Actual","activity_description":"Chapter 224 of the Acts of 2012 (Ch. 224), the Massachusetts legislature enacted two significant provisions related to EHR use and HIE use. First, as a condition of medical licensure, applicants must \"demonstrate the skills to comply with the 'meaningful use' requirements, as set forth in 45 C.F.R. Part 170\" (1). Second, all providers in the state (not just physicians and hospitals), \"All providers in the commonwealth shall implement fully interoperable electronic health records systems that connect to the statewide health information exchange\" by January 1, 2017 (2).   In January 2015, the Mass Board of Registration in Medicine published its final regulations on the \"EHR Proficiency Requirement,\" stating that proficiency could be demonstrated via participation in the Meaningful Use program, employment with, credentialed to provide patient care at, or in a contractual agreement with an eligible hospital or critical access hospital with a CMS Meaningful Use program, by being a participant in the Massachusetts Health Information Highway, or completion of 3 CME hours on MU and eCQMs (3).","source":"New Data source for Physician EHR Proficiency Requirement","source_url":"http://www.massmed.org/Advocacy/Regulatory-Issues/Board-of-Registration-in-Medicine-Regulations-on-EHRs-and-Meaningful-Use-(pdf)"},{"state":"Massachusetts","policy_lever":"Private Grants/Contracts","activity_status":"Actual","activity_description":"The Massachusetts eHealth Institute (MeHI) is issuing direct grants to provider organizations for adoption of EHR systems as well as connectivity to the Mass HIway.  Grants are targeted at populations that have not been eligible for Meaningful Use funding in the past.  These populations include Behavioral Health and Long Term Care providers.","source":"","source_url":"http://mehi.masstech.org/funding/equality-incentive-program-eqip"},{"state":"Massachusetts","policy_lever":"Public Health Surveillance","activity_status":"Actual","activity_description":"Registry Connectivity: The Department of Public Health is in the process of adding its registries as nodes on the HIway. As these are added to the HIway, DPH is phasing out other mechanisms of submitting to these registries to help drive adoption of the HIway. Public Health nodes currently live on the HIway include: ? Massachusetts Immunization Information System (MIIS) ? Electronic Lab Reporting (ELR) ? Syndromic Surveillance  ? Intake Enrollment and Assessment Transfer Service (IEATS)/Opioid Treatment Program (OTP) ? The Massachusetts Cancer Registry ? Phase 1 of the eReferral program ? Childhood Lead Poisoning Prevention Program (CLPPP)  ? Adult Lead Poisoning Program ? Children's Behavioral Health Initiative","source":"HIWay Health Information Technology Council June Update","source_url":"http://www.mass.gov/eohhs/docs/eohhs/masshiway/20140609hitcouncilpresentation.pdf"},{"state":"Massachusetts","policy_lever":"State Designation of Exchange Entity","activity_status":"Proposed","activity_description":"Feb 2013: MA H 1909 would establish state-designated statewide health information exchange, with detailed privacy standards, the establishment of a secure website accessible to patients, and data available for evaluation of quality and cost.","source":"Affordable Care Act Legislative Database","source_url":"http://www.ncsl.org/research/health/new-health-reform-database.aspx"},{"state":"Massachusetts","policy_lever":"Accountable Care Arrangements","activity_status":"Actual","activity_description":"Payment reform initiatives, mandated by Chapter 224, such as the creation of ACOs and other integrated care models, will also require clinical coordination and help drive adoption.","source":"Summary of Chapter 224 of the Acts of 2012","source_url":"http://bluecrossmafoundation.org/sites/default/files/download/publication/Chapter%20224%20summary_1.pdf"},{"state":"Massachusetts","policy_lever":"State HIE / HISP Accreditation, Certification, Registration, or Qualification","activity_status":"Actual","activity_description":"Chapter 224 of the Acts of 2012 (Ch. 224), the Massachusetts legislature enacted two significant provisions related to EHR use and HIE use. First, as a condition of medical licensure, applicants must \"demonstrate the skills to comply with the 'meaningful use' requirements, as set forth in 45 C.F.R. Part 170\" (1). Second, all providers in the state (not just physicians and hospitals), \"All providers in the commonwealth shall implement fully interoperable electronic health records systems that connect to the statewide health information exchange\" by January 1, 2017 (2).   In January 2015, the Mass Board of Registration in Medicine published its final regulations on the \"EHR Proficiency Requirement,\" stating that proficiency could be demonstrated via participation in the Meaningful Use program, employment with, credentialed to provide patient care at, or in a contractual agreement with an eligible hospital or critical access hospital with a CMS Meaningful Use program, by being a participant in the Massachusetts Health Information Highway, or completion of 3 CME hours on MU and eCQMs (3).","source":"New Data source for Physician EHR Proficiency Requirement","source_url":"http://www.massmed.org/Advocacy/Regulatory-Issues/Board-of-Registration-in-Medicine-Regulations-on-EHRs-and-Meaningful-Use-(pdf)"},{"state":"Michigan","policy_lever":"Advanced Directives Registry","activity_status":"Actual","activity_description":"To raise awareness of advanced directives and to highlight the availability and importance of Michigan?s Peace of Mind Registry, Governor Rick Snyder has declared April 16, 2015 as Healthcare Decisions Day in Michigan.  As part of Healthcare Decisions Day, the Michigan Department of Health and Human Services (MDHHS), along with Michigan Secretary of State Ruth Johnson, is encouraging residents to consider completing an advance directive and submitting the directive to the Peace of Mind Registry for easy access and safe keeping","source":"","source_url":"http://www.michigan.gov/som/0,4669,7-192-29942_34762-352640--,00.html"},{"state":"Michigan","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"Under the multi-payer reform initiatives demonstration program, funded by CMS, states are participating in initiatives to make advanced primary care practices more broadly available. The Michigan Primary Care Transformation (MiPCT) Project is a three-year, multi-payer, state-wide project aimed at reforming primary care payment models and expanding the capabilities of patient-centered medical homes (PCMH) throughout the state. The selection of Michigan as one of eight states in the Multi-Payer Advanced Primary Care Practice Demonstration (MAPCP), sponsored by the Centers for Medicare and Medicaid (CMS), was the catalyst for bringing together Medicare, Michigan Medicaid Health Plans, Blue Cross Blue Shield of Michigan and Blue Care Network to improve upon the strong PCMH foundation in the state and create a uniform, sustainable primary care platform. Additional payers are expected to join as the project proceeds","source":"","source_url":"http://mipct.org/"},{"state":"Michigan","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"MiHIN and the SOM are proceeding with the MiWay Consumer Directory project to establish an electronic directory that will enable consumer access for selecting preferences such as locations of integrated personal health records, opt-in/opt-out for ACOs, location of advanced directives, etc.  Consumer engagement efforts will likely be focused on three areas: a) Personal health record (PHR) and patient portal gateway activities, e.g., moving CCDs among portals and PHRs b) Standing up a patient directory services infrastructure in conjunction with the State of Michigan as it moves forward with its Master Person Index initiative c) Propagation of consent management preferences among the various sub-state HIE organizations.","source":"MiHIN Statewide Consumer Directory Overview - Direct Workgroup v4 03-09-15","source_url":"http://www.slideshare.net/mihinpr/mihin-statewide-consumer-directory-overview-direct-workgroup-v4-030915?related=3"},{"state":"Michigan","policy_lever":"eCQM Reporting","activity_status":"Proposed","activity_description":"Under the Trailblazers effort in 2013 MiHIN initiated the Clinical Quality Measure Recovery and Repository (CQMRR) project which started first accepting Quality Reporting Document Architecture (QRDA) Category 3 files and more recently began accepting QRDA Category 1 files in a DataMart for State Medicaid.  MiHIN's capabilities for quality measure reporting are being expanded to include measures from CCDs and Supplemental Clinical Data Files (SCDFs) for conversion into NCQA XML for HEDIS.  Later measure sets to be added will include QRS, Medicaid, and PQRS.","source":"MiHIN Health Provider Directory Demo Slides with CQMRR v43 02-18-15","source_url":"http://www.slideshare.net/mihinpr/mihin-health-provider-directory-demo-slides-with-cq-v43-02-1815?related=2"},{"state":"Michigan","policy_lever":"eCQM Reporting","activity_status":"Actual","activity_description":"The State of Michigan has worked with MiHIN to create and test a mechanism for automated reporting of eCQMs to the state.  This mechanism already works for reporting QRDA Category 1 and 3 files to MiHIN via multiple transport secure mechanisms including Direct Secure Messaging and Michigan's Health Information Exchanges connected via Virtual Private Networks. The state and MiHIN have also stated the use of CCDs will be support as the quality payload mechanism for integrated care initiatives and ACOs.    CQMs collected by MiHIN will be viewable by providers and payers via quality portals in the Statewide Health Provider Directory","source":"MiHIN Presentation to ONC Grantees, November 2013","source_url":"http://mihin.org/wp-content/uploads/2013/12/State-HIE-All-Grantee-Webinar-November-CQMRR_11202013.pptx"},{"state":"Michigan","policy_lever":"Federal or State Grants","activity_status":"Actual","activity_description":"The former Great Lakes HIE (GLHIE), located in Michigan, significantly increased the number of hospitals and providers exchanging health information by using funding from the Michigan Health Information Network?s (MiHIN) Shared Services Capacity Building Grant Program to help rural hospitals, Federally Qualified Health Centers (FQHCs), free clinics, and physician practices pay for interfacing costs and subscription fees to GLHIE?s infrastructure. Since inception in May 2011, Great Lakes HIE signed up over 2,000 providers and with the help of MiHIN?s program as of 2012.  In 2014, GLHIE merged with Michigan's largest HIE, Michigan Health Connect, forming Great Lakes Health Connect with 126 member hospitals to become one of the largest operating HIEs in the U.S.","source":"State HIE Bright Spots Synthesis: Capacity Building Approaches","source_url":"http://www.healthit.gov/sites/default/files/bright-spots-synthesis_capacity-builder_final_12212012.pdf"},{"state":"Michigan","policy_lever":"State Privacy and Security Policies","activity_status":"Actual","activity_description":"On January 1,?in accordance with Public Act 129 of 2014, MDCH released the standard consent form?to?make consent simpler for individuals and providers.?In the past, providers developed?their?own forms?to receive consent to share information. The differences between forms made sharing information across the health care system difficult for individuals and providers.?The form will streamline information sharing?for?the following types of information: Behavioral health or mental health services that are provided by or are under contract with the MDCH or a Community Mental Health Service Provider , Referrals and /or treatment for a substance use disorder, Communicable diseases such as sexually transmitted diseases and human immunodeficiency virus (HIV Infection, Acquired Immune Deficiency Syndrome or AIDS Related Complex).","source":"","source_url":"http://www.michigan.gov/mdch/0,4612,7-132-2941_58005_70642---,00.html"},{"state":"Michigan","policy_lever":"Private Grants/Contracts","activity_status":"Actual","activity_description":"Society of Hospital Medicine?s BOOST project: Better Outcomes for Older adults through Safe Transitions.   By improving hospital discharge processes, Project BOOST aims to: -Reduce 30 day readmission rates for general medicine patients (with particular focus on older adults) -Improve patient satisfaction scores and H-CAHPS scores related to discharge -Improve flow of information between hospital and outpatient physicians and providers -Identify high-risk patients and target specific interventions to mitigate their risks for adverse events -Improve patient and family preparation for discharge","source":"Project BOOST? Facts & Implementation Toolkit","source_url":"http://www.hospitalmedicine.org/ResourceRoomRedesign/RR_CareTransitions/html_CC/project_boost_background.cfm"},{"state":"Michigan","policy_lever":"Public Health Surveillance","activity_status":"Actual","activity_description":"The Michigan Department of Community Health (MDCH), Michigan?s public health authority, requires public health reporting for meaningful use to be transported through the Michigan Health Information Network Shared Services (MiHIN). MiHIN is the state?s designated entity to coordinate health information exchange. Providers must select a MiHIN qualified organization or sub-state health information exchange (HIE) to handle the transmission of public health messages.","source":"","source_url":"https://www.michiganhealthit.org/public-health/"},{"state":"Michigan","policy_lever":"State Purchasing/Contracting of Health Care Services","activity_status":"Actual","activity_description":"Through volume purchasing, offering discounts on the purchase of cyber liability insurance, biometric and/or dual authentication security devices and systems, etc.","source":"MI State Medicaid HIT Plan, 2013","source_url":"https://www.michiganhealthit.org/wp-content/uploads/Michigan-SMHP-V2-10.pdf"},{"state":"Michigan","policy_lever":"State-level Legal Protections","activity_status":"Actual","activity_description":"Under the direction of the Michigan HIT Commission, MiHIN has created policies and procedures that protect organizations under its legal ?umbrella?  and its trust framework. These policies offer both operational and financial advantages to participating organizations: examples include shared security and privacy policies, dispute resolution that avoids litigation and arbitration, volume pricing on cybersecurity insurance, shared services for statewide public health reporting and transitions of care, and a shared statewide network infrastructure.","source":"MiHIN Legal Umbrella for Organization Agreements including FOAs v5 03-10-15","source_url":"http://www.slideshare.net/mihinpr/mi-hin-legal-umbrella-for-organization-agrements-including-fo-as-v5-031015-47337939?related=4"},{"state":"Michigan","policy_lever":"State-level Legal Protections","activity_status":"Actual","activity_description":"Reduction of exposure to antitrust violations because MiHIN activities are open, transparent, and monitored by the HIT Commission, as opposed to private infrastructure that might be vulnerable to charges of collusion, barriers to access, data hoarding, unfair business practices, and/or restraint of trade.","source":"MI State Medicaid HIT Plan, 2013","source_url":"https://www.michiganhealthit.org/wp-content/uploads/Michigan-SMHP-V2-10.pdf"},{"state":"Minnesota","policy_lever":"eCQM Reporting","activity_status":"Actual","activity_description":"Minnesota requires clinical quality reporting of clinics and hospitals.  Many are submitted electronically from EHRs.","source":"Minnesota Community Measurement Website","source_url":"http://mncm.org/"},{"state":"Minnesota","policy_lever":"E-Prescribing (eRx) Mandate or Encouragement","activity_status":"Actual","activity_description":"2011 e-prescribing mandate - Minn. Stat. ?62J.497 - Effective January 1, 2011, all providers, group purchasers, prescribers, and dispensers were required to establish, maintain, and use an electronic prescription drug program. E-prescribing rates have increased significantly since the e-prescribing mandate was adopted, and the requirement encourages incremental progress towards HIE.","source":"State Health Information Exchange Cooperative Agreement: Minnesota 2012 Strategic and Operational Plan Update","source_url":"http://www.health.state.mn.us/divs/hpsc/ohit/ohitdocs/sp2012update.pdf"},{"state":"Minnesota","policy_lever":"Federal or State Grants","activity_status":"Actual","activity_description":"MN revolving EHR loan program - Minn. Stat. ?62J.496 - Provides funds assist with purchasing and using an EHR. Revolving account allows program to open at least biennially with ample available funds. Borrowers selected through competitive review process.","source":"State Health Information Exchange Cooperative Agreement: Minnesota 2012 Strategic and Operational Plan Update","source_url":"http://www.health.state.mn.us/divs/hpsc/ohit/ohitdocs/sp2012update.pdf"},{"state":"Minnesota","policy_lever":"Federal or State Grants","activity_status":"Proposed","activity_description":"MN EHR grant program Minn. Stat. ?144.3345 - When funded, will provide grants to assist community collaboratives, community clinics and regional or community health information exchange organizations with planning and/or adopting EHRs or health information exchange.","source":"State Health Information Exchange Cooperative Agreement: Minnesota 2012 Strategic and Operational Plan Update","source_url":"http://www.health.state.mn.us/divs/hpsc/ohit/ohitdocs/sp2012update.pdf"},{"state":"Minnesota","policy_lever":"Federal or State Grants","activity_status":"Actual","activity_description":"Following the e-prescribing mandate in 2008 (mandating e-prescribing starting January 1, 2011), Minnesota e-Health launched the Minnesota e-Health Connectivity Grant Program for Health Information Exchange in late 2011, a grant program focused on health care providers, hospitals, and pharmacies in rural and underserved areas in the state to build health information exchange capacity. The program officially began in October 2011.","source":"ONC State Health Information Technology Program: Spotlight on: Minnesota?s Electronic Prescribing Success through Policy Levers and Financial Incentives","source_url":"http://www.healthit.gov/sites/default/files/mn_erx_implementation-brief_updated_061420121.pdf"},{"state":"Minnesota","policy_lever":"Federal or State Grants","activity_status":"Actual","activity_description":"In March, 2014, CMS awarded planning grants to nine qualified states to test quality measurement tools and demonstrate e-health in Medicaid community-based long term services and supports (LTSS). The grant program, known as TEFT, is designed to field test an experience survey and a set of functional assessment items, demonstrate personal health records, and create a standard electronic LTSS record. The state grantees will have an opportunity to extend the grant period to a total of four years. With the total grant program nearing $42 million, this is the first time the Centers for Medicare & Medicaid Services (CMS) is promoting the use of health information technology in the community-based LTSS system.","source":"TEFT Info CMS","source_url":"http://www.medicaid.gov/medicaid-chip-program-information/by-topics/delivery-systems/grant-programs/teft-program.html"},{"state":"Minnesota","policy_lever":"Federal or State Grants","activity_status":"Actual","activity_description":"MN released a RFP to establish a grant program that supports multi-entity arrangements seeking to conduct secure exchange of medical or health-related information between organizations participating in, or preparing to participate in, accountable care models so that it occurs in a more seamless/real time way across settings (clinic/hospital/long-term and post-acute care/behavioral health/local public health/ social services), for the purpose of more effectively identifying opportunities for improvement and coordination, to improve health and health care.","source":"Minnesota Department of Health: RFP Accountable Health Model e-Health Grant Program","source_url":"http://www.dhs.state.mn.us/main/groups/sim/documents/pub/sim_e-health.pdf"},{"state":"Minnesota","policy_lever":"HIE Advisory Council / Oversight Board","activity_status":"Actual","activity_description":"Establishment of e-Health Advisory Committee Minn. Stat. ?62J.495 Establishes a public/private framework and forum for continued policy recommendations and evaluation of future core e-health priorities and goals.","source":"State Health Information Exchange Cooperative Agreement: Minnesota 2012 Strategic and Operational Plan Update","source_url":"http://www.health.state.mn.us/divs/hpsc/ohit/ohitdocs/sp2012update.pdf"},{"state":"Minnesota","policy_lever":"HIE Advisory Council / Oversight Board","activity_status":"Actual","activity_description":"Establishment of Standards - Minn. Stat. ?62J.495 - The Commissioner of Health has the authority, with input from the Advisory Committee, to establish and update recommendations on standards for meeting the 2015 interoperable EHR mandate.","source":"State Health Information Exchange Cooperative Agreement: Minnesota 2012 Strategic and Operational Plan Update","source_url":"http://www.health.state.mn.us/divs/hpsc/ohit/ohitdocs/sp2012update.pdf"},{"state":"Minnesota","policy_lever":"HIE Connection or Interoperability Mandate","activity_status":"Actual","activity_description":"2015 Interoperable EHR Mandate - Minn. Stat. ?62J.495 - Requires by January 1, 2015 for all hospitals and health care providers across the continuum of healthcare to have an ?interoperable electronic health records system.? There must also be a statewide plan to meet this goal, including uniform standards to be used for the interoperable system for sharing and synchronizing patient data across systems. The mandate also requires providers to connect to a State-Certified health information organization either directly or through a connection facilitated by a State-Certified Health Data Intermediary as defined in section 62J.498.","source":"State Health Information Exchange Cooperative Agreement: Minnesota 2012 Strategic and Operational Plan Update","source_url":"http://www.health.state.mn.us/divs/hpsc/ohit/ohitdocs/sp2012update.pdf"},{"state":"Minnesota","policy_lever":"Medicaid State Plan Amendments (SPA)","activity_status":"Actual","activity_description":"MN Health care Homes -Minn. Stat. ?256B.0751 -0753  Requires certification for health care homes, including several requirements pertaining to health information technology: ? Staff, on-call providers, phone triage staff have continuous access to participant?s medical record and that there is an audit process in place to collect data that demonstrates continuous access to healthcare home services ? Health care homes must use a searchable, electronic registry to record participant information and track participant care. The registry must enable the health care home team to conduct systematic reviews of the healthcare home?s participant population to manage health care services, provide appropriate follow-up, and identify any gaps in care ? Health care homes needs to provide documentation of communication between the care coordinator and personal clinician such as meeting minutes, inbox messaging, notes of personal clinician approval orders, etc. ? Health care home?s medical chart must document the following elements of care coordination: referrals for specialty care, tests ordered, admissions to hospitals or skilled nursing facilities, timely post discharge planning, communication with participant?s pharmacy regarding use of medication and medication reconciliation, etc.","source":"State Health Information Exchange Cooperative Agreement: Minnesota 2012 Strategic and Operational Plan Update","source_url":"http://www.health.state.mn.us/divs/hpsc/ohit/ohitdocs/sp2012update.pdf"},{"state":"Minnesota","policy_lever":"State Privacy and Security Policies","activity_status":"Actual","activity_description":"Minnesota Health Records Act - Minn. Stat. ?144.291-298 - Sets privacy requirements for the electronic exchange of health information. 2007 revision improved readability and defined new definitions (e.g., health record, medical emergency, health information exchange, record locator service).","source":"State Health Information Exchange Cooperative Agreement: Minnesota 2012 Strategic and Operational Plan Update","source_url":"http://www.health.state.mn.us/divs/hpsc/ohit/ohitdocs/sp2012update.pdf"},{"state":"Minnesota","policy_lever":"State HIE / HISP Accreditation, Certification, Registration, or Qualification","activity_status":"Actual","activity_description":"Minnesota Health Information Exchange Oversight Law. In 2010, the Minnesota Legislature enacted the Minnesota Health Information Exchange Oversight Law (Minn. Stat. ?62J.498-62J.4982) which established the requirement that any entity operating as a Health Information Exchange service provider to apply for and obtain a Certificate of Authority to do business in Minnesota. To become a State-Certified HIE Service Provider, an applicant must demonstrate, as part of the comprehensive application process, that it has established policies and procedures to ensure compliance with all federal and state privacy and security laws. These include, but are not limited to, all HIPAA and HITECH laws and regulations, such as administrative, technical and physical safeguards; minimum necessary policies, breach notification procedures, accounting and auditing processes, and protections of individual choice and rights.   In addition, the Minnesota HIE Oversight Law incorporates the requirement for state-certified entities to be accredited by the Electronic Healthcare Network Accreditation Commission (EHNAC) under its Health Information Exchange Accreditation Program, further demonstrating its compliance with nationally recognized federal privacy and security requirements. Furthermore, a state-certified HIE service provider must provide a complete set of its policies and procedures establishing that it is in compliance with Minnesota privacy laws.","source":"State Health Information Exchange Cooperative Agreement: Minnesota 2012 Strategic and Operational Plan Update","source_url":"http://www.health.state.mn.us/divs/hpsc/ohit/ohitdocs/sp2012update.pdf"},{"state":"Minnesota","policy_lever":"Accountable Care Arrangements","activity_status":"Actual","activity_description":"MN released a RFP to establish a grant program that supports multi-entity arrangements seeking to conduct secure exchange of medical or health-related information between organizations participating in, or preparing to participate in, accountable care models so that it occurs in a more seamless/real time way across settings (clinic/hospital/long-term and post-acute care/behavioral health/local public health/ social services), for the purpose of more effectively identifying opportunities for improvement and coordination, to improve health and health care.","source":"Minnesota Department of Health: RFP Accountable Health Model e-Health Grant Program","source_url":"http://www.dhs.state.mn.us/main/groups/sim/documents/pub/sim_e-health.pdf"},{"state":"Minnesota","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"MN Health care Homes -Minn. Stat. ?256B.0751 -0753  Requires certification for health care homes, including several requirements pertaining to health information technology: ? Staff, on-call providers, phone triage staff have continuous access to participant?s medical record and that there is an audit process in place to collect data that demonstrates continuous access to healthcare home services ? Health care homes must use a searchable, electronic registry to record participant information and track participant care. The registry must enable the health care home team to conduct systematic reviews of the healthcare home?s participant population to manage health care services, provide appropriate follow-up, and identify any gaps in care ? Health care homes needs to provide documentation of communication between the care coordinator and personal clinician such as meeting minutes, inbox messaging, notes of personal clinician approval orders, etc. ? Health care home?s medical chart must document the following elements of care coordination: referrals for specialty care, tests ordered, admissions to hospitals or skilled nursing facilities, timely post discharge planning, communication with participant?s pharmacy regarding use of medication and medication reconciliation, etc.","source":"State Health Information Exchange Cooperative Agreement: Minnesota 2012 Strategic and Operational Plan Update","source_url":"http://www.health.state.mn.us/divs/hpsc/ohit/ohitdocs/sp2012update.pdf"},{"state":"Missouri","policy_lever":"Medicaid State Plan Amendments (SPA)","activity_status":"Actual","activity_description":"Missouri's two Medicaid health home SPAS  target (1) individuals with two chronic conditions, or those with  one chronic condition and at risk of developing another, especially those at risk due to tobacco use or diabetes and (2)  individuals with SPMI (Serious Persistent Mental Illness).  The following is a summary of HIT currently available for Health Home providers to conduct comprehensive care management, care coordination, health promotion, individual and family support and referral to community and social support services. Also included is a description of the state?s process to improve health information exchange (HIE) for comprehensive transitional care services. As Missouri implements its Health Home models, the State will also be working toward the development of a single data portal to facilitate information exchange, measures documentation and calculation and state reporting to CMS. The state will also continue to refine a process for HIE between CMHCs and primary care practices and has contacted SAMSHA to learn more about opportunities available under the national technical assistance center on integrated care. 1. HIT for Comprehensive Care Management and Care Coordination ? MO HealthNet maintains a web-based electronic health record (EHR) accessible to enrolled Medicaid providers, including CMHCs, primary care practices, and schools. The tool is a HIPAA-compliant portal that enables providers to: (a) Download paid claims data submitted for an enrollee by any provider over the past three years (e.g., drug claims, diagnosis codes, CPT codes); (b) View dates and providers of hospital emergency department services; (c) Identify clinical issues that affect an enrollee?s care and receive best practice information; d) Prospectively examine how specific preferred drug list (PDL) and clinical edit criteria would affect a prescription for an individual enrollee and determine if a prescription meets requirement for Medicaid payment; e) Electronically request a drug prior authorization or clinical edit override; pre-certifications for radiology, durable medical equipment (DME), optical and inpatient services; (f) Identify approved or denied drug prior authorizations or clinical edit overrides or medical pre-certifications previously issues and transmit a prescription electronically to the enrollee?s pharmacy of choice; and (g) Review laboratory data and clinical trait data; (h) Determine medication adherence information and calculate medication possession ratios (MPR); and (i)  Offer counseling opportunities for pharmacists through a point of service medication therapy management (MTM) module. 2. HIT for Health Promotion and Individual and Family Support Services ? A module of the MO HealthNet comprehensive, web based EHR allows enrollees to access their own healthcare utilization information and receive the same content in laypersons? terms. The information facilitates self-management and monitoring necessary for an enrollee to attain the highest levels of health and functioning. Health Home providers will provide instruction to individuals on the use of the module. Utilization data available through the module includes: (a) Administrative claims data for the past 3 years; (b) Cardiac and diabetic risk calculators; (c) Chronic health condition information awareness (d) A drug information library; and (e) The functionality to create a personal health plan and discussion lists to use with healthcare providers. 3. HIT for Comprehensive Transitional Care ? MO HealthNet maintains an initial and concurrent authorization of stay tool which requires hospitals to notify MO HealthNet (via accessing the online authorization tool) within 24 hours of the next usual workday regarding a new admission of any Medicaid enrollee and provide information about diagnosis, condition and treatment for authorization of an inpatient stay. MO HealthNet and the Department of Mental Health are working with the vendor to develop capacity for a daily data transfer listing all new hospital admissions discharges. This information will be transferred to the states data analytics contractor which will match it to a list of all persons assigned and/or enrolled in a Health Home. The contractor would then immediately notify the Health Home provider of the admission, which would enable the Health Home provider to: (a) Use the hospitalization episode to locate and engage persons need of health home services; (b) Perform the required continuity of care coordination between inpatient and outpatient; and (c) Coordinate with the hospital to discharge an avoidable admission as soon as possible. The daily data transfer will be in place within six months of implementation of the SPA. In the interim, Health Homes will continue to implement or develop memoranda of understanding (MOU) with local hospitals for notification about hospital admissions. 4. Referral to Community and Social Support Services ? Health Home providers will be encouraged to monitor continuing Medicaid eligibility using the FSD eligibility website and data base. MO HealthNet and the Department of Mental Health will also refine process to notify Health Home providers of impending eligibility lapses (e.g., 60 days in advance). 5. Specific HIT Strategies for CMHCs Customer Information Management, Outcomes and Reporting (CIMOR) - CMHCs will continue to utilize CIMOR for routine functions (e.g., contract management, billing, benefit eligibility, etc.); however CIMOR?s capacity will continue to be expanded in support of CMHC comprehensive care management and care coordination functions. CIMOR will enable assignment of enrollees to a CMHC Health Home based on enrollee choice and admission for services. CMHC Health Home providers utilize CIMOR to report Department of Mental Health required outcome measures. In addition, the CMHC Health Home enrollment data in CIMOR will be cross referenced with MO Health Net inpatient pre-authorization data to enable the automated real-time reporting of inpatient authorizations to the appropriate CMHC. 6. Behavioral Pharmacy Management System  As of 2014, Missouri added two new additional systems for each IT support of Transitions of Care: 1) overnight notification of inpatient hospital admission - hospitals initiating a hospital admission for any Medicaid patients both fee-for-service and managed care except for dual eligibles are required to contact either the state operated or managed-care plan Initial Authorization of Stay website and/or helpdesk at the time of hospital admission after identifying the person and briefly describing their clinical condition and admission diagnosis they are given an Initial Authorization of Stay. These authorizations of stay are maintained in the database used for that purpose. We have set up a system where every night overnight that system generates a flat file of all new initial authorizations of stay that occurred within the last 24 hours. This file is transferred automatically to an access database. The access database has been programmed to sort the new initial authorization of stay patients out by health home and generate an automatic email to the health home director of each health home. So every morning the health home directors all get an email of all new hospital admissions. Since Medicaid does not require initial authorization of hospital stay we are unable to monitor hospital admissions of dual eligible patients in this manner. 2)  overnight notification of emergency room visits - the majority of hospitals in most states are required to report ER visits in the reason for the ER visits to the state health department for the purposes of syndromic surveillance (monitoring for new outbreaks of things like anthrax or ebola). Every night overnight our state health department matches all new ER encounters reported through its syndromic surveillance system with the current list of actively eligible Medicaid enrollees and sends that file to the Medicaid agency. The file is matched to the current health home enrollees, sorted out by health homes and an email list of all new ER encounters in the previous 24 hours is sent to each health home director.","source":"Medicaid Approved Health Home State Plan Amendments (Filter by State; Search term= Health Home) MO 11-0011 Approval Date 10/20/2011  MO 11-0015 Approval Date 12/22/2011","source_url":"http://www.medicaid.gov/state-resource-center/medicaid-state-plan-amendments/medicaid-state-plan-amendments.html"},{"state":"Missouri","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"Missouri's two Medicaid health home SPAS  target (1) individuals with two chronic conditions, or those with  one chronic condition and at risk of developing another, especially those at risk due to tobacco use or diabetes and (2)  individuals with SPMI (Serious Persistent Mental Illness).  The following is a summary of HIT currently available for Health Home providers to conduct comprehensive care management, care coordination, health promotion, individual and family support and referral to community and social support services. Also included is a description of the state?s process to improve health information exchange (HIE) for comprehensive transitional care services. As Missouri implements its Health Home models, the State will also be working toward the development of a single data portal to facilitate information exchange, measures documentation and calculation and state reporting to CMS. The state will also continue to refine a process for HIE between CMHCs and primary care practices and has contacted SAMSHA to learn more about opportunities available under the national technical assistance center on integrated care. 1. HIT for Comprehensive Care Management and Care Coordination ? MO HealthNet maintains a web-based electronic health record (EHR) accessible to enrolled Medicaid providers, including CMHCs, primary care practices, and schools. The tool is a HIPAA-compliant portal that enables providers to: (a) Download paid claims data submitted for an enrollee by any provider over the past three years (e.g., drug claims, diagnosis codes, CPT codes); (b) View dates and providers of hospital emergency department services; (c) Identify clinical issues that affect an enrollee?s care and receive best practice information; d) Prospectively examine how specific preferred drug list (PDL) and clinical edit criteria would affect a prescription for an individual enrollee and determine if a prescription meets requirement for Medicaid payment; e) Electronically request a drug prior authorization or clinical edit override; pre-certifications for radiology, durable medical equipment (DME), optical and inpatient services; (f) Identify approved or denied drug prior authorizations or clinical edit overrides or medical pre-certifications previously issues and transmit a prescription electronically to the enrollee?s pharmacy of choice; and (g) Review laboratory data and clinical trait data; (h) Determine medication adherence information and calculate medication possession ratios (MPR); and (i)  Offer counseling opportunities for pharmacists through a point of service medication therapy management (MTM) module. 2. HIT for Health Promotion and Individual and Family Support Services ? A module of the MO HealthNet comprehensive, web based EHR allows enrollees to access their own healthcare utilization information and receive the same content in laypersons? terms. The information facilitates self-management and monitoring necessary for an enrollee to attain the highest levels of health and functioning. Health Home providers will provide instruction to individuals on the use of the module. Utilization data available through the module includes: (a) Administrative claims data for the past 3 years; (b) Cardiac and diabetic risk calculators; (c) Chronic health condition information awareness (d) A drug information library; and (e) The functionality to create a personal health plan and discussion lists to use with healthcare providers. 3. HIT for Comprehensive Transitional Care ? MO HealthNet maintains an initial and concurrent authorization of stay tool which requires hospitals to notify MO HealthNet (via accessing the online authorization tool) within 24 hours of the next usual workday regarding a new admission of any Medicaid enrollee and provide information about diagnosis, condition and treatment for authorization of an inpatient stay. MO HealthNet and the Department of Mental Health are working with the vendor to develop capacity for a daily data transfer listing all new hospital admissions discharges. This information will be transferred to the states data analytics contractor which will match it to a list of all persons assigned and/or enrolled in a Health Home. The contractor would then immediately notify the Health Home provider of the admission, which would enable the Health Home provider to: (a) Use the hospitalization episode to locate and engage persons need of health home services; (b) Perform the required continuity of care coordination between inpatient and outpatient; and (c) Coordinate with the hospital to discharge an avoidable admission as soon as possible. The daily data transfer will be in place within six months of implementation of the SPA. In the interim, Health Homes will continue to implement or develop memoranda of understanding (MOU) with local hospitals for notification about hospital admissions. 4. Referral to Community and Social Support Services ? Health Home providers will be encouraged to monitor continuing Medicaid eligibility using the FSD eligibility website and data base. MO HealthNet and the Department of Mental Health will also refine process to notify Health Home providers of impending eligibility lapses (e.g., 60 days in advance). 5. Specific HIT Strategies for CMHCs Customer Information Management, Outcomes and Reporting (CIMOR) - CMHCs will continue to utilize CIMOR for routine functions (e.g., contract management, billing, benefit eligibility, etc.); however CIMOR?s capacity will continue to be expanded in support of CMHC comprehensive care management and care coordination functions. CIMOR will enable assignment of enrollees to a CMHC Health Home based on enrollee choice and admission for services. CMHC Health Home providers utilize CIMOR to report Department of Mental Health required outcome measures. In addition, the CMHC Health Home enrollment data in CIMOR will be cross referenced with MO Health Net inpatient pre-authorization data to enable the automated real-time reporting of inpatient authorizations to the appropriate CMHC. 6. Behavioral Pharmacy Management System  As of 2014, Missouri added two new additional systems for each IT support of Transitions of Care: 1) overnight notification of inpatient hospital admission - hospitals initiating a hospital admission for any Medicaid patients both fee-for-service and managed care except for dual eligibles are required to contact either the state operated or managed-care plan Initial Authorization of Stay website and/or helpdesk at the time of hospital admission after identifying the person and briefly describing their clinical condition and admission diagnosis they are given an Initial Authorization of Stay. These authorizations of stay are maintained in the database used for that purpose. We have set up a system where every night overnight that system generates a flat file of all new initial authorizations of stay that occurred within the last 24 hours. This file is transferred automatically to an access database. The access database has been programmed to sort the new initial authorization of stay patients out by health home and generate an automatic email to the health home director of each health home. So every morning the health home directors all get an email of all new hospital admissions. Since Medicaid does not require initial authorization of hospital stay we are unable to monitor hospital admissions of dual eligible patients in this manner. 2)  overnight notification of emergency room visits - the majority of hospitals in most states are required to report ER visits in the reason for the ER visits to the state health department for the purposes of syndromic surveillance (monitoring for new outbreaks of things like anthrax or ebola). Every night overnight our state health department matches all new ER encounters reported through its syndromic surveillance system with the current list of actively eligible Medicaid enrollees and sends that file to the Medicaid agency. The file is matched to the current health home enrollees, sorted out by health homes and an email list of all new ER encounters in the previous 24 hours is sent to each health home director.","source":"Medicaid Approved Health Home State Plan Amendments: (Filter by State; Search term= Health Home) MO 11-0011 Approval Date 10/20/2011  MO 11-0015 Approval Date 12/22/2011","source_url":"http://www.medicaid.gov/state-resource-center/medicaid-state-plan-amendments/medicaid-state-plan-amendments.html"},{"state":"Nebraska","policy_lever":"eCQM Reporting","activity_status":"Actual","activity_description":"The Blueprint for Health program establishes a clinical data repository in support of evidence-based practice and a learning health system. Measure sets are established and clinical data is collected for a number of chronic conditions and acute conditions are now being addressed as well.","source":"Vermont Information Technology Leaders Website: Blueprint for Health Central Clinical Repository Interface Services","source_url":"https://www.vitl.net/connect/connectivity-services/blueprint-health-central-clinical-repository-interface-services"},{"state":"Nebraska","policy_lever":"E-Prescribing (eRx) Mandate or Encouragement","activity_status":"Actual","activity_description":"LB 179 (2011) eliminates the requirement for pharmacists to write the date of filling and sign the face of a prescription for controlled substances listed in Schedule II, facilitating the future use of e-prescribing for controlled substances.","source":"Legislative Bill 179","source_url":"http://nebraskalegislature.gov/FloorDocs/102/PDF/Slip/LB179.pdf"},{"state":"Nebraska","policy_lever":"Medicare and Medicaid EHR Incentive Program (Meaningful Use)","activity_status":"Actual","activity_description":"An IAPD for the use of Health Information Exchange to support Meaningful Use was submitted by the Nebraska Department of Health and Human Services Division of Medicaid and Long-Term Care on July 1, 2013. The IAPD was approved by CMS in October 2014 and the contract between NeHII and the Nebraska Department of Health and Human Services was approved by CMS in March 2015.","source":"Information provided by Anne Byers, eHealth and Community Information Technology Manager, on April 22, 2015","source_url":""},{"state":"Nebraska","policy_lever":"Prescription Drug Monitoring Programs (PDMP)","activity_status":"Actual","activity_description":"LB 237 (2011) authorizes the Department of Health and Human Services to collaborate with NeHII to establish a prescription drug monitoring program.","source":"Legislative Bill 237","source_url":"http://nebraskalegislature.gov/bills/view_bill.php?DocumentID=11992"},{"state":"Nebraska","policy_lever":"State Privacy and Security Policies","activity_status":"Actual","activity_description":"On April 13, 2010, Governor Heineman signed LB849 which contains a provision eliminating the 180-day limit on authorizations for the release of health information. The 180-day limit is more restrictive than current federal law and creates a barrier to electronic health information exchange. LB849 will be beneficial to the state?s health information exchanges, including the Nebraska Health Information Initiative (NeHII).","source":"Legislative Bill 849","source_url":"http://nebraskalegislature.gov/FloorDocs/103/PDF/Intro/LB849.pdf"},{"state":"Nebraska","policy_lever":"Public Health Surveillance","activity_status":"Actual","activity_description":"LB 591 (2011) includes provisions which will facilitate the electronic exchange of syndromic surveillance and immunization information.","source":"Legislative Bill 591","source_url":"http://nebraskalegislature.gov/FloorDocs/102/PDF/Intro/LB591.pdf"},{"state":"Nebraska","policy_lever":"Public Health Surveillance","activity_status":"Actual","activity_description":"The Nebraska Department of Health and Human Services (DHHS) Division of Public Health has worked with NeHII to develop bidirectional exchange with the State?s immunization registry (NESIIS). NeHII and the Division of Public Health continue to discuss public health reporting through NeHII to the State?s syndromic surveillance and disease surveillance systems. The Division of Public Health also worked with Governor Heineman to include $500,000 in General Funds for FY 2013-14 and $500,000 in General Funds for FY 2014-15 for the support of health information exchange in the Governor?s budget recommendations. Pending inclusion in the State?s final budget, this funding can be used to leverage Medicaid?s HITECH 90/10 matching funds from CMS.","source":"Information provided by Anne Byers, eHealth and Community Information Technology Manager, on April 22, 2015","source_url":""},{"state":"Nebraska","policy_lever":"State Appropriated Funds","activity_status":"Actual","activity_description":"$500,000 in General Funds for FY 2013-14 and $500,000 in General Funds for FY 2014-15 for the support of health  information exchange in the Governor?s budget recommendations.  LB 905 included an additional $500,000 in funding in FY 2014-2105 for the support of health information exchange.","source":"Summary of Governor's Recommendations - Budget Division","source_url":"http://www.nebraskalegislature.gov/FloorDocs/103/PDF/Slip/LB905.pdf"},{"state":"Nevada","policy_lever":"Advanced Directives Registry","activity_status":"Actual","activity_description":"The Nevada Legislature, during its 2013 session, passed Assembly Bill 344 (AB 344).  For advanced directives that meet certain statutory requirements, the Secretary of State, with the person?s consent, can deposit the advanced directives in Nevada?s statewide HIE system. AB 344 has been signed into law by Governor Sandoval, and is effective  October 1, 2013.","source":"Assembly Bill 344","source_url":"http://www.leg.state.nv.us/Session/77th2013/Reports/history.cfm?billname=AB344"},{"state":"Nevada","policy_lever":"HIE Advisory Council / Oversight Board","activity_status":"Proposed","activity_description":"The Office of Health Information Technology ceased operation on February 7, 2014. The Department of Health and Human Services is currently sponsoring a bill (SB48) in the 2015 session to revise Nevada statute to provide a new governance structure which will provide the Department of Health and Human Services the authority to certify Health Information Exchanges within the state.","source":"Senate Bill 78","source_url":"https://legiscan.com/NV/bill/SB48/2015"},{"state":"New Hampshire","policy_lever":"All Payer Claims Database (APCD) Policies","activity_status":"Actual","activity_description":"The New Hampshire Comprehensive Healthcare Information System began accepting claims submissions in 2005 in response to a need for more transparency in the commercial insurance system. The drivers listed in the statute include the provision of a resource for continuous review of health care utilization, expenditures, and performance data by insurers, purchasers, employers, providers and state agencies. Also expressed was the goal to help consumers and employers make informed and cost effective health care choices. In addition, data were desired for comparison to Medicaid quality, cost, utilization, and price.","source":"Statute","source_url":"http://www.gencourt.state.nh.us/rsa/html/XXXVII/420-G/420-G-11-a.htm"},{"state":"New Hampshire","policy_lever":"Federal or State Grants","activity_status":"Actual","activity_description":"In March, 2014, CMS awarded planning grants to nine qualified states to test quality measurement tools and demonstrate e-health in Medicaid community-based long term services and supports (LTSS). The grant program, known as TEFT, is designed to field test an experience survey and a set of functional assessment items, demonstrate personal health records, and create a standard electronic LTSS record. The state grantees will have an opportunity to extend the grant period to a total of four years. With the total grant program nearing $42 million, this is the first time the Centers for Medicare & Medicaid Services (CMS) is promoting the use of health information technology in the community-based LTSS system.","source":"TEFT Info CMS","source_url":"http://www.medicaid.gov/medicaid-chip-program-information/by-topics/delivery-systems/grant-programs/teft-program.html"},{"state":"New Hampshire","policy_lever":"HIE Advisory Council / Oversight Board","activity_status":"","activity_description":"Stakeholders have successfully shepherded House Bill 489 (now New Hampshire Chapter 232) through the NH General Court. Chapter 232 created the New Hampshire Health Information Organization (NH HIO). This bill also requires the commissioner of the department of health and human services to enter into a contract with the health information exchange to administer the grant for the New Hampshire Information Exchange Planning and Implementation Project.","source":"HB 489","source_url":"http://openstates.org/nh/bills/2011/HB489/"},{"state":"New Hampshire","policy_lever":"Prescription Drug Monitoring Programs (PDMP)","activity_status":"Actual","activity_description":"The NH Board of Pharmacy maintains the NH Prescription Drug Monitoring monitors controlled drug prescriptions (in DEA Schedules II through IV) to track/flag \"doctor shoppers\" and multiple/duplicate controlled substance prescriptions for a patient and      notify law enforcement and the various state/federal regulatory boards of any unusual activity.","source":"PMP Statute","source_url":"http://www.nh.gov/pharmacy/prescription-monitoring/pmp_statute.htm"},{"state":"New Hampshire","policy_lever":"State Privacy and Security Policies","activity_status":"Actual","activity_description":"New Hampshire Health Information Organization Helps Pass Legislation Allowing for More Effective Use of State Electronic Network; Greater Safeguards of Protected Health Information for Patients. New Hampshire Senate Bill 229 title: an act relative to the use and disclosure of protected health information (PHI), is now in effect. This bill expands the availability of the network to a larger group of care providers, and helps increase the protections for patient information as it is shared between healthcare providers. Now, care coordinators, clinical support staff and other members of the care team can utilize the NHHIO to securely share health information with the provider community, helping to improve disease management and efficient care coordination. The legislation went into effect September 9, 2014.","source":"Senate Bill 229","source_url":"http://www.gencourt.state.nh.us/legislation/2014/SB0229.pdf"},{"state":"New Hampshire","policy_lever":"Public Health Surveillance","activity_status":"Actual","activity_description":"In June 2012, the NH General Court passed Senate Bill 288 now allowing healthcare providers otherwise required or authorized by law to submit data to the Department of Health and Human Services to do so through a health information organization. Public Health may now participate in NHHIO and the value of the network has increased. The state previously could not participate in HIE and there were prohibitions against interstate exchange. This service directly impacts providers? abilities to meet meaningful use requirements for public health reporting while aligning meaningful use incentive payments with NHHIO?s customer value proposition and sustainability.","source":"Senate Bill 288","source_url":"http://openstates.org/nh/bills/2014/SB288/"},{"state":"New Jersey","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"Delivery System Reform Incentive Payment (DSRIP):  Participating hospitals and providers are required to submit various performance/outcome measures. The source of many of the measures is the provider's EHR system.","source":"CMS Medicare and Medicaid Waiver Authority - NJ Comprehensive Waiver Demonstration","source_url":"http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/nj/nj-1115-request-ca.pdf"},{"state":"New Jersey","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"The Comprehensive Primary Care (CPC) initiative is a four-year multi-payer initiative designed to strengthen primary care.","source":"CMS Comprehensive Primary Care Initiative","source_url":"http://innovation.cms.gov/initiatives/Comprehensive-Primary-Care-Initiative/"},{"state":"New Jersey","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"The FQHC Advanced Primary Care Practice Demonstration showed how the patient-centered medical home model can improve quality of care, promote better health, and lower costs (concluded Oct 2014)","source":"","source_url":"http://innovation.cms.gov/initiatives/fqhcs/"},{"state":"New Jersey","policy_lever":"Federal or State Grants","activity_status":"Actual","activity_description":"Strong Start for Mothers & Newborns Initiative aims to reduce preterm births and improve outcomes for newborns and pregnant women.","source":"","source_url":"http://innovation.cms.gov/initiatives/strong-start/"},{"state":"New Jersey","policy_lever":"Public Health Surveillance","activity_status":"Actual","activity_description":"The Department of Health's Syndromic Surveillance system, EpiCenter, is used by for early event detection and monitoring of influenza-like illness during flu season, illnesses and injuries associated with a bioterrorism event, infectious disease symptoms, and emerging outbreaks and issues of public health concern in the community through collection of ?pre diagnostic? information.","source":"NJ Dept of Health","source_url":"http://nj.gov/health/meaningfuluse/syndromic_surveillance_faq.shtml"},{"state":"New Jersey","policy_lever":"Public Health Surveillance","activity_status":"Actual","activity_description":"The Department of Health's New Jersey Immunization Information System (NJIIS) provides current recommended immunization schedules for infants, adolescents and adults. It consolidates immunization information from all providers into one record to provide an accurate immunization assessment and eliminates the use of manual vaccine administration logs. NJIIS assists state and federal agencies with population assessments in the event of a preventable disease outbreak and helps communities assess their immunization coverage and identify pockets of need.","source":"NJIIS is the official Immunization Registry per the Statewide Immunization Registry Act, N.J.S.A. 26:4-131 et seq. (P.L. 2004, c. 138)","source_url":""},{"state":"New Jersey","policy_lever":"Public Health Surveillance","activity_status":"Actual","activity_description":"The Department of Health's New Jersey State Cancer Registry is a population-based registry that collects data on all cancer cases diagnosed and/or treated in New Jersey since October 1, 1978. The NJSCR serves the entire state of New Jersey, which is estimated to have a population of 8.6 million people.","source":"NJSCR is the official Cancer Registry per N.J.S.A. 26:2-10 et seq. (P.L. 1977, c. 266)","source_url":""},{"state":"New Jersey","policy_lever":"State Lab Requirements","activity_status":"Proposed","activity_description":"The Department of Banking and Insurance (DOBI) published a proposed regulation for public comment.  The rule would require clinical labs to send lab results to the ordering provider electronically as a requirement for prompt payment of an insurance claim.","source":"NJ Dept of Banking and Insurance, Proposed Amendments - Prompt Payment of Medical Laboratory Claims","source_url":"http://www.nj.gov/dobi/proposed/prn12_66.pdf"},{"state":"New Jersey","policy_lever":"Medicaid State Plan Amendments (SPA)","activity_status":"Actual","activity_description":"New Jersey's two Medicaid Health Home SPAs both provide Behavioral Health Home services. One targets children with Serious Emotional Disturbance (SED), co-occurring developmental disability and mental illness, co-occurring mental health and substance abuse or DD eligible with symptomology of SED.  The second targets adults with an SMI who are high utilizers of services or at risk of high utilization. The provider standards set by NJDCF require that BHH providers are able to interface with primary care, specialty care, hospitals, and support services. Every provider is required to utilize the State's EHR (CSA). Providers are also expected to use other available means to exchange protected health information safely and securely, to include but not be limited to direct messaging, facsimile, and telephonic services. All children's (NJ 14-006) BHH providers utilize the Contracted System Administrator's (CSA) electronic record, which is purchased by the State. State is making amendments to the technology to include specific BHH data parameters.  All BHH providers (NJ 14-005) will be required to have an EHR and BHH startup funds will be available to assist providers to either purchase or amend any current EHR.","source":"Medicaid Approved Health Home State Plan Amendments (Filter by State; Search term= Health Home)  NJ 14-005 (Adults) Approval Date 03/12/2015;  NJ 14-006 (Children) Approval Date 3/12/2015.","source_url":"http://www.medicaid.gov/state-resource-center/medicaid-state-plan-amendments/medicaid-state-plan-amendments.html"},{"state":"New Jersey","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"New Jersey's two Medicaid Health Home SPAs both provide Behavioral Health Home services. One targets children with Serious Emotional Disturbance (SED), co-occurring developmental disability and mental illness, co-occurring mental health and substance abuse or DD eligible with symptomology of SED.  The second targets adults with an SMI who are high utilizers of services or at risk of high utilization. The provider standards set by NJDCF require that BHH providers are able to interface with primary care, specialty care, hospitals, and support services. Every provider is required to utilize the State's EHR (CSA). Providers are also expected to use other available means to exchange protected health information safely and securely, to include but not be limited to direct messaging, facsimile, and telephonic services. All children's (NJ 14-006) BHH providers utilize the Contracted System Administrator's (CSA) electronic record, which is purchased by the State. State is making amendments to the technology to include specific BHH data parameters.  All BHH providers (NJ 14-005) will be required to have an EHR and BHH startup funds will be available to assist providers to either purchase or amend any current EHR.","source":"Medicaid Approved Health Home State Plan Amendments   (Filter by State; Search term= Health Home)  NJ 14-005 (Adults) Approval Date 03/12/2015;  NJ 14-006 (Children) Approval Date 3/12/2015.","source_url":"http://www.medicaid.gov/state-resource-center/medicaid-state-plan-amendments/medicaid-state-plan-amendments.html"},{"state":"New York","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"The Comprehensive Primary Care (CPC) initiative is a four-year multi-payer initiative designed to strengthen primary care.","source":"CMS Comprehensive Primary Care Initiative","source_url":"http://innovation.cms.gov/initiatives/Comprehensive-Primary-Care-Initiative/"},{"state":"New York","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"Under the multi-payer reform initiatives demonstration program, funded by CMS, states are participating in initiatives  to make advanced primary care practices more broadly available. The demonstration will evaluate whether advanced primary care practice will reduce unjustified utilization and expenditures, improve the safety, effectiveness, timeliness, and efficiency of health care, increase patient decision-making and increase the availability and delivery of care in underserved areas.","source":"CMS Multi-Payer Advanced Primary Care Practice:","source_url":"http://innovation.cms.gov/initiatives/Multi-Payer-Advanced-Primary-Care-Practice/"},{"state":"New York","policy_lever":"E-Prescribing (eRx) Mandate or Encouragement","activity_status":"Actual","activity_description":"New York passed the I-STOP law which took into effect on 8/27/2013. The law (1) overhauled New York's Prescription Monitoring Program; (2) required practitioners to consult the PMP before prescribing; (3) required dispensing data be reported in 'real time'; (4) required electronic prescribing; and (5) placed hydrocodone on C-II and tramadol on C-IV. The law will hold providers accountable for ensuring broader adoption of e-prescribing and in doing so help them better leverage HIT data from different sources.","source":"NYS DOH I-STOP/PMP","source_url":"https://www.health.ny.gov/professionals/narcotic/prescription_monitoring/"},{"state":"New York","policy_lever":"Federal or State Grants","activity_status":"Proposed","activity_description":"Proposed in 2013: NY S 5784 Relates to credit enhancement for health reform projects, relates to establishing a program to assist in restructuring health care delivery systems by providing credit enhancement solely to hospitals that lack the credit resources necessary to finance health reform projects from conventional lenders, provides that the program applies to medically underserved regions and to rural regions, relates to renovations of facilities, medical high technology equipment and health information technology.","source":"Assembly S05784","source_url":"http://assembly.state.ny.us/leg/?default_fld=%0D%0A&bn=S05784&term=2013&Summary=Y&Text=Y"},{"state":"New York","policy_lever":"Certificate of Need (CON) Regulations","activity_status":"Actual","activity_description":"For various facility types in NYS that are proposing to purchase and implement health information technology or other information systems, with a total project cost between $6,000,000 and $15,000,000 are required to submit a Limited Review Application under the Certificate of Need (CON) application.","source":"CON Limited Review Application materials","source_url":"https://www.health.ny.gov/facilities/cons/limited_review_application/docs/schedule_lra_9.doc"},{"state":"New York","policy_lever":"Medicaid State Plan Amendments (SPA)","activity_status":"Actual","activity_description":"New York's Medicaid Health Home SPA targets individuals with two chronic conditions including BMI >25 or with mental illness or HIV/AIDS. To facilitate the use of health information technology by health homes to improve service delivery and coordination across the care continuum, NY has developed initial and final HIT standards for health homes that are consistent with NYS' Operational Plan for Health Information Technology and Exchange approved by CMS. Providers must meet initial HIT standards to implement a health home. Furthermore, applicants must provide a plan to achieve the formal standards within eighteen months of program initiation in order to be approved as a health home provider. Health home providers will make use of available HIT and access data through the regional health information organization (RHIOs)/Qualified Entities (QE) to conduct these processes as feasible, to comply with the initial standards cited in items 6a.-6d for implementation of health homes. In order to be approved as health home provider, applicants must provide a plan to achieve the final standards within eighteen (18) months of program initiation. Initial Standards -Health home provider has structured information systems, policies, procedures and practices to create, document, execute, and update a plan of care for every patient. - Health home provider has a systematic process to follow-up on tests, treatments, services and, and referrals which is incorporated into the patient's plan of care. - Health home provider has a health record system which allows the patient's health information and plan of care to be accessible to the interdisciplinary team of providers and which allows for population management and identification of gaps in care including preventive services. - Health home provider makes use of available HIT and accesses data through the RHIO/QE to conduct these processes, as feasible. Final Standards - Health home provider has structured interoperable health information technology systems, policies, procedures and practices to support the creation, documentation, execution, and ongoing management of a plan of care for every patient. - Health home provider uses an electronic health record system that qualifies under the Meaningful Use provisions of the HITECH Act, which allows the patient's health information and plan of care to be accessible to the interdisciplinary team of providers. If the provider does not currently have such a system, they will provide a plan for when and how they will implement it. - Health home provider will be required to comply with the current and future version of the Statewide Policy Guidance  (https://www.health.ny.gov/technology/statewide_policy_guidance.htm) which includes common information policies, standards and technical approaches governing health information exchange. - Health home provider commits to joining regional health information networks or qualified health IT entities for data exchange and includes a commitment to share information with all providers participating in a care plan. RHIOs/QE provides policy and technical services required for health information exchange through the Statewide Health Information Network of New York (SHIN-NY). - Health home provider supports the use of evidence based clinical decision making tools, consensus guidelines, and best practices to achieve optimal outcomes and cost avoidance. One example of such a tool is PSYCKES.","source":"Medicaid Approved Health Home State Plan Amendments  (Filter by State; Search term= Health Home)  NY 14-0016 Approval Date 03/10/2015","source_url":"http://www.medicaid.gov/state-resource-center/medicaid-state-plan-amendments/medicaid-state-plan-amendments.html"},{"state":"New York","policy_lever":"Medicaid State Plan Amendments (SPA)","activity_status":"Actual","activity_description":"NY has used their 1915 waiver and SPA process to create a Health Home Development fund that can support TA and technical support for health home connectivity.","source":"NY MRT Waiver Amendment Program","source_url":"https://www.health.ny.gov/health_care/medicaid/redesign/docs/waiver_amend_prog_implem_spa_and_mc.pdf"},{"state":"New York","policy_lever":"Medicaid Waivers and Demonstrations","activity_status":"Actual","activity_description":"Uncompensated care: The State provides grants to voluntary, non-profit and publicly-sponsored Diagnostic and Treatment Centers (D&TCs) for services delivered to the uninsured through the state through an Indigent Care Pool (ICP).","source":"CMS Approval Letter","source_url":"http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ny/ny-f-shrp-ca.pdf"},{"state":"New York","policy_lever":"Medicaid Waivers and Demonstrations","activity_status":"Proposed","activity_description":"New York's pending $8 billion 1115 waiver includes as a System Transformation Metric that a \"Performing Provider System\" under their delivery system reform incentive payment (DSRIP) program report on certain metrics of health IT. Specifically, they must report on the \"Percent of Eligible Providers with participating agreements with RHIO?s; meeting MU Criteria and able to participate in bidirectional exchange.\"   The waiver also includes a Hospital-Medical Home Demonstration that requires awardees to select one of four possible system improvement initiatives, including one on \"Care Transitions/Medication Reconciliation Programs.\" This initiative requires the awardee to \"develop integrated information systems between hospital inpatient and outpatient sites to enable improved continuity and follow up care.\"","source":"CMS Temporary Approval Letter","source_url":"http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ny/ny-partnership-plan-ca.pdf"},{"state":"New York","policy_lever":"Medicaid Waivers and Demonstrations","activity_status":"Actual","activity_description":"Health Care Efficiency and Affordability Law for New Yorkers Capital Grant Program. This program included multiple components and hundreds of millions of dollars of state grants.","source":"NYS DOH Health Care Efficiency and Affordability Law for New Yorkers Capital Grant Program","source_url":"https://www.health.ny.gov/technology/efficiency_and_affordability_law/"},{"state":"New York","policy_lever":"State Appropriated Funds","activity_status":"Actual","activity_description":"New York State passed the Health Care Efficiency and Affordability Law for New Yorkers Capital Grant Program in 2004, often referred to as the HEAL NY Program (totaling $439 million).","source":"NYS DOH Health Care Efficiency and Affordability Law for New Yorkers Capital Grant Program","source_url":"https://www.health.ny.gov/technology/efficiency_and_affordability_law/"},{"state":"New York","policy_lever":"State Appropriated Funds","activity_status":"Actual","activity_description":"Passed in 2008, New York SB 6808 allows providers who meet certain standards set by the Department of Health to receive supplemental payments for increased costs to use electronic health records. To receive payment, the provider must have an operational electronic health record systems and a set percentage of patients who are on Medicaid or uninsured.","source":"NCSL Health Information Technology: 2007 and 2008 State Legislation","source_url":"http://www.ncsl.org/print/health/forum/hit_enacted.pdf"},{"state":"New York","policy_lever":"State Designation of Exchange Entity","activity_status":"Proposed","activity_description":"NYSDOH enters into a contract with the state designated entity that will govern the relationship between the department and the SDE and set minimum standards for the SDE and the QEs.","source":"Proposed Regulations, New York State Department of Health","source_url":"http://w3.health.state.ny.us/dbspace/propregs.nsf/4ac9558781006774852569bd00512fda/e00f1f2cd3b9582285257d43006a8427?OpenDocument"},{"state":"New York","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"New York's Medicaid Health Home SPA targets individuals with two chronic conditions including BMI >25 or with mental illness or HIV/AIDS. To facilitate the use of health information technology by health homes to improve service delivery and coordination across the care continuum, NY has developed initial and final HIT standards for health homes that are consistent with NYS' Operational Plan for Health Information Technology and Exchange approved by CMS. Providers must meet initial HIT standards to implement a health home. Furthermore, applicants must provide a plan to achieve the formal standards within eighteen months of program initiation in order to be approved as a health home provider. Health home providers will make use of available HIT and access data through the regional health information organization (RHIOs)/Qualified Entities (QE) to conduct these processes as feasible, to comply with the initial standards cited in items 6a.-6d for implementation of health homes. In order to be approved as health home provider, applicants must provide a plan to achieve the final standards within eighteen (18) months of program initiation. Initial Standards -Health home provider has structured information systems, policies, procedures and practices to create, document, execute, and update a plan of care for every patient. - Health home provider has a systematic process to follow-up on tests, treatments, services and, and referrals which is incorporated into the patient's plan of care. - Health home provider has a health record system which allows the patient's health information and plan of care to be accessible to the interdisciplinary team of providers and which allows for population management and identification of gaps in care including preventive services. - Health home provider makes use of available HIT and accesses data through the RHIO/QE to conduct these processes, as feasible. Final Standards - Health home provider has structured interoperable health information technology systems, policies, procedures and practices to support the creation, documentation, execution, and ongoing management of a plan of care for every patient. - Health home provider uses an electronic health record system that qualifies under the Meaningful Use provisions of the HITECH Act, which allows the patient's health information and plan of care to be accessible to the interdisciplinary team of providers. If the provider does not currently have such a system, they will provide a plan for when and how they will implement it. - Health home provider will be required to comply with the current and future version of the Statewide Policy Guidance  (https://www.health.ny.gov/technology/statewide_policy_guidance.htm) which includes common information policies, standards and technical approaches governing health information exchange. - Health home provider commits to joining regional health information networks or qualified health IT entities for data exchange and includes a commitment to share information with all providers participating in a care plan. RHIOs/QE provides policy and technical services required for health information exchange through the Statewide Health Information Network of New York (SHIN-NY). - Health home provider supports the use of evidence based clinical decision making tools, consensus guidelines, and best practices to achieve optimal outcomes and cost avoidance. One example of such a tool is PSYCKES.","source":"Medicaid Health Homes Health IT","source_url":"https://www.health.ny.gov/health_care/medicaid/program/medicaid_health_homes/health_info_technology.htm"},{"state":"New York","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"NY has used their 1915 waiver and SPA process to create a Health Home Development fund that can support TA and technical support for health home connectivity.","source":"NY MRT Waiver Amendment Program","source_url":"https://www.health.ny.gov/health_care/medicaid/redesign/docs/waiver_amend_prog_implem_spa_and_mc.pdf"},{"state":"New York","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"Health Care Efficiency and Affordability Law for New Yorkers Capital Grant Program. This program included multiple components and hundreds of millions of dollars of state grants.","source":"NYS DOH Health Care Efficiency and Affordability Law for New Yorkers Capital Grant Program","source_url":"https://www.health.ny.gov/technology/efficiency_and_affordability_law/"},{"state":"North Carolina","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"Under the multi-payer reform initiatives demonstration program, funded by CMS, states are participating in initiatives  to make advanced primary care practices more broadly available. NC is one of the participating states.","source":"CMS Multi-Payer Advanced Primary Care Practice","source_url":"http://innovation.cms.gov/initiatives/Multi-Payer-Advanced-Primary-Care-Practice/"},{"state":"North Carolina","policy_lever":"eCQM Reporting","activity_status":"Actual","activity_description":"\"Medicaid [has a] requirement for eCQM reporting from providers\" (Final Report) The N3CN Informatics Center (IC) has been designated as the vehicle for collecting Stage 2 Meaningful Use clinical quality measures for all professionals statewide who are eligible for the NC Medicaid EHR Incentive Program. In letters dated December 27, 2010 and July 6, 2012, CMS approved the use of HITECH funds for expanding connectivity between providers and the N3CN IC and enhancing the IC?s current capacity and functionalities to accommodate Stage 2 MU data collection and analytics. (IAPD)","source":"NC HIE and Meeting Meaningful Use","source_url":"http://www.nchie.org/service-offerings/meaningful-use/"},{"state":"North Carolina","policy_lever":"HIE Advisory Council / Oversight Board","activity_status":"Actual","activity_description":"The Legal and Policy Workgroup drafted consensus legislation that will facilitate the creation and operation of NC HIE and provide an opt-out consent model for the exchange of patient information through the NC HIE and associated QOs. The legislation, Senate Bill 375 ? Facilitate Statewide Health Information Exchange, passed both the House and Senate.  It was signed into law by the Governor on June 27, 2011.[1]  The bill is designated to facilitate and regulate the disclosure of protected health information through the voluntary, NC HIE network. The Legal and Policy Workgroup also identified the relevant federal and state privacy regulations that needed to be harmonized so as to clarify responsibilities for the safe protection of the information handled by NC HIE. The team developed the NC HIE Privacy Policy which provides the policies and associated procedures that will be used to manage the access and use of Personal Health Information (PHI) and any aggregates of information created by or from NC HIE.","source":"Senate Bill 375","source_url":"http://www.ncleg.net/Sessions/2011/Bills/Senate/PDF/S375v1.pdf"},{"state":"North Carolina","policy_lever":"HIE Advisory Council / Oversight Board","activity_status":"Actual","activity_description":"North Carolina DHHS has established a committee (DHHS Integrated HIT Steering Committee) to direct the health IT and HIE activities of Medicaid and all associated DHHS agencies including Public Health, Mental Health, and Rural Health.","source":"NC DHHS Website: North Carolina Health IT","source_url":"http://www.ncdhhs.gov/healthit/about.htm"},{"state":"North Carolina","policy_lever":"Medicaid State Plan Amendments (SPA)","activity_status":"Actual","activity_description":"North Carolina's Medicaid Health Home SPA targets individuals with two chronic conditions or one chronic condition and at risk of another one. The Care Management Information System (CMIS) is a Web-based portal accessible to all networks, allowing care managers to maintain a health record and single care plan that stays with the patient as he or she moves from one area of the state to another. A monthly import of Medicaid enrollment and claims data populates the CMIS patient record with demographic and primary care provider information as well as a view of the individual's hospital emergency department and pharmacy claims. Community Care monitors and evaluates the performance and activities of all care managers through the CMIS. Each manager's patient activity is standardized, and networks and the central office have the ability to create parameterized queries at the patient, practice, network or care manager level. These reports enable both care managers and supervisors to examine activities and interventions on a macro level and compare progress and outcomes of interventions. The Informatics Center Provider Portal was released in August of 2010. This portal was built with the treating provider in mind, offering elements of CMIS, Pharmacy Home, and the Reports Site, tailored to the target user. Through a secure web portal, treating providers in the primary care medical home, hospital, emergency room, or mental health system can access a Medicaid patient health record which includes patient information, care team contact information, visit history, pharmacy claims history, and clinical care alerts. Importantly, the use of Medicaid claims data provides key information typically unavailable within the provider chart or electronic health record. For example, providers are able to see encounter information, hospitalizations, ED visits, primary care and specialist visits, laboratory and imaging) that occurred outside of their local clinic or health system. Contact information for the patient's case manager, pharmacy, mental health therapy provider, durable medical equipment supplier, home health or personal care service provider is readily available. Providers can discern whether prior prescriptions were ever filled, and what medications have been prescribed for the patient by others. Built-in clinical alerts appear if the claims history indicates the patient may be overdue for recommended care (e.g. diabetes eye exam, mammography).  The following is a list of the types of Comprehensive Care Management activities documented in CMIS. All of these activities can be used in queries and reports. ? Initial screenings and assessments. ? Patient care plan. ? Information gathered during in-person visits or telephonically. ? Results from chart audits, includin9 gaps in care. ? Interventions and strategies used 1n the care management processes. ? Patient's progress in achieving individual goals. ? Care management activities (including number of patients receiving comprehensive assessments, depression screening, patient self-management notebook, transitional support, pharmacy consult, medication review, home visit, education, face-to-face encounters, etc.). ? Patients meeting \"priority\" criteria for assessment who were touched by the care manager and the Intensity level of the care management activity. ? Percentage of patients being managed at \"heavy- or medium-\" intensity levels. ? Percentage of hospitalized patients who were touched by a care manager in a specified period of time. ? Communication gathered from other providers and resources. ? Needed follow-ups and reminders. Community Care monitors and evaluates the performance and activities of all care managers through the CMIS. Each manager's patient activity is standardized, and networks and the central office have the ability to create parameterized queries at the patient, practice, network or care manager level. These reports enable both care managers and supervisors to examine activities and interventions on a macro level and compare progress and outcomes of interventions.  The following is a list of the types of Health Promotion activities documented in CMIS and available in queries and reports: ? Patient self-management tool kit. ? Medication review. ? Education, including preventive care, disease management and/or self-management training such as educating patient on medications and potential side effects, teaching about the medical home, and reviewing disease red flags to report to the PCP.  The following is a list of the types of Transition Care activities documented in CMIS. All of these activities can be used in queries and reports. ? Patient care plan. ? Information gathered during in-person visits or telephonically. ? Transitional support. ? Medication review. ? Medication reconciliation. ? Home visit. ? Percentage of hospitalized patients who were touched by a care manager in a specified period of time. ? Communication gathered from other providers and resources. ? Needed follow-ups and reminders.  The following is a list of the types of Individual and Family Support Services activities documented in CMIS. All of these activities can be used in queries and reports. ? Referral to community resources and social supports. ? Advocacy. ? Conducting medication education. ? Providing Patient Tool Kits (including Patient Self-Management tool kit). ? Scheduling support (including for transportation services).","source":"Medicaid Approved Health Home State Plan Amendments   (Filter by State; Search term= Health Home)  NC 11-0050 Approval Date 05/24/2012","source_url":"http://www.medicaid.gov/state-resource-center/medicaid-state-plan-amendments/medicaid-state-plan-amendments.html"},{"state":"North Carolina","policy_lever":"State Designation of Exchange Entity","activity_status":"Actual","activity_description":"Designation of the North Carolina Health Information Exchange as the State-Designated Entity.","source":"Executive Order 73, signed December 22, 2010","source_url":"http://digital.ncdcr.gov/cdm/ref/collection/p16062coll5/id/12113"},{"state":"North Carolina","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"North Carolina's Medicaid Health Home SPA targets individuals with two chronic conditions or one chronic condition and at risk of another one. The Care Management Information System (CMIS) is a Web-based portal accessible to all networks, allowing care managers to maintain a health record and single care plan that stays with the patient as he or she moves from one area of the state to another. A monthly import of Medicaid enrollment and claims data populates the CMIS patient record with demographic and primary care provider information as well as a view of the individual's hospital emergency department and pharmacy claims. Community Care monitors and evaluates the performance and activities of all care managers through the CMIS. Each manager's patient activity is standardized, and networks and the central office have the ability to create parameterized queries at the patient, practice, network or care manager level. These reports enable both care managers and supervisors to examine activities and interventions on a macro level and compare progress and outcomes of interventions. The Informatics Center Provider Portal was released in August of 2010. This portal was built with the treating provider in mind, offering elements of CMIS, Pharmacy Home, and the Reports Site, tailored to the target user. Through a secure web portal, treating providers in the primary care medical home, hospital, emergency room, or mental health system can access a Medicaid patient health record which includes patient information, care team contact information, visit history, pharmacy claims history, and clinical care alerts. Importantly, the use of Medicaid claims data provides key information typically unavailable within the provider chart or electronic health record. For example, providers are able to see encounter information, hospitalizations, ED visits, primary care and specialist visits, laboratory and imaging) that occurred outside of their local clinic or health system. Contact information for the patient's case manager, pharmacy, mental health therapy provider, durable medical equipment supplier, home health or personal care service provider is readily available. Providers can discern whether prior prescriptions were ever filled, and what medications have been prescribed for the patient by others. Built-in clinical alerts appear if the claims history indicates the patient may be overdue for recommended care (e.g. diabetes eye exam, mammography).  The following is a list of the types of Comprehensive Care Management activities documented in CMIS. All of these activities can be used in queries and reports. ? Initial screenings and assessments. ? Patient care plan. ? Information gathered during in-person visits or telephonically. ? Results from chart audits, includin9 gaps in care. ? Interventions and strategies used 1n the care management processes. ? Patient's progress in achieving individual goals. ? Care management activities (including number of patients receiving comprehensive assessments, depression screening, patient self-management notebook, transitional support, pharmacy consult, medication review, home visit, education, face-to-face encounters, etc.). ? Patients meeting \"priority\" criteria for assessment who were touched by the care manager and the Intensity level of the care management activity. ? Percentage of patients being managed at \"heavy- or medium-\" intensity levels. ? Percentage of hospitalized patients who were touched by a care manager in a specified period of time. ? Communication gathered from other providers and resources. ? Needed follow-ups and reminders. Community Care monitors and evaluates the performance and activities of all care managers through the CMIS. Each manager's patient activity is standardized, and networks and the central office have the ability to create parameterized queries at the patient, practice, network or care manager level. These reports enable both care managers and supervisors to examine activities and interventions on a macro level and compare progress and outcomes of interventions.  The following is a list of the types of Health Promotion activities documented in CMIS and available in queries and reports: ? Patient self-management tool kit. ? Medication review. ? Education, including preventive care, disease management and/or self-management training such as educating patient on medications and potential side effects, teaching about the medical home, and reviewing disease red flags to report to the PCP.  The following is a list of the types of Transition Care activities documented in CMIS. All of these activities can be used in queries and reports. ? Patient care plan. ? Information gathered during in-person visits or telephonically. ? Transitional support. ? Medication review. ? Medication reconciliation. ? Home visit. ? Percentage of hospitalized patients who were touched by a care manager in a specified period of time. ? Communication gathered from other providers and resources. ? Needed follow-ups and reminders.  The following is a list of the types of Individual and Family Support Services activities documented in CMIS. All of these activities can be used in queries and reports. ? Referral to community resources and social supports. ? Advocacy. ? Conducting medication education. ? Providing Patient Tool Kits (including Patient Self-Management tool kit). ? Scheduling support (including for transportation services).","source":"Medicaid Approved Health Home State Plan Amendments  (Filter by State; Search term= Health Home)  NC 11-0050 Approval Date 05/24/2012","source_url":"http://www.medicaid.gov/state-resource-center/medicaid-state-plan-amendments/medicaid-state-plan-amendments.html"},{"state":"North Dakota","policy_lever":"E-Prescribing (eRx) Mandate or Encouragement","activity_status":"Actual","activity_description":"House Bill Number 1422 from the 2011 Legislative session is an act that requires drug prior authorization request to be submitted electronically effective August 1, 2013.","source":"House Bill 1422","source_url":"http://www.legis.nd.gov/assembly/62-2011/documents/11-0684-01000.pdf?20151202115045"},{"state":"North Dakota","policy_lever":"State Privacy and Security Policies","activity_status":"Actual","activity_description":"SECTION 5. A new section to chapter 54-59 of the North Dakota Century Code is created, via passage of SB 2037, and enacted as follows: Immunity for reliance on data from the health information exchange. A health care provider that relies in good faith upon any information provided through the health information exchange in the treatment of a patient is immune from criminal or civil liability arising from any damages caused by that good-faith reliance. The immunity granted under this section does not apply to acts or omissions constituting gross negligence or reckless, wanton, or intentional misconduct.","source":"Senate Bill 2037","source_url":"http://www.legis.nd.gov/assembly/62-2011/documents/11-0241-02000.pdf?20151202115103"},{"state":"North Dakota","policy_lever":"State Privacy and Security Policies","activity_status":"Actual","activity_description":"Senate Bill Number 2250 from the 2013 Legislative Session created a new section of century code relating to participation in the NDHIN. Essentially, individual?s information, by default is searchable within the NDHIN. However, an individual has the right to opt out of participating or conditionally opt out, in which case the accessibility of the individual?s individually identifiable health information is limited to access by a health care provider who determines access is required by a medical emergency.","source":"Senate Bill 2250","source_url":"http://openstates.org/nd/bills/64/SB2250/"},{"state":"North Dakota","policy_lever":"State Appropriated Funds","activity_status":"Actual","activity_description":"The State of North Dakota Legislature has twice appropriated funds in support of the Health Information Exchange. In the 2009 session, the legislature appropriated up to $8,000,0000 to cover ONC matching requirements and $5,000,000 for the State of North Dakota Bank Loan Fund, and for building the HIE. In the 2011 session, the legislature appropriated another $5,000,000 to the Bank Loan program and continued the $8,000,000 appropriation for match on grants and for ongoing operational costs of the HIE. During the 2013 legislative session, funds were appropriated to continue the implementation and operation of the NDHIN.","source":"North Carolina HIT Planning Loan Program","source_url":"http://www.healthit.nd.gov/wp-content/uploads/sites/2/sites/2/2011/07/ND2014-PLanning-Loan-Program-July-2014.pdf"},{"state":"Oklahoma","policy_lever":"Medicaid State Plan Amendments (SPA)","activity_status":"Actual","activity_description":"Oklahoma's two Medicaid Health Home SPAs focus (1) on children with serious emotional disturbances and (2) on adults with serious mental illness. Providers must meet the initial HIT standards to implement a Health Home. In addition, provider applicant must provide a plan to achieve the final standards within 18 months of program initiation in order to maintain HH status. Initial Standards: 1. Have structured information systems, policies, procedures & practices to create, document, execute, and update a plan of care for every member; 2. Have a systematic process to follow up on tests, treatments, services and referrals; 3. Have a health record system which allows the member?s health information and comprehensive, person-centered service plan to be accessible to the interdisciplinary team of providers and allow for population management and identification of gaps in care, including preventive services; and 4. Is required to make use of available HIT and access members? data through the health information exchange or Direct to conduct all processes, as feasible.  Final Standards: The final standards require HH providers to use HIT for the following: 1. Have structured interoperable health information technology systems, policies, procedures and practices 2. Utilize an electronic health record system that qualifies under the Meaningful Use provisions of the HITECH Act. If the provider does not currently have such a system, they will have to provide a plan for when and how they will implement it. 3. Join a certified health information exchange for data exchange and make a commitment to share information with all providers. 4. Support the use of evidence based clinical decision making tools, consensus guidelines, and best practices. Oklahoma HH providers will be encouraged to use wireless technology as available to improve coordination and management of care and member adherence to recommendations made by their provider. This may include the use of telemedicine, cell phones, peripheral monitoring devices, and access member care management records, as feasible. To facilitate the use of health information technology by Health Homes to improve service delivery and coordination across the care continuum, Oklahoma has developed initial and final HIT standards. Providers must meet the initial HIT standard to implement a HH, as feasible. The feasibility of exchanging electronic health information depends largely on the capacity of the external care providers, such as hospitals and physicians, to exchange information in an electronic, structured format. Currently, there is not an infrastructure within the State for electronic interchange, although certified health information organizations (HIOs)are available. Work is underway to create a network or networks but  it is not completed at this time. All CMHCs utilize an electronic medical record (EMR) and are in the process of upgrading to an Office of the National Coordinator (ONC) certified electronic health record (EHR). Providers will be required to work with one of these HIOs. Through funding from a SAMHSA-HRSA award, CMHCs have been given vouchers to fund the development of an interface with an HIO and 12-month connection fees for clinicians. Similar voucher programs are being provided to rural hospitals and primary care professionals; however, until statewide adoption has occurred, many external physicians working with the HH will not be able to electronically accept or receive health information. Using secure messaging, HH can exchange health information with external care providers who are not capable of exchanging information through an HIO. Applicant Health Homes must provide a plan in order to achieve the final HIT standards within 18 months of program initiation in order to be approved as a HH provider.  HH providers will work with HIOs or through secure messaging to access patient data and to develop partnerships that maximize the use of HIT across providers. The Health Home provider will utilize HIT to communicate with health facilities and other systems and to facilitate interdisciplinary collaboration among all providers, the member, family, care givers and local supports when external partners have the capability to send and receive electronic, structured records.  HH providers will work with HIOs or through secure messaging to electronically communicate referrals to community and social support services and to follow-up on referrals and access to needed services as determined by the partnering agency?s ability to communicate electronically.","source":"Medicaid Approved Health Home State Plan Amendments  (Filter by State; Search term= Health Home)  OK 14-0011 Approval Date 02/10/2015  OK 14-0012 Approval Date 2/10/15","source_url":"http://www.medicaid.gov/state-resource-center/medicaid-state-plan-amendments/medicaid-state-plan-amendments.html"},{"state":"Oklahoma","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"Oklahoma's two Medicaid Health Home SPAs focus (1) on children with serious emotional disturbances and (2) on adults with serious mental illness. Providers must meet the initial HIT standards to implement a Health Home. In addition, provider applicant must provide a plan to achieve the final standards within 18 months of program initiation in order to maintain HH status. Initial Standards: 1. Have structured information systems, policies, procedures & practices to create, document, execute, and update a plan of care for every member; 2. Have a systematic process to follow up on tests, treatments, services and referrals; 3. Have a health record system which allows the member?s health information and comprehensive, person-centered service plan to be accessible to the interdisciplinary team of providers and allow for population management and identification of gaps in care, including preventive services; and 4. Is required to make use of available HIT and access members? data through the health information exchange or Direct to conduct all processes, as feasible.  Final Standards: The final standards require HH providers to use HIT for the following: 1. Have structured interoperable health information technology systems, policies, procedures and practices 2. Utilize an electronic health record system that qualifies under the Meaningful Use provisions of the HITECH Act. If the provider does not currently have such a system, they will have to provide a plan for when and how they will implement it. 3. Join a certified health information exchange for data exchange and make a commitment to share information with all providers. 4. Support the use of evidence based clinical decision making tools, consensus guidelines, and best practices. Oklahoma HH providers will be encouraged to use wireless technology as available to improve coordination and management of care and member adherence to recommendations made by their provider. This may include the use of telemedicine, cell phones, peripheral monitoring devices, and access member care management records, as feasible. To facilitate the use of health information technology by Health Homes to improve service delivery and coordination across the care continuum, Oklahoma has developed initial and final HIT standards. Providers must meet the initial HIT standard to implement a HH, as feasible. The feasibility of exchanging electronic health information depends largely on the capacity of the external care providers, such as hospitals and physicians, to exchange information in an electronic, structured format. Currently, there is not an infrastructure within the State for electronic interchange, although certified health information organizations (HIOs)are available. Work is underway to create a network or networks but  it is not completed at this time. All CMHCs utilize an electronic medical record (EMR) and are in the process of upgrading to an Office of the National Coordinator (ONC) certified electronic health record (EHR). Providers will be required to work with one of these HIOs. Through funding from a SAMHSA-HRSA award, CMHCs have been given vouchers to fund the development of an interface with an HIO and 12-month connection fees for clinicians. Similar voucher programs are being provided to rural hospitals and primary care professionals; however, until statewide adoption has occurred, many external physicians working with the HH will not be able to electronically accept or receive health information. Using secure messaging, HH can exchange health information with external care providers who are not capable of exchanging information through an HIO. Applicant Health Homes must provide a plan in order to achieve the final HIT standards within 18 months of program initiation in order to be approved as a HH provider.  HH providers will work with HIOs or through secure messaging to access patient data and to develop partnerships that maximize the use of HIT across providers. The Health Home provider will utilize HIT to communicate with health facilities and other systems and to facilitate interdisciplinary collaboration among all providers, the member, family, care givers and local supports when external partners have the capability to send and receive electronic, structured records.  HH providers will work with HIOs or through secure messaging to electronically communicate referrals to community and social support services and to follow-up on referrals and access to needed services as determined by the partnering agency?s ability to communicate electronically.","source":"Medicaid Approved Health Home State Plan Amendments   (Filter by State; Search term= Health Home)  OK 14-0011 Approval Date 02/10/2015  OK 14-0012 Approval Date 2/10/15","source_url":"http://www.medicaid.gov/state-resource-center/medicaid-state-plan-amendments/medicaid-state-plan-amendments.html"},{"state":"Oregon","policy_lever":"Advanced Directives Registry","activity_status":"Actual","activity_description":"The Oregon Physician Orders for Life Sustaining Treatment (POLST) Registry is a secure electronic record of POLST orders. The Registry allows health care professionals treating you to access your POLST orders if the paper copy cannot be found. Information in the Registry is protected and confidential.  Providers may submit and receive POLST information through Direct secure messaging.","source":"POLST","source_url":"http://www.or.polst.org/"},{"state":"Oregon","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"CMS Comprehensive Primary Care Initiative participants are encouraged to connect to the statewide HIE to exchange clinical information.","source":"CMS Comprehensive Primary Care Initiative","source_url":"http://innovation.cms.gov/initiatives/Comprehensive-Primary-Care-Initiative/"},{"state":"Oregon","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"Oregon has implemented CCOs under an 1115 waiver and significant financial support from CMS.  With support from Oregon's CMS CMMI State Innovation Model (SIM) grant, Oregon will work to accelerate and spread the coordinated care model beyond the Medicaid population to public employees, Medicare, and private payers.    Under the 1115 Waiver, CCOs are: - Directed to use HIT to link services and core providers across the continuum of care - Expected to achieve minimum standards in foundational HIT and develop its own transformational areas of HIT use","source":"Oregon 1115 Demonstration Waiver","source_url":"http://www.oregon.gov/oha/healthplan/DataReportsDocs/July%205,%202012%20through%20June%2030,%202017.pdf"},{"state":"Oregon","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"Oregon clinics may apply to be recognized as a Patient-Centered Primary Care Home (PCPCH). Clinics recognized through the PCPCH program have different levels (Tier 1, Tier 2, Tier 3, Tier 3 Star) according to the types of criteria met, with Tier 3 Star being the most advanced and meeting most criteria.? PCPCH-recognized clinics may be eligible for incentive payments.  PCPCH measures for HIT/HIE include: - Sharing clinical information electronically with other providers and care entities - Meeting \"Meaningful Use\" standards with the electronic health record - Being able to provide patients with their medical record electronically upon request","source":"PCPCH 2014 Recognition Criteria (last updated April 2015)","source_url":"http://www.oregon.gov/oha/pcpch/Documents/TA-Guide.pdf"},{"state":"Oregon","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"MOUs between CCOs and each local Aging and People with Disabilities (APD)/Area Agency on Aging (AAA) to improve coordination and care for clients served by both CCOs and APDs/AAAs.","source":"MOUs signed by CCOs and APD/AAA","source_url":"http://www.oregon.gov/dhs/pages/hst/apd-cco-info.aspx"},{"state":"Oregon","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"In 2013, the Oregon Health Policy Board (OHPB) recommended strategies and actions to align the Affordable Care Act implementation with Oregon?s health system reform. Among these recommendations, the OHPB called for the spread of the Coordinated Care Model (CCM) to the broader market by aligning model principles across payers and implementing organizational alignment around those principles. To fulfill that request, the Coordinated Care Model Alignment Workgroup was formed. The workgroup developed a framework for CCM purchasing that includes elements such as:   - Encouraging contracted physician and hospital providers encouraged to use real -time electronic clinical information exchange across all care settings","source":"2014-2016 Coordinated Care Model Alignment Workgroup","source_url":"http://www.oregon.gov/oha/OHPR/Pages/2014-Coordinated-Care-Model-Alignment-Work-Group.aspx"},{"state":"Oregon","policy_lever":"Credentialing Policies","activity_status":"Actual","activity_description":"OHA is required to establish a program and database for the purpose of providing credentialing organizations access to information necessary to credential all health care practitioners in the State.  Legislation in 2013 created the Oregon Common Credentialing Program under OHA to simplify and centralize the administrative processes associated with credentialing health professionals. Under this program:  ? Health professionals or their designees must submit necessary credentialing information into a mandatory web-based Common Credentialing Solution and ? Credentialing organizations (e.g., hospitals, health insurers, and ambulatory surgical centers) must use the solution to obtain that information for their credentialing processes. ? Verification of primary source documentation will be addressed centrally, reducing duplicative processes.","source":"","source_url":"http://www.oregon.gov/oha/OHPR/occp/Pages/index.aspx"},{"state":"Oregon","policy_lever":"eCQM Reporting","activity_status":"Proposed","activity_description":"The Oregon Health Authority is using quality health metrics to show how well Coordinated Care Organizations (CCOs) are improving care, making quality care accessible, eliminating health disparities, and curbing the rising cost of health care.  Seventeen outcome and quality measures have been developed by the Metrics and Scoring Committee for measurement years 2013 and 2014. Funds from a quality pool will be awarded to CCOs based on their annual performance on these 17 CCO Incentive Measures. Three of the 17 CCO incentive measures are meaningful use clinical quality measures.  Oregon is developing a Clinical Quality Metrics Registry (CQMR) to aggregate key clinical quality data to use to calculate CCO incentive payments and meaningful use payments to providers for the Medicaid EHR Incentive Program. CCOs will be able to receive collected clinical data for members for quality improvement efforts.","source":"","source_url":"http://www.oregon.gov/oha/analytics/Pages/CCO-Baseline-Data.aspx"},{"state":"Oregon","policy_lever":"Federal or State Grants","activity_status":"Actual","activity_description":"A portion of Oregon's State Innovation Model (SIM) grant is funding five telehealth pilot programs to evaluate the feasibility of and increase the access to telehealth in different patient populations and with telehealth modalities across Oregon, with an emphasis on rural locations.","source":"Telehealth Pilot Projects","source_url":"http://www.ohsu.edu/xd/outreach/oregon-rural-health/resources/orh-sources/telehealth-pilot-project.cfm"},{"state":"Oregon","policy_lever":"Federal or State Grants","activity_status":"Actual","activity_description":"A portion of Oregon's State Innovation Model (SIM) grant supported Oregon hospitals implementation of the Emergency Department Information Exchange (EDIE) program, a Web-based communication technology that enables intra- and inter-emergency department communication.","source":"EDIE","source_url":"http://www.orhealthleadershipcouncil.org/our-current-initiatives/emergency-department-information-exchange-edie"},{"state":"Oregon","policy_lever":"HIE Advisory Council / Oversight Board","activity_status":"Actual","activity_description":"The Health Information Technology Oversight Council (HITOC) is a statutory body of Governor appointed, Senate confirmed citizens, tasked with setting goals and developing a strategic health information technology plan for the state, as well as monitoring progress in achieving those goals and providing oversight for the implementation of the plan.  The HITOC is currently coordinating Oregon's public and private statewide efforts in electronic health records adoption and the eventual development of a statewide system for electronic health information exchange. The HITOC will help Oregon meet federal requirements so that providers may be eligible for millions of federal health information technology stimulus dollars.","source":"Legislation establishing HITOC","source_url":"https://olis.leg.state.or.us/liz/2009R1/Downloads/MeasureDocument/HB2009/Enrolled"},{"state":"Oregon","policy_lever":"Prescription Drug Monitoring Programs (PDMP)","activity_status":"Actual","activity_description":"The Oregon Prescription Drug Monitoring Program (PDMP) is a Web-based data  system that contains information on controlled prescription medications dispensed by Oregon-licensed retail pharmacies.  Oregon-licensed healthcare providers and pharmacists and their staff may be authorized for an account to access information from the PDMP system. Bordering state licensed healthcare providers may also be authorized for access accounts. By law their access is limited to patients under their care.","source":"","source_url":"http://www.orpdmp.com/"},{"state":"Oregon","policy_lever":"Public Health Surveillance","activity_status":"Actual","activity_description":"Syndromic surveillance in Oregon (a project called Oregon ESSENCE - Electronic Surveillance System for the Early Notification of Community-Based Epidemics) provides real-time data for public health and hospitals to monitor what is happening in emergency departments across the state before, during and after a public health emergency.  With Oregon ESSENCE, hospital users and public health personnel will have a window into the health consequences of emergencies and planned events. Participating facilities are encouraged to leverage Electronic Health Record systems to automate reporting of health records (often in coordination with Federal Meaningful Use preparations).","source":"Surveillance System","source_url":"https://public.health.oregon.gov/DiseasesConditions/CommunicableDisease/PreparednessSurveillanceEpidemiology/essence/Pages/index.aspx"},{"state":"Oregon","policy_lever":"State Lab Requirements","activity_status":"Actual","activity_description":"The Oregon Electronic Laboratory Reporting (ELR) project is a long-term effort to convert major labs, county health departments and the state public health division to electronic data interchange.  In this system, the state health department functions as an electronic hub to accept, route, and process electronic HL7 messages containing lab and clinical data.","source":"Oregon ELR","source_url":"https://public.health.oregon.gov/DiseasesConditions/CommunicableDisease/ReportingCommunicableDisease/ElectronicLabReporting/Pages/index.aspx"},{"state":"Oregon","policy_lever":"State Purchasing/Contracting of Health Care Services","activity_status":"Actual","activity_description":"Oregon's Medicaid Coordinated Care Organizations (CCOs) must: ? Demonstrate how they will achieve minimum standards in foundational areas of HIT such as: ? Facilitating provider adoption and meaningful use of EHRs ? Participating in HIE to support sharing patient information ? Develop goals for transformational elements of HIT such as  ? Analytics, quality reporting ? Patient engagement ? Develop Transformation Plans with milestones, and report on progress","source":"CCO Model Contract","source_url":"http://www.oregon.gov/oha/OHPB/docs/2015_CCO_Model_Contract.pdf"},{"state":"Pennsylvania","policy_lever":"Advanced Directives Registry","activity_status":"Proposed","activity_description":"The Pennsylvania eHealth Partnership Authority includes an examination of how best to enable exchange of advance directives and similar documents via the Pennsylvania Patient and Provider Network (P3N). This may take the form of standards adopted by the community for creation, storage, and exchange of these documents by individual participants in the P3N, or may take the form of a registry developed and implemented within the state government. The Authority is seeking funding for this work under an IAPD proposal.","source":"2014-2017 Strategic and Operational Plan select \"2014-2017 Strategic and Operational Plan for Electronic Health Information Exchange\"","source_url":"http://www.paehealth.org/resources"},{"state":"Pennsylvania","policy_lever":"eCQM Reporting","activity_status":"Actual","activity_description":"One service offered by the Pennsylvania eHealth Partnership Authority as part of the Pennsylvania Patient and Provider Network (P3N), is the Public Health Gateway (PHG). This joint effort between the Authority, the Department of Human Services, and the Department of Health creates a single point of connection from the private sector to enable submission of reports to various state maintained registries, to include the eCQM registry maintained by the Department of Human Services.   Future planned PHG enhancements include enabling bi-directional exchange so the private sector can query for information from the public registries, and expansion to include other agencies, possibly to include the Pennsylvania Health Care Cost Containment Council, the Department of Corrections, and the Department of Veterans' Affairs.","source":"Public Health Gateway (PHG) 2014-2017 Strategic and Operational Plan","source_url":"http://www.paehealth.org/resources"},{"state":"Pennsylvania","policy_lever":"Medicare and Medicaid EHR Incentive Program (Meaningful Use)","activity_status":"Actual","activity_description":"The State is expected to achieve minimum standards in foundational areas of HIT and to develop its own goals for the transformational areas of HIT use.  Pennsylvania must have plans for health IT adoption for providers. This will include creating a pathway (and/or a plan) to adoption of certified EHR technology and the ability to exchange data through the state?s HIE. If providers do not currently have this technology, there must be a plan in place to encourage adoption, especially for those providers eligible for the Medicare and Medicaid EHR Incentive Program.   The state must participate in all efforts to ensure that all regions have coverage by a HIE. Federal funding for developing health information exchange (HIE) infrastructure may be available, per State Medicaid Director letter #11-004, to the extent that allowable costs are properly allocated among payers.  Currently there are multiple HIOs and multiple HISPs offering eHIE service to providers in every county in the state.","source":"Pennsylvania's HIE Strategic and Operational Plan, Section 9","source_url":"http://www.paehealth.org/news/285-september-11-2014"},{"state":"Pennsylvania","policy_lever":"Public Health Surveillance","activity_status":"Actual","activity_description":"One service offered by the Pennsylvania eHealth Partnership Authority as part of the Pennsylvania Patient and Provider Network (P3N), is the Public Health Gateway (PHG). This joint effort between the Authority, the Department of Human Services, and the Department of Health creates a single point of connection from the private sector to enable submission of reports to various state maintained registries, to include the Cancer Registry, Syndromic Surveillance Registry, Immunization Registry, and Electronic Lab Reporting Registry, all maintained by the Department of Health.  The Department of Health will work with the PA eHealth Partnership Authority to define and coordinate the exchange of data to the private sector in order to advance population health goals that are currently being developed within the Commonwealth?s Innovation Plan.  Future planned PHG enhancements include enabling bi-directional exchange so the private sector can query for information from the public registries, and expansion to include other agencies, possibly to include the Pennsylvania Health Care Cost Containment Council, the Department of Corrections, and the Department of Veterans' Affairs.","source":"select 2014-2017 Strategic and Operational Plan for Electronic Health Information Exchange","source_url":"http://www.paehealth.org/resources"},{"state":"Pennsylvania","policy_lever":"State Appropriated Funds","activity_status":"Actual","activity_description":"The Authority's core operations are financed via a combination of state appropriations, fees paid by participating HIOs, and private donations. A fee schedule is publicly posted. The Authority will gradually increase reliance on HIO fees to eventually achieve balance between this source of funding and state appropriations.","source":"Pennsylvania eHealth Partnership Authority Strategic and Operational Plan","source_url":"http://www.paehealth.org/resources"},{"state":"Pennsylvania","policy_lever":"State Designation of Exchange Entity","activity_status":"Actual","activity_description":"The purpose of the Pennsylvania eHealth Partnership Authority (the Authority) is to improve healthcare delivery and healthcare outcomes in Pennsylvania by enabling the secure exchange of health information (HIE). The Authority was created through unanimously-passed legislation (P.L. 1042) in July 2012.","source":"Pennsylvania eHealth Information Technology Act","source_url":"http://www.legis.state.pa.us/WU01/LI/LI/US/HTM/2012/0/0121..HTM"},{"state":"Pennsylvania","policy_lever":"State Designation of Exchange Entity","activity_status":"Actual","activity_description":"The Pennsylvania eHealth Partnership Authority announced on March 18, 2015 the availability of up to $11.8 million in onboarding grant funds to help connect hospitals and ambulatory practices to the Authority?s Pennsylvania Patient & Provider Network, or P3N. The P3N enables electronic health information exchange (eHIE) across the state through the connection of healthcare providers to health information organizations (HIO), and the connection of HIOs to the P3N. This program is funded in part with IAPD funds received from CMS via the Pennsylvania Department of Human Services. The Authority expects to apply for funding and then make this program available to HIOs in each year in which IAPD funds are available until nearly all hospitals are connected and HIOs have built interfaces to most major EHR vendors, or at least those each HIO is interested in. The grant requires that HIOs not only establish and implement technical interfaces, but also that they provide workflow integration, training, and go-live support. The grant also includes a small amount to assist HIOs in connecting to the P3N, and in the future may incentivize specific objectives of the Authority and Pennsylvania's State Medicaid Health IT Plan, such as creation of portals to permit eHIE participation by long term/post-acute care providers that do not have sophisticated EHR systems.","source":"","source_url":"http://www.paehealth.org/news/319-march-18-2015"},{"state":"Pennsylvania","policy_lever":"State HIE / HISP Accreditation, Certification, Registration, or Qualification","activity_status":"Actual","activity_description":"The Pennsylvania eHealth Partnership Authority (the Authority) is the custodian and guardian of the Pennsylvania Patient and Provider Network (P3N), a combination of governance, certification programs, and thin-layer of technical services that enables interoperability across health information organizations (HIOs) and health information service providers (HISPs) operating in the Commonwealth. Certification is voluntary, but HIOs and HISPs wishing to participate in Pennsylvania's \"trust community\" and P3N must achieve certification. Certification is also a precondition of most grants provided to the HIOs and HISPs by the Authority (see PA Adoption Incentives Policy Lever item).   Certification includes agreement to a common legal framework, attestation and in some cases evidence that they have faithfully implemented security and privacy policies, compliance with adopted technical standards, and testing to prove that constituents of the HIO or HISP can in fact interoperate with constituents of other trust community HIOs and/or HISPs.   All aspects of the certification programs were developed and are maintained through consensus-based decisions of the members of the trust community themselves, guided by the Authority. National-level standards are leveraged wherever possible, but compliance with federal and state law is paramount.  Organizations seeking to operate both as HIOs and HISPs must achieve both certifications. Community Shared Services (CSS) and the PA-HIE Network trust community. To protect the citizens of Pennsylvania and the PA-HIE Network trust community that serves them, health information service provider (HISP) and health information exchange (HIE) organizations need to fulfill a number of requirements. Those requirements make up the HISP and PA-HIE Network certification programs. HIE organizations without HISP services need only apply for PA-HIE Network certification. However, if the organization is an HIE with HISP services, it will need HISP certification as well.   The certification program ensures that participating HISPs have agreed to a common legal framework, can prove their ability to comply with the applicable technical standards, and have faithfully implemented security and privacy policies in keeping with DIRECT project guidance. The Authority requires certified HISPs to undergo interoperability testing to ensure that any client using one certified HISPs services can communicate with any other client of any other HISP. The Authority launched the HISP certification program in mid-2012.","source":"P3N Onboarding & Certification Requirements for HIOs","source_url":"http://www.paehealth.org/certification"},{"state":"Rhode Island","policy_lever":"Advanced Directives Registry","activity_status":"Proposed","activity_description":"The statewide HIE is enabled to accept  Medical Life sustaining Order documents  (MOLST) documents there by making them available to other providers for an enrolled patient.  The policy framework to support this technical capability is under development. Additionally the HIE will allow patients to upload their advance directives through Currentcare are For Me, the HIE's patient portal once the portal is expanded and rolled out","source":"RI Regulations","source_url":"http://www.sos.ri.gov/documents/archives/regdocs/released/pdf/DOH/8003.pdf"},{"state":"Rhode Island","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"Rhode Island's statewide, all-payer Patient Centered Medical Home project, known as The Care Transformation Collaborative (CTC-RI) is an all-payer PCMH collaborative of over 73 practices ((including 22 Community Health Center sites) that provides care to 250,000 Rhode Islanders. Payment rates are tied to achievement of clinical quality, utilization and process improvement targets.  CTC is one of the 8 Medicare Advanced Primary Care Practice demonstration sites and was the nation?s only statewide Beacon Community. Support for the practices comes through the developmental contract, an agreement negotiated between the health plans and the participating primary care practices under the auspices of the Office of the Health Insurance Commissioner. The contract calls for payments to supplement the traditional fee-for-service structure, providing practices with per member per month payments designed to drive practice transformation and quality improvement. These supplemental payments allow the practices to make structural enhancements, including the addition of a Nurse Care Manager, who oversees care coordination efforts, as well as an analytical structure to use electronic medical records  to track patient data. AS part of CTC the PCMHs  are required to have an EHR meeting meaningful use standards and are also strongly encouraged to  offer CurrentCare (HIE) enrollment to their patients  and to use the statewide HIE  viewer as well as the alert service for ED and hospital admissions and discharges","source":"PCMH Website","source_url":"https://www.pcmhri.org/news/rhode-island-statewide-patient-centered-medical-home-learning-collaborative-engaging-practices-"},{"state":"Rhode Island","policy_lever":"All Payer Claims Database (APCD) Policies","activity_status":"Actual","activity_description":"RI  has established and APCD and mandates that  RI insurers submit medical and pharmacy claims data to the RI APCD at least quarterly, including historical data from 2011 to present. Although the data is deidentified claims are longitundally linked with an encrypted unique identifier so that there is a longitudinal view of claims  for each deidentified individual . Data will be used for. The data for  trend analysis, total cost of care, evaluation of different payment models but at this it can not be linked with individual HIE data .","source":"OHIC Regulation 2, Section 10 (b)(1)(A)","source_url":"http://www.ohic.ri.gov/documents/2_Adopted%20Regulation%202%20Amendments.pdf"},{"state":"Rhode Island","policy_lever":"eCQM Reporting","activity_status":"Proposed","activity_description":"As part of Rhode Island's newly  awarded a SIM round 2 model test Cooperative agreement, the state is seeking to  create, collect and feedback a set of  harmonized quality measures.  RI is planning to develop a Health Care Quality Measurement, Reporting and Feedback System.  This system would support statewide capacity to obtain, analyze, benchmark, and feedback healthcare data from providers and their practice settings.  A centralized system would be developed  to  streamline redundant reporting processes for providers and payers.  This would result in a more efficient use of the limited resources available for informing quality monitoring and improvement, health care purchasing, and consumer choice.","source":"Source: Amy Zimmerman","source_url":""},{"state":"Rhode Island","policy_lever":"Federal or State Grants","activity_status":"Actual","activity_description":"Rhode Island was awarded a SIM Grant Model Test. One activity of the grant is to harmonized measurement is through developing a Health Care Quality Measurement, Reporting and Feedback System. This system would support statewide capacity to obtain, analyze, benchmark, and feedback healthcare data from providers and their practice settings. A centralized system would be developed to streamline redundant reporting processes for providers and payers. This would result in a more efficient use of the limited resources available for informing quality monitoring and improvement, health care purchasing, and consumer choice.","source":"Source: Amy Zimmerman","source_url":""},{"state":"Rhode Island","policy_lever":"HIE Advisory Council / Oversight Board","activity_status":"Actual","activity_description":"There are several  groups that provide some level of Oversight to the statewide HIE.  RIQI, as the state designated entity, has a board of directors that consists of the major health care leaders  in the state  including CEOS of: The major hospital systems in RI, payers, large provider groups, as well as business, academia, behavioral health providers, government officials  and consumer representatives. There is also the HIE Advisory Commission that makes recommendations to the Director of Health and by statute are most heavily focused on  ensuring the privacy and security of the  HIE data. There is also the SIM Steering committee that will be recommending and monitoring the HIT plan as part of SIM. Many of the SIM steering Committee members are also on the RIQI board of directors.","source":"Chapter 23, 17.17 and 42-35","source_url":"http://sos.ri.gov/documents/archives/regdocs/released/pdf/DOH/7305.pdf"},{"state":"Rhode Island","policy_lever":"Certificate of Need (CON) Regulations","activity_status":"Actual","activity_description":"The RI Department of Health has included conditions  a part of  the Hospital Conversion Act  or CON approval process for the for hospital acquisitions, mergers,  conversions etc   related to HIT including requirements to enrolling their patients in the statewide HIE , sharing their data with the HIE, obtaining Direct messaging accounts and having their providers be trained on and have access to the  HIE viewer and alerts.","source":"CHAPTER 23-17.14   Hospital Conversion Act","source_url":"http://www.health.ri.gov/programs/hospitalconversionsmerger/"},{"state":"Rhode Island","policy_lever":"Medicare and Medicaid EHR Incentive Program (Meaningful Use)","activity_status":"Actual","activity_description":"RI participates in the administering the Medicaid EHR incentive program. As such there is 90/10 funding to support the HIE at the $1PMPM. Additionally there is a contract being out in place with the states regional extension center which is the same entity as the state designated entity for HIE to provide technical assistance for EHR adoption and meeting meaningful use.","source":"Source: Amy Zimmerman","source_url":""},{"state":"Rhode Island","policy_lever":"Medicaid State Plan Amendments (SPA)","activity_status":"Actual","activity_description":"The Affordable Care Act of 2010, Section 2703, created an optional Medicaid State Plan benefit for states to establish Health Homes to coordinate care for people with Medicaid who have chronic conditions by adding Section 2703 of the Social Security Act. Health Homes providers will integrate and coordinate all primary, acute, behavioral health, and long-term services and supports to treat the whole person. Rhode Island's plan was approved November 23, 2011.  As part of being a RI Health Home,   the following HIT efforts were  encouraged or required: participation in the State's HIE; data sharing with MCOs; use of the PDMP.  As Licensed Behavioral Healthcare providers, Health Home programs are required to offer all clients enrollment in the State's HIE. - \"  11.10 The organization shall offer enrollment in the HIE to each patient and maintain documentation evidencing the offer of enrollment in the treatment record of each individual. If the individual chooses to enroll in the HIE, the organization shall ensure that the individual executes an HIE enrollment form and a Uniform Authorization Form for the disclosure of health information to the HIE attached as Appendix IV.\"","source":"Approved Health Home State Plan Amendments","source_url":"http://www.medicaid.gov/State-Resource-Center/Medicaid-State-Technical-Assistance/Health-Homes-Technical-Assistance/Approved-Health-Home-State-Plan-Amendments.html"},{"state":"Rhode Island","policy_lever":"Prescription Drug Monitoring Programs (PDMP)","activity_status":"Actual","activity_description":"RI mandates submission of all dispensed controlled substance prescriptions to the PDMP within 72 hours of being dispensed.  The PDMP is housed in the Rhode Island Department of Health.  Prescribers, Pharmacists, and their delegates can log into the PDMP website and perform live queries on specific patients and their medication dispensing history.  Physicians are required to register with the PDMP, and are mandated to check the PDMP before prescribing opioids in many scenarios.","source":"Source: Amy Zimmerman","source_url":""},{"state":"Rhode Island","policy_lever":"State Privacy and Security Policies","activity_status":"Actual","activity_description":"The RI HIE Act of 2008  gives the RI Department of Health regulatory authority over the designated statewide HIE with a specific focus on privacy and security and requires that  participation in the HIE is voluntary for both patients and providers. It  stipulates the uses of the data and it also creates a HIE advisory  commission to The HIE Advisory Commission makes policy recommendations to the Director of Health regarding the use of confidential patient information in the HIE.   There are also some protections for providers as part of this statute. Legislation has been introduced that would require the HIE Advisory commission to develop an interoperability plan for the HIE.","source":"Source: Amy Zimmerman","source_url":""},{"state":"Rhode Island","policy_lever":"State Appropriated Funds","activity_status":"Actual","activity_description":"RI's statewide HIE, known as  Currentcare is largely funded through a voluntary payer contribution model ( as opposed to a legislated assessment) where commercial and self funded employers are asked to voluntarily contribute a  $1 per member per month for  the number of lives they cover.  RI's Medicaid and  State Employees Health Benefit program participates in this  voluntary  contribution model and as such has a contract which stipulates a set of deliverables to met by the  HIE state designated entity (also know as the RHIO).  Medicaid HIE funds are obtained through the EHR incentive dollars at a 90/10 match rate","source":"Source: Amy Zimmerman","source_url":""},{"state":"Rhode Island","policy_lever":"State Designation of Exchange Entity","activity_status":"Proposed","activity_description":"RIQI, as the state designated entity for health information exchange, is building a provider directory that will include provider relationships to practice settings, hospitals, plans, etc. Existing efforts are underway to expand the  tool to serve as the state?s Single Common Provider Directory Database (CPDB). Creating this shared service will significantly reduce the individual provider data management needs of numerous state and private initiatives and allow bi-directional interfaces to occur in near-real-time. By developing this shared service, information about relationships between individual providers and provider organizations will be available and consistent across various programs. This will be critical when calculating quality, utilization and cost measures upon which provider and provider organizations will be paid.","source":"Source: Amy Zimmerman","source_url":""},{"state":"Rhode Island","policy_lever":"State Designation of Exchange Entity","activity_status":"Actual","activity_description":"The RI HIE Act of 2008  gives the RI Department of Health regulatory authority over the designated statewide HIE with a specific focus on privacy and security and requires that  participation in the HIE is voluntary for both patients and providers. It  stipulates the uses of the data and it also creates a HIE advisory  commission to The HIE Advisory Commission makes policy recommendations to the Director of Health regarding the use of confidential patient information in the HIE.   There are also some protections for providers as part of this statute. Legislation has been introduced that would require the HIE Advisory commission to develop an interoperability plan for the HIE.","source":"","source_url":"http://webserver.rilin.state.ri.us/Statutes/title5/5-37.7/index.htm"},{"state":"Rhode Island","policy_lever":"State Insurance Commission (Commissioner) Policies","activity_status":"Actual","activity_description":"RI's Health Insurance Commissioner requires insurers to spend at least 10.7% of their annual medical expenses (for all insured lines of business) on primary care, including both direct and indirect primary care spending. As part of indirect primary care spending, insurers are required to spend at least their proportionate share of the expenses of RI's health information exchange established by R.I.G.L Chapter 5-37.7e.","source":"","source_url":"http://webserver.rilin.state.ri.us/Statutes/title5/5-37.7/index.htm"},{"state":"Rhode Island","policy_lever":"State Purchasing/Contracting of Health Care Services","activity_status":"Actual","activity_description":"As part of the State Employees Health benefits wellness program, cash  incentives are  earned by  state employees  for participating  in certain wellness activities ( tracking  physical activity for a month,  blood pressure screening etc).  In the past, enrolled in currentcare (statewide HIE)  qualified state employees for earning  cash incentive.","source":"State employee health benefit program","source_url":"http://www.employeebenefits.ri.gov/Active%20Employee%20Benefits.php"},{"state":"Rhode Island","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"The Affordable Care Act of 2010, Section 2703, created an optional Medicaid State Plan benefit for states to establish Health Homes to coordinate care for people with Medicaid who have chronic conditions by adding Section 2703 of the Social Security Act. Health Homes providers will integrate and coordinate all primary, acute, behavioral health, and long-term services and supports to treat the whole person. Rhode Island's plan was approved November 23, 2011.  As part of being a RI Health Home,   the following HIT efforts were  encouraged or required: participation in the State's HIE; data sharing with MCOs; use of the PDMP.  As Licensed Behavioral Healthcare providers, Health Home programs are required to offer all clients enrollment in the State's HIE. - \"  11.10 The organization shall offer enrollment in the HIE to each patient and maintain documentation evidencing the offer of enrollment in the treatment record of each individual. If the individual chooses to enroll in the HIE, the organization shall ensure that the individual executes an HIE enrollment form and a Uniform Authorization Form for the disclosure of health information to the HIE attached as Appendix IV.\"","source":"Approved Health Home State Plan Amendments","source_url":"http://www.medicaid.gov/State-Resource-Center/Medicaid-State-Technical-Assistance/Health-Homes-Technical-Assistance/Approved-Health-Home-State-Plan-Amendments.html"},{"state":"Rhode Island","policy_lever":"State Assessment, Fee, Tax, or Tax-like Fund","activity_status":"Actual","activity_description":"RI's statewide HIE, known as  Currentcare is largely funded through a voluntary payer contribution model ( as opposed to a legislated assessment) where commercial and self funded employers are asked to voluntarily contribute a  $1 per member per month for  the number of lives they cover.  RI's Medicaid and  State Employees Health Benefit program participates in this  voluntary  contribution model and as such has a contract which stipulates a set of deliverables to met by the  HIE state designated entity (also know as the RHIO).  Medicaid HIE funds are obtained through the EHR incentive dollars at a 90/10 match rate","source":"Source: Amy Zimmerman","source_url":""},{"state":"South Dakota","policy_lever":"Medicaid State Plan Amendments (SPA)","activity_status":"Actual","activity_description":"South Dakota's Medicaid Health Home SPA targets 1) individuals with two chronic conditions or one chronic condition and at risk for developing a second or 2) individuals with a single occurrence of a diagnosis for Severe Mental Illness or Emotional Disability limited to schizophrenia, bipolar, major depression, mood disorders, Ethyl Alcohol-related psychotic disorders, anxiety, personality/social disorders, Attention Deficit Hyperactivity Disorder.   To facilitate the exchange of health information in support of care for recipients receiving or in need of Health Home services, several methods of health information technology (HIT) will be utilized initially and enhanced as Health Homes mature. The State of South Dakota is in development stages of a Health Information Exchange (HIE). The HIE is a HIPAA compliant portal that will be accessible to Health Home providers and will enable providers to access recipient administrative and clinical data for the development and ongoing refinement of individual care plans, comprehensive care management, and care coordination. Until the HIE is operational, South Dakota Medicaid will electronically provide claims history to each Health Home. The data will be provided in a HIPAA compliant manner, supplement the Health Home' s Electronic Health Record required for Health Home Providers) which enables the providers to provide the six core services. Each Health Home is required to have an Electronic Health Record( EHR). Through that EHR and other electronic communication tools providers are utilizing, Health Home recipients may have access to on- line records, treatment plans and educational materials. In some cases these functions may be available through mobile devices. These tools and others in various stages of development may be used by the Health Home and the Health Home recipient to record and monitor progress against the agreed upon care plan. The EHR also facilitates communication and monitoring of referrals to other needed providers and/ or community based services. It is the responsibility of the Health Home Providers to secure the information needed to effectively deliver the required Health Home Services. Each Health Home site may accomplish this in a different manner. Methods of doing this include but are not limited to HIE, claims data, information sharing agreements and using their own Health system's EHR more effectively.  Health Home Providers will utilize their electronic health record to record and track recipient health promotion activities and, based on recipient needs, provide educational material electronically as appropriate. Health Homes will provide reporting via the Electronic Health Record. South Dakota Medicaid requires hospitals to report any Medicaid inpatient stay of 6 days or more. Hospitals provide information about diagnoses, condition and plan of treatment, as well as anticipated discharge date. Registered Nurses with SD Medicaid track all reported stays until discharge. If the notification is for a Health Home recipient, the State will notify the Health Home of recipient's hospitalization. Nurses will also be available to provide technical assistance to the discharge planning team about placement options. The Health Home care coordinator will:     a. Perform the required continuity of care coordination between inpatient and outpatient services;     b. Work with the hospital personnel to coordinate the hospital discharge and avoid readmission; and     c. Update recipient's care plan in the electronic health record. The following is a list of the types of Individual and Family Support Services documented in the Electronic Health Record. All of these activities can be used in queries and reports.     a. Referrals to community resources and social supports;     b. Conducting medication education;     c. Providing recipient tool kits to include self- management tool kits; and     d. Scheduling support (including transportation services). Health Homes will provide reporting via the Electronic Health Record.","source":"Medicaid Approved Health Home State Plan Amendments (Filter by State; Search term= Health Home)  SD 13-0008 Approval Date 11/21/2013","source_url":"http://www.medicaid.gov/state-resource-center/medicaid-state-plan-amendments/medicaid-state-plan-amendments.html"},{"state":"South Dakota","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"South Dakota's Medicaid Health Home SPA targets 1) individuals with two chronic conditions or one chronic condition and at risk for developing a second or 2) individuals with a single occurrence of a diagnosis for Severe Mental Illness or Emotional Disability limited to schizophrenia, bipolar, major depression, mood disorders, Ethyl Alcohol-related psychotic disorders, anxiety, personality/social disorders, Attention Deficit Hyperactivity Disorder.   To facilitate the exchange of health information in support of care for recipients receiving or in need of Health Home services, several methods of health information technology (HIT) will be utilized initially and enhanced as Health Homes mature. The State of South Dakota is in development stages of a Health Information Exchange (HIE). The HIE is a HIPAA compliant portal that will be accessible to Health Home providers and will enable providers to access recipient administrative and clinical data for the development and ongoing refinement of individual care plans, comprehensive care management, and care coordination. Until the HIE is operational, South Dakota Medicaid will electronically provide claims history to each Health Home. The data will be provided in a HIPAA compliant manner, supplement the Health Home' s Electronic Health Record required for Health Home Providers) which enables the providers to provide the six core services. Each Health Home is required to have an Electronic Health Record( EHR). Through that EHR and other electronic communication tools providers are utilizing, Health Home recipients may have access to on- line records, treatment plans and educational materials. In some cases these functions may be available through mobile devices. These tools and others in various stages of development may be used by the Health Home and the Health Home recipient to record and monitor progress against the agreed upon care plan. The EHR also facilitates communication and monitoring of referrals to other needed providers and/ or community based services. It is the responsibility of the Health Home Providers to secure the information needed to effectively deliver the required Health Home Services. Each Health Home site may accomplish this in a different manner. Methods of doing this include but are not limited to HIE, claims data, information sharing agreements and using their own Health system's EHR more effectively.  Health Home Providers will utilize their electronic health record to record and track recipient health promotion activities and, based on recipient needs, provide educational material electronically as appropriate. Health Homes will provide reporting via the Electronic Health Record. South Dakota Medicaid requires hospitals to report any Medicaid inpatient stay of 6 days or more. Hospitals provide information about diagnoses, condition and plan of treatment, as well as anticipated discharge date. Registered Nurses with SD Medicaid track all reported stays until discharge. If the notification is for a Health Home recipient, the State will notify the Health Home of recipient's hospitalization. Nurses will also be available to provide technical assistance to the discharge planning team about placement options. The Health Home care coordinator will:     a. Perform the required continuity of care coordination between inpatient and outpatient services;     b. Work with the hospital personnel to coordinate the hospital discharge and avoid readmission; and     c. Update recipient's care plan in the electronic health record. The following is a list of the types of Individual and Family Support Services documented in the Electronic Health Record. All of these activities can be used in queries and reports.     a. Referrals to community resources and social supports;     b. Conducting medication education;     c. Providing recipient tool kits to include self- management tool kits; and     d. Scheduling support (including transportation services). Health Homes will provide reporting via the Electronic Health Record.","source":"Medicaid Approved Health Home State Plan Amendments  (Filter by State; Search term= Health Home)  SD 13-0008 Approval Date 11/21/2013","source_url":"http://www.medicaid.gov/state-resource-center/medicaid-state-plan-amendments/medicaid-state-plan-amendments.html"},{"state":"Tennessee","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Proposed","activity_description":"TN is working on provisions in their Medicaid Patient Centered Medical Homes and Health Homes","source":"HCFA Innovation Office","source_url":"http://www.tn.gov/HCFA/strategic.shtml"},{"state":"Tennessee","policy_lever":"All Payer Claims Database (APCD) Policies","activity_status":"Actual","activity_description":"TN currently has deployed an All Payers Claims Database System","source":"Statue","source_url":"http://state.tn.us/sos/acts/106/pub/pc0611.pdf"},{"state":"Tennessee","policy_lever":"Episode of Care Risk-Sharing","activity_status":"Actual","activity_description":"TN is deploying an Episode of Care Risk-Sharing initiative that encourages HIT/HIE participation to coordinate care","source":"HCFA Innovation Office","source_url":"http://www.tn.gov/HCFA/strategic.shtml"},{"state":"Tennessee","policy_lever":"E-Prescribing (eRx) Mandate or Encouragement","activity_status":"Actual","activity_description":"From December 1, 2009 to November 30, 2011, the Tennessee Office of eHealth Initiatives (OEHI) and the Tennessee Pharmacists Association (TPA) along with its educational arm (the Tennessee Pharmacists Research and Education Foundation - TPREF) partnered to offer up to $675,000 in state-funded grants to help independent community pharmacies adopt e-prescribing. Pharmacies were able to receive up to $3,500 towards any expense related to e-prescribing.","source":"ONC State Health Information Technology Program: Spotlight on: Tennessee?s Electronic Prescribing Success APRIL 2012 through Partnerships and Incentives","source_url":"http://www.healthit.gov/sites/default/files/tn_erx_implementation-brief_updated_061420121.pdf"},{"state":"Tennessee","policy_lever":"Federal or State Grants","activity_status":"Actual","activity_description":"TN receives federal grant monies as well as awards grants to HIE initiatives across the state.","source":"Interested parties must request a copy from George Beckett.","source_url":""},{"state":"Tennessee","policy_lever":"Medicare and Medicaid EHR Incentive Program (Meaningful Use)","activity_status":"Actual","activity_description":"TN currently administers the Medicaid EHR Incentive Program","source":"","source_url":"http://www.tn.gov/tenncare/ehr_intro.shtml"},{"state":"Tennessee","policy_lever":"Medicare and Medicaid EHR Incentive Program (Meaningful Use)","activity_status":"Actual","activity_description":"TN requires EHR certification as part of our Meaningful Use initiative.","source":"","source_url":"http://www.tn.gov/tenncare/ehr_intro.shtml"},{"state":"Tennessee","policy_lever":"Prescription Drug Monitoring Programs (PDMP)","activity_status":"Actual","activity_description":"TN requires providers to check the PDMP before they prescribe a controlled substance.","source":"Tennessee State Department of Health: Controlled Substance Monitoring Database Program","source_url":"http://tn.gov/health/article/CSMD-faq"},{"state":"Tennessee","policy_lever":"State Appropriated Funds","activity_status":"Actual","activity_description":"TN has a one-time appropriation to support HIE activities.","source":"TN State Budget","source_url":""},{"state":"Tennessee","policy_lever":"State Purchasing/Contracting of Health Care Services","activity_status":"Actual","activity_description":"TN has provisions in their MCO contracts, State Employee Benefits Contracts, and State Agency Contracts for HIE involvement and participation.","source":"TennCare MCO Contract","source_url":"https://www.tn.gov/assets/entities/tenncare/attachments/MCOStatewideContract.pdf"},{"state":"Tennessee","policy_lever":"State Purchasing/Contracting of Health IT Infrastructure (non-Medicaid)","activity_status":"Actual","activity_description":"TN requires much of the communication of PHI information throughout the state and between the state and state contractors to use the DIRECT standards.","source":"Interested parties must request a copy from George Beckett.","source_url":""},{"state":"Texas","policy_lever":"HIE Connection or Interoperability Mandate","activity_status":"Actual","activity_description":"Texas Legislature directed the Health and Human Services Commission (HHSC) to develop an electronic health information exchange system. Further, the Legislature directed HHSC to ensure that appropriate information technology systems used by HHS agencies are interoperable with each other, as well as interoperable with external information technology systems in receiving and exchanging electronic health information, among other requirements.","source":"Texas HHS Commission Website: HS Circular C-044  Enterprise Health Information Exchange Policy","source_url":"http://www.hhsc.state.tx.us/news/circulars/C-044.shtml"},{"state":"Texas","policy_lever":"State Privacy and Security Policies","activity_status":"Actual","activity_description":"The Texas Legislature approved House Bill 300 (HB 300) in 2011. This legislation requires that Texas covered entities must provide individuals with general notice that their protected health information (PHI) may be electronically disclosed.","source":"House Bill 300","source_url":"http://www.legis.state.tx.us/BillLookup/History.aspx?LegSess=82R&Bill=HB300"},{"state":"Texas","policy_lever":"Public Health Surveillance","activity_status":"Actual","activity_description":"In 2007, Texas passed SB 204, which requires that electronic medical record systems sold to Texas health care providers who administer immunizations be able to interface with the state immunization registry.","source":"NCSL: Health Information Technology 2007 and 2008 State Legislation","source_url":"http://www.ncsl.org/print/health/forum/hit_enacted.pdf"},{"state":"Texas","policy_lever":"State Designation of Exchange Entity","activity_status":"Actual","activity_description":"The Texas Health Services Authority (THSA) was created by the Texas Legislature in 2007 as a public private partnership, legally structured as a nonprofit corporation, to support the improvement of the Texas health care system by promoting and coordinating HIE and health information technology (HIT) throughout the state to ensure that the right information is available to the right health care providers at the right times.","source":"Public Law","source_url":"http://www.hietexas.org/component/docman/doc_download/3-chapter-182-texas-health-and-safety-code?Itemid="},{"state":"Texas","policy_lever":"State HIE / HISP Accreditation, Certification, Registration, or Qualification","activity_status":"Actual","activity_description":"SECURETexas provides HIEs and others privacy and security certification for compliance with state and federal laws that govern the use of protected health information (PHI). The program, managed by the Texas Health Services Authority (THSA) in conjunction with industry collaborative Health Information Trust Alliance (HITRUST) was created as a result of amendments to the Texas Medical Records Privacy Act and the THSA?s enabling statute in 2011. House Bill 300 (82nd Texas Legislature, 2011) directed the THSA to develop and submit privacy and security standards for the electronic sharing of protected health information to the Texas Health and Human Services Commission. Those standards are designed to comply with HIPAA, the Texas Medical Records Privacy Act, and any other state and federal law relating to the security and confidentiality of information electronically maintained or disclosed by a covered entity.","source":"","source_url":"http://securetexas.org/about/background/"},{"state":"Utah","policy_lever":"All Payer Claims Database (APCD) Policies","activity_status":"Actual","activity_description":"Passed in 2010, Utah HB 294 Health System Reform Amendments provides access to the Department of Health's all payer claims database to the Insurance Department's health care delivery and health care payment reform demonstration project, and for the risk adjusting mechanism of the defined contribution insurance market and authorizes the all payer claims database to analyze the data it collects to provide consumer awareness of costs and transparency in the health care market.","source":"2010 HB 294","source_url":"http://le.utah.gov/~2010/bills/hbillenr/hb0294.htm"},{"state":"Utah","policy_lever":"All Payer Claims Database (APCD) Policies","activity_status":"Actual","activity_description":"Passed in 2007, Utah HB9 Health Care Cost and Quality Data amended the Health Data Authority Act to authorize the Health Data Committee to collect data on the costs of episodes of health care, and authorized the Department of Health to develop a plan to measure and compare costs of episodes of care using All Payer Claims Data.","source":"2007 HB9","source_url":"http://le.utah.gov/~2007/bills/hbillenr/hb0009.htm"},{"state":"Utah","policy_lever":"E-Prescribing (eRx) Mandate or Encouragement","activity_status":"Actual","activity_description":"Passed in 2009, Utah H.B. 128 enacted the electronic prescribing act in Utah. Passed in 2012 HB 122 amended the 2009 HB 128 by requiring the entity transmitting the prescription to meet certain standards; and delays implementation of e-prescribing mandates until July 1, 2013.","source":"2009 HB 128","source_url":"http://le.utah.gov/~2009/bills/hbillenr/hb0128.htm"},{"state":"Utah","policy_lever":"HIE Advisory Council / Oversight Board","activity_status":"Actual","activity_description":"Governor?s Digital Health Services Commission (UDHSC) was developed by status in 2000, 2008, and 2015 and serves a coordinating role  and advises the Executive Director of the Health and the state policy makers on topics related to digital health services. The UDHSC is comprised of Commissioners appointed by the Governor  that represent  organizations and constituents with expertise and interest in  information technology and improved healthcare delivery and healthcare outcomes for all Utahns.","source":"Utah Digital Health Service Commission Meetings","source_url":"http://health.utah.gov/phi/?formname=dhscmeetings"},{"state":"Utah","policy_lever":"HIE Connection or Interoperability Mandate","activity_status":"Actual","activity_description":"Passed in 2008, Utah HB 47 authorizes the Department of Health to adopt standards for electronic health information exchange. Payers and providers must use the standards adopted by the department to electronically exchange health information between health care systems. Payers and providers are not required to use the standards if they electronically exchange health information within a health care system","source":"2008 HB 47","source_url":"http://le.utah.gov/~2008/bills/hbillenr/hb0047.pdf"},{"state":"Utah","policy_lever":"State Privacy and Security Policies","activity_status":"Actual","activity_description":"Passed in 2012, Utah HB 25 Patient Identity Validation authorized the Department of Health to establish methods or measures for health care providers, public health entities, and health care insurers to coordinate among themselves to verify the identity of the individuals they serve.","source":"2012 HB 25","source_url":"http://le.utah.gov/~2012/bills/hbillenr/hb0025.pdf"},{"state":"Utah","policy_lever":"State Privacy and Security Policies","activity_status":"Actual","activity_description":"Passed in 2012, Utah HB 19 requires a government entity to phase out the use of a nine digit number as an identifying number for an individual if: the government entity can phase out the use of the number under existing appropriations; or the government entity is redesigning its information technology system and can phase out the nine digit number.","source":"2012 HB 19","source_url":"http://le.utah.gov/~2012/bills/hbillenr/hb0019.pdf"},{"state":"Utah","policy_lever":"State Designation of Exchange Entity","activity_status":"Actual","activity_description":"Passed in 2009, Utah HB 165 modified the Health Code and the Insurance Code to provide standards for the exchange of information between health care providers, health care insurers, and patients regarding payment for services.","source":"2009 HB 165","source_url":"http://le.utah.gov/~2009/bills/hbillenr/hb0165.htm"},{"state":"Utah","policy_lever":"State Insurance Commission (Commissioner) Policies","activity_status":"Actual","activity_description":"Passed in 2010, Utah HB 52 Health Reform - Uniform Electronic Standards - Insurance Information amended provisions related to uniform electronic standards for health insurance claims processing, electronic insurance eligibility information, and electronic information regarding the coordination of benefits and established a voluntary registry of software vendors who comply with electronic standards, including a master person index.","source":"2012 HB 52","source_url":"http://le.utah.gov/~2010/bills/hbillenr/hb0052.htm"},{"state":"Utah","policy_lever":"State Purchasing/Contracting of Health Care Services","activity_status":"Actual","activity_description":"Passed in 2012, Utah HB 46 Electronic Personal Medical Records amended the duties of the state Medicaid, CHIP, and Public Employees Health Programs to enroll their members in the electronic exchange of clinical health records unless the individual opts out.","source":"2012 HB 46","source_url":"http://le.utah.gov/~2012/bills/hbillenr/hb0046.pdf"},{"state":"Vermont","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"Under the multi-payer reform initiatives demonstration program, funded by CMS, states are participating in initiative  to make advanced primary care practices more broadly available.","source":"CMS Multi-Payer Advanced Primary Care Practice","source_url":"http://innovation.cms.gov/initiatives/Multi-Payer-Advanced-Primary-Care-Practice/"},{"state":"Vermont","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"Vermont?s Blueprint for Health is an early implementation of a patient centered medical home concept, and is supported by founding legislation and subsequently supported by legislation for expansion. It is the goal of the Blueprint for Health program to have every Vermont person participating in a Blueprint practice. Payment reform has also been implemented as part of the Blueprint for Health program, adding elements of an accountable care organization. The Blueprint is also staffed to provide facilitation and project management assistance to practices as they implement their EHR systems and begin to move data through the exchange and into a clinical data repository. Hundreds of thousands of such transactions occur each month and there is much expansion to go. Essentially the Blueprint represents an early implementation of REC-like services.","source":"Blueprint for Health Website","source_url":"http://blueprintforhealth.vermont.gov/Blueprint_101"},{"state":"Vermont","policy_lever":"All Payer Claims Database (APCD) Policies","activity_status":"Actual","activity_description":"Vermont has a Multi-Payer Claims Database which includes data from all payers who cover more than 200 lives in Vermont. In addition to collecting this data from these payers, a fee is collected which is the primary source of funds for the State HIT Fund, also administered by DHR.","source":"All-Payer Claims Database Website","source_url":"http://apcdcouncil.org/state/vermont"},{"state":"Vermont","policy_lever":"HIE Connection or Interoperability Mandate","activity_status":"Actual","activity_description":"Act 48, Sec. 10 requires a review of the scope of HIT to ensure that the full range of information technology related to health care reform is included.","source":"Act 48","source_url":"www.leg.state.vt.us/docs/2012/Acts/ACT048.pdf"},{"state":"Vermont","policy_lever":"HIE Connection or Interoperability Mandate","activity_status":"Actual","activity_description":"The statute (Act 128) also requires hospitals, which operate most of the clinical laboratory services in the state, to maintain interoperable connectivity to the HIE network as a condition in their annual budget approval process. The connection requirement, although not specifically related to lab requirements enabled most hospitals to send lab information to the HIE as well.","source":"Act 128","source_url":"http://www.leg.state.vt.us/docs/2010/Acts/ACT128.pdf"},{"state":"Vermont","policy_lever":"HIE Connection or Interoperability Mandate","activity_status":"Actual","activity_description":"Vermont has a single HIE, established by law, and mandated to provide specific services to the Vermont health care environment. The requirement is on the hospitals to be connected to VITL.","source":"ONC Health Information Technology: Vermont Health Information Technology Strategic and Operational Plan Profile","source_url":"http://healthit.gov/sites/default/files/vt-plan-summary_updated-2012-01-04_508.pdf"},{"state":"Vermont","policy_lever":"Medicaid State Plan Amendments (SPA)","activity_status":"Actual","activity_description":"In 2010, in Act 128, the Vermont legislature codified the developmental work conducted through the Blueprint?s pilots, defining the components of medical homes, community health teams, and payment reform in statute.  Act 128 also sets an ambitious expansion schedule for the Blueprint: by July 1, 2011, there shall be at least two medical homes in each of the state?s 13 hospital service areas (HSA) and by October 1, 2013, the Blueprint shall expand statewide to primary care practices ? including pediatric practices ? to serve every Vermonter.","source":"Medicaid Approved Health Home State Plan Amendments (Filter by State; Search term= Health Home)  ID 12-0009 Approval Date 11/21/2012","source_url":"http://www.medicaid.gov/state-resource-center/medicaid-state-plan-amendments/medicaid-state-plan-amendments.html"},{"state":"Vermont","policy_lever":"State Assessment, Fee, Tax, or Tax-like Fund","activity_status":"Actual","activity_description":"Realizing the state?s ambitious goals could not be achieved without more formal, systemic investment in HIT, Vermont instituted its Health IT Fund in 2008. A fee (2ths of 1%) paid on all health insurance claims generates annual revenues for the state Fund which then provides grants to support HIT and HIE. The Fund is currently scheduled to sunset July 1, 2017, though proposals have been made to the State legislature to extend the Fund further.","source":"Vermont Statute Chapter 241 - Health IT Fund","source_url":"http://legislature.vermont.gov/statutes/section/32/241/10301"},{"state":"Vermont","policy_lever":"State HIE / HISP Accreditation, Certification, Registration, or Qualification","activity_status":"Actual","activity_description":"In a health information exchange, the core infrastructure includes the systems and personnel to operate the components at the center of the network. The core infrastructure shall be certified for compliance by at least one independent certifier of industry standard information security practices, such as the Electronic Healthcare Network Accreditation Commission (EHNAC). EHNAC is an independent, non-profit accrediting agency that evaluates an organization?s ability to meet standards and best practices.","source":"Vermont Health Information Technology Plan October 2009","source_url":"http://hcr.vermont.gov/sites/hcr/files/IT_Strategic__Implementation_Plan__10-11-09__0.pdf"},{"state":"Vermont","policy_lever":"Medicaid State Plan Amendments (SPA)","activity_status":"Actual","activity_description":"Vermont's Medicaid Health Home SPA targets beneficiaries receiving Medication Assisted Therapy (MAT) for the chronic condition of Opioid Therapy.  The Hub & Spoke system will build on the Blueprint?s Health Information architecture, which includes a central clinical registry (Covisint DocSite) and use of the Vermont Health Information Exchange providers. This health information architecture supports guideline-based preventive healthcare, coordinated health services, an integrated health record across services and organizations, and flexible reporting. The Hub & Spoke initiative will be the first expansion of this capacity to specialty addictions treatment providers. An opioid treatment measures set is being developed for DocSite for visit planning and documentation. Hub and Spoke Health Home staff will document directly in the practice EMR. The goal is to have information on day-to-day provisions of care documented in practice EMRs, hospital data systems, and practice management systems and then transmitted via interfaces to the Health Information Exchange (VHIE) and then into the Covisint DocSite Clinical Registry. DocSite is web-based and receives data feeds of guideline-based data elements from practices and hospitals. Data sources include EMRs, hospital data systems, practice management systems, and direct data entry. To facilitate concurrent review of hospital stays for better transitional care planning, the State is developing automated procedures with hospital ERs and inpatient discharge planners, as well as CHTs, to receive daily feeds on Medicaid patients. Residential substance abuse service providers also will be included in the procedures developed.  Treatment information will be documented in the EMR and communicated through the central clinical registry Covisint DocSite, which contains clinical information as well as documentation and tracking of self management goals and action plans. Information will be shared through the central clinical registry Covisint DocSite as well as through existing information sharing technologies and Electronic Medical Records (EMRs). DocSite is a web-based registry that receives feeds of guideline-based data elements from practices and hospitals. Data sources include EMRs, hospital data systems, practice management systems, and direct data entry. Data from these sources is sent to the registry through Vermont?s Health Information Exchange infrastructure run by Vermont Information Technology Leaders (VITL). In addition to patient care and population management, the registry supports flexible performance reporting with measures derived from national guidelines on health care quality and outcomes. Concurrent review of hospital stays requires that Vermont Medicaid be notified when admissions occur. The State is developing automated procedures with hospital emergency departments and inpatient discharge planners, as well as CHTs, to receive daily feeds on Medicaid patients. Residential substance abuse providers also will be included in the procedures developed. Covisint DocSite can make specific information related to a patient?s care available for reference in Individual and Family Support Services.","source":"Medicaid Approved Health Home State Plan Amendments (Filter by State; Search term= Health Home)      VT 14-007    Approval Date 4/10/14","source_url":"http://www.medicaid.gov/state-resource-center/medicaid-state-plan-amendments/medicaid-state-plan-amendments.html"},{"state":"Vermont","policy_lever":"State Designation of Exchange Entity","activity_status":"Actual","activity_description":"Vermont has a single HIE, established by law, and mandated to provide specific services to the Vermont health care environment. The requirement is on the hospitals to be connected to VITL.","source":"ONC Health Information Technology: Vermont Health Information Technology Strategic and Operational Plan Profile","source_url":"http://healthit.gov/sites/default/files/vt-plan-summary_updated-2012-01-04_508.pdf"},{"state":"Vermont","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"In 2010, in Act 128, the Vermont legislature codified the developmental work conducted through the Blueprint?s pilots, defining the components of medical homes, community health teams, and payment reform in statute.  Act 128 also sets an ambitious expansion schedule for the Blueprint: by July 1, 2011, there shall be at least two medical homes in each of the state?s 13 hospital service areas (HSA) and by October 1, 2013, the Blueprint shall expand statewide to primary care practices ? including pediatric practices ? to serve every Vermonter.","source":"Act 128","source_url":"http://www.leg.state.vt.us/docs/2010/Acts/ACT128.pdf"},{"state":"Vermont","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"Vermont's Medicaid Health Home SPA targets beneficiaries receiving Medication Assisted Therapy (MAT) for the chronic condition of Opioid Therapy.  The Hub & Spoke system will build on the Blueprint?s Health Information architecture, which includes a central clinical registry (Covisint DocSite) and use of the Vermont Health Information Exchange providers. This health information architecture supports guideline-based preventive healthcare, coordinated health services, an integrated health record across services and organizations, and flexible reporting. The Hub & Spoke initiative will be the first expansion of this capacity to specialty addictions treatment providers. An opioid treatment measures set is being developed for DocSite for visit planning and documentation. Hub and Spoke Health Home staff will document directly in the practice EMR. The goal is to have information on day-to-day provisions of care documented in practice EMRs, hospital data systems, and practice management systems and then transmitted via interfaces to the Health Information Exchange (VHIE) and then into the Covisint DocSite Clinical Registry. DocSite is web-based and receives data feeds of guideline-based data elements from practices and hospitals. Data sources include EMRs, hospital data systems, practice management systems, and direct data entry. To facilitate concurrent review of hospital stays for better transitional care planning, the State is developing automated procedures with hospital ERs and inpatient discharge planners, as well as CHTs, to receive daily feeds on Medicaid patients. Residential substance abuse service providers also will be included in the procedures developed.  Treatment information will be documented in the EMR and communicated through the central clinical registry Covisint DocSite, which contains clinical information as well as documentation and tracking of self management goals and action plans. Information will be shared through the central clinical registry Covisint DocSite as well as through existing information sharing technologies and Electronic Medical Records (EMRs). DocSite is a web-based registry that receives feeds of guideline-based data elements from practices and hospitals. Data sources include EMRs, hospital data systems, practice management systems, and direct data entry. Data from these sources is sent to the registry through Vermont?s Health Information Exchange infrastructure run by Vermont Information Technology Leaders (VITL). In addition to patient care and population management, the registry supports flexible performance reporting with measures derived from national guidelines on health care quality and outcomes. Concurrent review of hospital stays requires that Vermont Medicaid be notified when admissions occur. The State is developing automated procedures with hospital emergency departments and inpatient discharge planners, as well as CHTs, to receive daily feeds on Medicaid patients. Residential substance abuse providers also will be included in the procedures developed. Covisint DocSite can make specific information related to a patient?s care available for reference in Individual and Family Support Services.","source":"Medicaid Approved Health Home State Plan Amendments (Filter by State; Search term= Health Home)      VT 14-007    Approval Date 4/10/14","source_url":"http://www.medicaid.gov/state-resource-center/medicaid-state-plan-amendments/medicaid-state-plan-amendments.html"},{"state":"Washington","policy_lever":"Medicaid State Plan Amendments (SPA)","activity_status":"Actual","activity_description":"Washington's Medicaid Health Home SPA targets individuals with one chronic condition and at risk for developing a second, defined as a PRISM risk score of 1.5 or greater. Chronic conditions may include cancer, dementia, Intellectual disability or disease, HIV/AIDs as well as others. The State integrates fee-for-service claims data, managed care encounter data, eligibility, and enrollment data for medical, pharmacy, mental health, substance use disorder, long term services and supports, and Medicaid and dual eligible Medicare covered services in a secure web-based clinical decision support tool called PRISM. PRISM also pulls from other clinical assessment data within the state such as CARE. The State will use the PRISM tools to support the beneficiary and the Health Home Care Coordinator to identify the unmet needs, gaps in care, clinical protocols required and current utilization of case management, medical and behavioral health services. Use of these tools will enable the Health Home Care Coordinator to better coordinate care and ensure that the beneficiary?s complex needs are met. Use of these tools will allow the State to monitor cost and utilization data to ensure program goals are met. The State has developed an HIT pilot for Health Action Plans through OneHealthPort, an entity contracted with HCA to also consult on building a statewide health information exchange. HCA has developed the Medicaid Health Profile clinical data repository, with clinical data passed through OneHealthPort HIE using the Continuity of Care Document (CCD) and the Admit/ Discharge/Transfer Document (ADT) transaction sets. Updates to the Medicaid Database to refine or to correct identified data collection errors occur whenever a need is identified.  The Health Action Plan (HAP) may be shared via secure email or hard copy. The HAP includes: ? Beneficiary and Care Coordinator prioritized action items; ? Beneficiary identified goals (short and long term); ? Action steps for the beneficiary, the Health Home Care Coordinator and/or other direct service and medical providers;  ? If the beneficiary has a personal care worker, the HAP will include action steps for them to support identified health action goals identified by the beneficiary.  The HAP is updated and modified by the Health Home Care Coordinator quarterly, and as needed to support care transition. The HAP is also updated and modified as needed according to: ? A change in the beneficiary?s condition; ? New immediate goals to be addressed through the Health Home; and ? Resolution of goals or action steps.  Future HIT development includes addition of the HAP data elements to an electronic application.  The Health Home will promote the use of web-based health information technology registries and referral tracking systems.","source":"Medicaid Approved Health Home State Plan Amendments (Filter by State; Search term= Health Home)  WA 15-0011 Approval Date 06/11/2015","source_url":"http://www.medicaid.gov/state-resource-center/medicaid-state-plan-amendments/medicaid-state-plan-amendments.html"},{"state":"Washington","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"Washington's Medicaid Health Home SPA targets individuals with one chronic condition and at risk for developing a second, defined as a PRISM risk score of 1.5 or greater. Chronic conditions may include cancer, dementia, Intellectual disability or disease, HIV/AIDs as well as others. The State integrates fee-for-service claims data, managed care encounter data, eligibility, and enrollment data for medical, pharmacy, mental health, substance use disorder, long term services and supports, and Medicaid and dual eligible Medicare covered services in a secure web-based clinical decision support tool called PRISM. PRISM also pulls from other clinical assessment data within the state such as CARE. The State will use the PRISM tools to support the beneficiary and the Health Home Care Coordinator to identify the unmet needs, gaps in care, clinical protocols required and current utilization of case management, medical and behavioral health services. Use of these tools will enable the Health Home Care Coordinator to better coordinate care and ensure that the beneficiary?s complex needs are met. Use of these tools will allow the State to monitor cost and utilization data to ensure program goals are met. The State has developed an HIT pilot for Health Action Plans through OneHealthPort, an entity contracted with HCA to also consult on building a statewide health information exchange. HCA has developed the Medicaid Health Profile clinical data repository, with clinical data passed through OneHealthPort HIE using the Continuity of Care Document (CCD) and the Admit/ Discharge/Transfer Document (ADT) transaction sets. Updates to the Medicaid Database to refine or to correct identified data collection errors occur whenever a need is identified.  The Health Action Plan (HAP) may be shared via secure email or hard copy. The HAP includes: ? Beneficiary and Care Coordinator prioritized action items; ? Beneficiary identified goals (short and long term); ? Action steps for the beneficiary, the Health Home Care Coordinator and/or other direct service and medical providers;  ? If the beneficiary has a personal care worker, the HAP will include action steps for them to support identified health action goals identified by the beneficiary.  The HAP is updated and modified by the Health Home Care Coordinator quarterly, and as needed to support care transition. The HAP is also updated and modified as needed according to: ? A change in the beneficiary?s condition; ? New immediate goals to be addressed through the Health Home; and ? Resolution of goals or action steps.  Future HIT development includes addition of the HAP data elements to an electronic application.  The Health Home will promote the use of web-based health information technology registries and referral tracking systems.","source":"Medicaid Approved Health Home State Plan Amendments  (Filter by State; Search term= Health Home)  WA 15-0011 Approval Date 06/11/2015","source_url":"http://www.medicaid.gov/state-resource-center/medicaid-state-plan-amendments/medicaid-state-plan-amendments.html"},{"state":"West Virginia","policy_lever":"Advanced Directives Registry","activity_status":"Actual","activity_description":"The WVHIN offers the WV e-Directory Registry in partnership with the WV Center for End of Life Care as one of the most comprehensive advance directives registries in the country. Providers may access the registry through the HIE or via an online portal.","source":"WVHIN","source_url":"http://www.wvhin.org/services/wv-e-directive-registry/default.aspx"},{"state":"West Virginia","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"Five WV FQHCs are participating in the CMS Advanced Primary Care Practice Demonstration Project. Valley Health System, Preston-Taylor, New River, Access Health and Community Care of WV are participating through thirteen participating clinical sites.","source":"CMS Advanced Primary Care Practice Demonstration","source_url":"http://innovation.cms.gov/initiatives/FQHCs/index.html"},{"state":"West Virginia","policy_lever":"E-Prescribing (eRx) Mandate or Encouragement","activity_status":"Actual","activity_description":"WVeScript - The Office of Pharmacy within the Bureau for Medical Services (BMS) was seeking a way to incentivize, educate, and generate interest in the benefits of ePrescribing within the West Virginia physician community. BMS  contracted with HID (Health Information Designs) to provide ePrescribing functionality via the Health Information Exchange portal (MediWeb portal).  This functionality allows all prescribing providers to ePrescribe for Medicaid members, using  a computer and Internet connectivity (no need to purchase a separate ePrescribing service).","source":"BMS SMA MediWeb Portal","source_url":""},{"state":"West Virginia","policy_lever":"Federal or State Grants","activity_status":"Actual","activity_description":"WV was the recipient of a CMS State Innovation Model grant under Round Two for the design of a value-based State Health System Innovation Plan. One of the activities under the SIM is to align a revised State Strategic HIT Plan with a Population Health Improvement Plan and a Health System Transformation Plan. The SHSIP contemplates use of data from multiple sources to improve outcomes and assist in the transition to an outcomes based and value-linked model of reimbursement.  The SIM initiative in WV will utilize the existing WV Health Improvement Collaborative representing a diverse group of stakeholders to provide input and direction on the development of the plans.","source":"","source_url":"http://www.wvhicollaborative.wv.gov/Pages/default.aspx"},{"state":"West Virginia","policy_lever":"HIE Advisory Council / Oversight Board","activity_status":"Actual","activity_description":"The legislation that created the WVHIN provided for oversight and direction by a Board of Directors consisting of seventeen members.  Members consist of educators, government officials, business leaders, legal experts, and physicians.  Twelve members are appointed legislatively in regard to the position they hold and five members appointed by the Governor represent the public who serve two four year terms or until a successor is appointed.  The WVHIN operates under the  WVHCA for purposes of administration but under the Board of Directors for policy and operational purposes.","source":"","source_url":"http://www.wvhin.org/about/board/default.aspx"},{"state":"West Virginia","policy_lever":"Medicare and Medicaid EHR Incentive Program (Meaningful Use)","activity_status":"Actual","activity_description":"The West Virginia Health Care Authority (HCA) requires participation in the WVHIN of any provider that receives a Rural Health Systems Program (RHSP) grant to help meet Stage 1 Meaningful Use. These grants were established to assist health care providers in making technology purchases or system upgrades to help meet meaningful use. The financial assistance will be important for small rural facilities in underserved areas of the state that are struggling to meet the financial requirements of implementing an EHR at their facility. In early 2013, the HCA partnered with the WVHIN to provide financial assistance to hospitals in achieving full service connectivity with the exchange by offering an Early Adopter Grant Program for Health Information Exchange. Five hospitals were awarded a grant and have completed the on-boarding process.                                                                                                                                                                                    The Bureau for Medical Services (BMS), which is the State Designated Medicaid Agency (SMA) and is part of the WV Department of Health and Human Resources, has been in Stakeholder of the WVHIN (and is represented on the WVHIN Board) since its inception.  The WVHIN now has 28 medical facilities utilizing the WV HIE to access the WV Immunization Registry. The WVHIN also has 32 medical facilities utilizing the HIE for Syndromic Surveillance Reporting to the West Virginia Bureau for Public Health via BioSense 2.0. Having these connections and access assists these providers in meeting Meaningful Use attestation.  As of April 1, 2015, the WVHIN facilitated reporting of 10,462,633 transactions from WV hospitals to BioSense 2.0.  The Healthcare Education Foundation of WV, in collaboration with The WV Office of Epidemiology and Prevention Services (OEPS) and the WV Health Information Network (WVHIN) is providing financial assistance to five West Virginia Hospital Emergency Departments (ED) to achieve connectivity to BioSense 2.0 through the WVHIN?s Health Information Exchange (HIE).                                                                                                                                          BMS, as the designated State Medicaid Agency, has established and is maintaining an Electronic Health Records (EHR) Provider Incentive Payment (PIP) program.  The PIP program offers financial support to assist eligible providers to adopt (acquire and install), implement (train staff, deploy tools, exchange data), or upgrade (expand functionality or interoperability) certified EHR technology; with the goal to improve outcomes, facilitate access, simplify care, and reduce costs of health care.   As of February 23, 2015, 47 Hospitals have attested to meaningful use under the WV Medicaid HIT incentive program and 1,450 eligible healthcare providers have attested to MU under the program.  Over $86 million in HIT incentives have been paid to hospitals and providers under the program.","source":"WVHIN Sustainability Plan","source_url":"http://www.wvhin.org/App_Media/assets/doc/wvhin/appendices/Appendix_O.pdf"},{"state":"West Virginia","policy_lever":"Medicaid State Plan Amendments (SPA)","activity_status":"Actual","activity_description":"The Bureau for Medical Services submitted Health Home State Plan Amendment.  The BMS Health Homes program provides a comprehensive system of care coordination for Medicaid members with chronic conditions. Health Home providers will coordinate all primary, acute, behavioral health and long-term services and supports to treat the ?whole person? across his/her lifespan.  Health Homes have been shown to increase patient?s health and reduce medical costs. Since the focus is on the whole patient, all of the health care providers a patient sees are part of his/her treatment team.","source":"Health Homes SPA","source_url":"http://www.dhhr.wv.gov/bms/WV%20Health%20Homes/approved%20amendment/Documents/042820144009%20Final%20Response%20SPA%2014-0009%20WV%20012715.pdf"},{"state":"West Virginia","policy_lever":"Prescription Drug Monitoring Programs (PDMP)","activity_status":"Actual","activity_description":"The West Virginia Controlled Substance Automated Prescription Program (C.S.A.P.P.) has been established by the West Virginia Board of Pharmacy to help prescribers and pharmacists identify patients who may benefit from a substance abuse referral. The database contains over 40 million entries of controlled substance drugs that were dispensed in West Virginia. Each year the C.S.A.P.P. program responds to more than 900,000 requests from practitioners and pharmacists.","source":"WV Board of Pharmacy","source_url":"http://www.wvbop.com/index.php?option=com_content&view=article&id=99&Itemid=117"},{"state":"West Virginia","policy_lever":"Public Health Surveillance","activity_status":"Actual","activity_description":"The West Virginia Bureau for Public Health utilizes BioSense 2.0 as the State?s syndromic surveillance system. Ongoing submission of syndromic surveillance data to BioSense 2.0 is facilitated through the WVHIN?s Health Information Exchange (HIE). Hospitals contribute real-time pre-diagnostic data to the HIE and the HIE delivers the data to BioSense 2.0. The Bureau for Public Health and Centers for Disease Control and Prevention (CDC) analyze the data to detect disease outbreaks and epidemics. This syndromic reporting system assists hospitals and providers in meeting Meaningful Use reporting requirements. Public Health Surveillance activities are conducted by several Offices in the WV Bureau for Public Health. Perhaps the highest profile activities are conducted by the Office of Epidemiology and Prevention Services which collects surveillance data under the State's Reportable Disease Rule (?64-7-12)  for Immunization Reporting; Syndromic Surveillance; and Cancer Surveillance which are all components of Meaningful Use. Other public health surveillance conducted by this office includes STD/HIV/Hepatitis as well as Food and Waterborne disease.  OEPS cooperates with the Office of Laboratory Services to support Electronic Laboratory Reporting for Meaningful Use. In addition to maintaining all of the State's Vital Statistics the Health Statistics Center conducts Public Health Surveillance by conducting surveys such as the Behavioral Risk Factor Surveillance Survey and the Youth Tobacco Survey. The Office of Maternal, Child and Family Health's surveillance systems include monitoring of Childhood Lead, Newborn Hearing Screening, the Pregnancy Risk Assessment Monitoring System, and Birth Score system.  The Office of Emergency Medical Services maintains the State's Trauma Registry.","source":"WVHIN","source_url":"http://www.wvhin.org/news/newsletter/2014-quarter-3/hie-update.aspx#"},{"state":"West Virginia","policy_lever":"Rate Setting and Rate Review","activity_status":"Actual","activity_description":"The West Virginia Health Care Authority (WVHCA) regulates acute care hospital rates as well as need for capital expenditures of covered services for health facilities through the rate review and certificate of need (CON) programs.  Since 1992, the WVHCA has operated a rate regulation structure that is a cost-based rate review system. The rate review process applies primarily to hospitals, which are also required to file discount contracts for review by WVHCA. A discount contract may not be implemented until it is approved by the board.","source":"","source_url":"http://www.hca.wv.gov/ratereview/Pages/default.aspx"},{"state":"West Virginia","policy_lever":"State Designation of Exchange Entity","activity_status":"Actual","activity_description":"The WVHIN has been in an active cooperative relationship for years with the West Virginia Primary Care Association (WVPCA) who has been encouraging their members to participate in the WVHIN?s HIE and WVDirect. The WVPCA recently received a 3-year cooperative agreement grant to assist with connecting 17 Federally Qualified Health Centers (FQHCs) to the exchange. These 17 FQHCs will be establishing a health reporting database and that database will connect to the WVHIN and therefore only one connection will be made to connect all 17 FQHCs to the WVHIN. Once the database is complete, WVHIN anticipates an incremental on-boarding of the 17 FQHCs over the next 3 years. WVHIN now has 14 hospitals connected and contributing data to the query based network as full service HIE users. The WVHIN also has twenty plus hospitals in the process of onboarding to the network with four hospitals that should complete the onboarding process in the second quarter of 2015.  The WVHIN has reached an agreement to create a \"hub\" to connect providers who have a Greenway EHR product expected to launch in 2015.  Efforts continue to connect providers having other EHR products.    The WVHIN also has assigned 1,159 individual WVDirect addresses representing 322 organizations and the WV eDirective Registry now has 104 organizations with access to the WV eDirective Registry. The WVHIN has started the process of configuring a test environment for the connection between the WV HIE and the Veterans Administration.","source":"WVPCA Newsroom","source_url":"http://www.wvpca.org/index.php?src=news&refno=148&category=News&prid=148"},{"state":"West Virginia","policy_lever":"State Purchasing/Contracting of Health Care Services","activity_status":"Actual","activity_description":"Highmark of West Virginia (approximately 490,000 individuals covered in West Virginia) is implementing contracts with pay for performance programs that require HIE participation. The WVHIN is in active discussion with Highmark to connect the WVHIN to the Highmark HIE with the WVHIN being the entry point for participants in West Virginia. Highmark WV has launched its PCMH incentive program.  Providers receive an incentive payment for having attained meaningful use and are encouraged to participate in the HIE.  Highmark is establishing a link to the WVHIN's HIE to coordinate the availability of claims data for Highmark WV patients. WVCHIP provides healthcare coverage to children in working families with incomes too high to qualify for Medicaid but who lack access to affordable healthcare coverage. While the exact level for eligibility changes with the age of the child, after full implementation of the eligibility changes included in the ACA, WVCHIP will cover children in families with incomes as low as 133% and up to 300% of the Federal Poverty Level (FPL). Leveraging existing processes and functions available through other state agencies, VCHIP system processing is migrating to BMS?s MMIS. Currently, WVCHIP partners with several West Virginia agencies. These partners include the West Virginia Public Employees Insurance Agency (WVPEIA) for benefits management, claims processing, contracting as it relates to the delivery of healthcare coverage, reimbursing providers for services on a fee for service basis, and utilizing the WVPEIA fee schedules and in-state provider networks. WVCHIP is in the process of being integrated into the West Virginia Department of Health and Human Resources (DHHR) which already leverages the Federally Facilitated Marketplace for eligibility determinations and utilizes a connection to the WVHIN.","source":"WVHIN Sustainability Plan","source_url":"http://www.wvhin.org/App_Media/assets/doc/wvhin/appendices/Appendix_O.pdf"},{"state":"West Virginia","policy_lever":"State Purchasing/Contracting of Health Care Services","activity_status":"Actual","activity_description":"PEIA offers a primary care program that allows members to receive primary care services and care coordination, while paying less. This benefit option is the Comprehensive Care Partnership (CCP) Program. Its purpose is to promote primary care health services, identify health problems early and maintain control of chronic conditions. Members who enroll in the CCP Program will have no co-payments or coinsurance for services at their CCP provider. CCP providers are expected to provide all primary care services, coordination of care, and with some CCP locations also provide pharmacy benefits.  Participating practices are expected to offer patient-centered medical home services, including care coordination and are encourage to participate in the State HIE.","source":"PEIA Comprehensive Care Program summary","source_url":"http://www.peia.wv.gov/customers/active-members/Pages/Comprehensive_Care_Program_%28CCP%29.aspx"},{"state":"West Virginia","policy_lever":"State Purchasing/Contracting of Health Care Services","activity_status":"Actual","activity_description":"The SMA initiated a risk-based managed care (MCO) program for certain Medicaid recipients in September 1996.  Currently there are four MCOs contracted with the SMA (Unicare, Coventry, The Health Plan, and Family Health Plan), and the program is known as Mountain Health Trust.  Beginning July 2015, the Medicaid expansion population will transition from fee for service to managed care, as well as the behavioral health benefit.  The expansion population transition is being completed to help improve health care coordination and will allow for the introduction of further requirements related to HIE utilization, electronic reporting of quality metrics and adoption of IT tool as technologies.  In total, approximately 350,000 members will be represented by managed care starting July 2015.","source":"WV BMS/SMA MCO Program Site","source_url":""},{"state":"West Virginia","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"The Bureau for Medical Services submitted Health Home State Plan Amendment.  The BMS Health Homes program provides a comprehensive system of care coordination for Medicaid members with chronic conditions. Health Home providers will coordinate all primary, acute, behavioral health and long-term services and supports to treat the ?whole person? across his/her lifespan.  Health Homes have been shown to increase patient?s health and reduce medical costs. Since the focus is on the whole patient, all of the health care providers a patient sees are part of his/her treatment team.","source":"Health Homes SPA","source_url":"http://www.dhhr.wv.gov/bms/WV%20Health%20Homes/approved%20amendment/Documents/042820144009%20Final%20Response%20SPA%2014-0009%20WV%20012715.pdf"},{"state":"Wisconsin","policy_lever":"All Payer Claims Database (APCD) Policies","activity_status":"Actual","activity_description":"In 2008, the Wisconsin Department of Health Services and the Department of Employee Trust Funds entered into a contract with the Wisconsin Health Information Organization (WHIO) to serve as the data organization defined in Wis. Stat. ? 153.01(3g). The Wisconsin Health Information Organization was formed to collect and aggregate health care claims data into a centralized repository (?Data Mart?) and subsequently analyze and publicly report on the delivery of health care in Wisconsin. The law does not require payers and health plan administrators to submit data to WHIO; it is voluntary.","source":"","source_url":"https://docs.legis.wisconsin.gov/statutes/statutes/153"},{"state":"Wisconsin","policy_lever":"E-Prescribing (eRx) Mandate or Encouragement","activity_status":"Actual","activity_description":"In March 2012, 2011 Wisconsin Act 159 was signed into law. This act aligned Wisconsin law with the new federal regulations on electronic prescriptions for controlled substances, Schedule II through V, that allow pharmacists to receive, dispense, and archive electronic prescriptions for controlled substances. Prior to this law change, Wisconsin law did not permit electronic prescriptions for Schedule II controlled substances except in an emergency.","source":"","source_url":"http://docs.legis.wisconsin.gov/2011/proposals/sb317"},{"state":"Wisconsin","policy_lever":"Federal or State Grants","activity_status":"Actual","activity_description":"Wisconsin Medicaid received the Centers for Medicare & Medicaid Services' approval in July 2014 for Health Information Technology for Economic and Clinical Health (HITECH) 90/10 administrative funding through Wisconsin's Health Information Technology (HIT) Implementation Advance Planning Document Update to establish a Medicaid HIT Extension Program with a qualified not-for-profit entity to provide outreach and technical assistance to health care providers enrolled in Medicaid who are eligible for either the Medicaid or Medicare Electronic Health Record Incentive Program. Wisconsin conducted a Request for Application and awarded a two-year grant in February 2015 to MetaStar Inc. which operates Wisconsin's Regional Extension Center (REC) under the federal HITECH REC grant.","source":"Wisconsin eHealth Program (for questions or more information, email ehealth@wi.gov)","source_url":"http://www.metastar.com/services/meaningful-use-consulting/healthitextension/"},{"state":"Wisconsin","policy_lever":"HIE Advisory Council / Oversight Board","activity_status":"Actual","activity_description":"In May 2010, 2009 Wisconsin Act 274, the Wisconsin Relay of Electronic Data (WIRED) for Health Act, was signed into law. This act, which added the Electronic Health Information Exchange subchapter of Wis. Stat. ch. 153  Health Care Information, authorizes the secretary of the Department of Health Services to create or designate a qualified organization to govern statewide Health Information Exchange at a state level.","source":"","source_url":"https://docs.legis.wisconsin.gov/statutes/statutes/153"},{"state":"Wisconsin","policy_lever":"Prescription Drug Monitoring Programs (PDMP)","activity_status":"Actual","activity_description":"In May 2010, 2009 Wisconsin Act 362 was signed into law. This law directed the Wisconsin Pharmacy Examining Board to create a program to monitor the dispensing of prescription drugs. The Prescription Drug Monitoring Program (PDMP) is a statewide program that collects information about controlled substances and other drugs with a substantial potential for abuse that are dispensed to patients in Wisconsin. Wis. Admin. Code ch. Phar 18 permits direct access to PDMP information by pharmacists and practitioners through the state-designated entity under Wis. Stat. ch. 153 if they are participants in and are lawfully authorized to access data from the state-designated entity. This is not a required method to access PDMP information but is one of the methods they may use that the PDMP is capable of supporting. The PDMP included dispensing data as of January 1, 2013, and was fully operational by the end of May 2013.","source":"","source_url":"https://docs.legis.wisconsin.gov/2009/proposals/ab227"},{"state":"Wisconsin","policy_lever":"State Privacy and Security Policies","activity_status":"Actual","activity_description":"Wisconsin's privacy law concerning the release of sensitive health data, such as mental health treatment records, was more restrictive than what the Health Insurance Portability and Accountability Act of 1996 (HIPAA) required for using and disclosing protected health information (PHI) for treatment, payment, and health care operations among covered entities. As a result, in March 2008, 2007 Wisconsin Act 108 was signed into law to allow exchange of certain sensitive health information between providers without written patient consent for treatment purposes and to change the Wisconsin law that did not permit providers to re-disclose received health information to other providers even with a patient's consent. In April 2014, additional legislation was passed, and 2013 Wisconsin Act 238 was signed into law. This act harmonized Wisconsin privacy laws concerning uses and disclosures of PHI with HIPAA.","source":"","source_url":"http://docs.legis.wisconsin.gov/2007/proposals/sb487"},{"state":"Wisconsin","policy_lever":"State Appropriated Funds","activity_status":"Actual","activity_description":"A provision in 2007 Wisconsin Act 20, enacted in October 2007, created a tax credit for providers who purchase software or hardware used to maintain medical records in electronic form. Providers could claim as a credit against taxes an amount up to 50 percent of the amount expended in the taxable year for information technology hardware or software used to maintain medical records in electronic form. The maximum amount of credit for all claimants in a taxable year is $10,000,000; however, the credit was deferred until 2012. Legislation was passed in 2014 to limit the tax credit to taxable years beginning before January 1, 2014.","source":"Section 1989, page 434","source_url":"https://docs.legis.wisconsin.gov/2007/related/acts/20.pdf"},{"state":"Wisconsin","policy_lever":"State Designation of Exchange Entity","activity_status":"Actual","activity_description":"In June 2010, Wisconsin conducted a Request for Application to select a state-designated entity for Health Information Exchange (HIE) governance and implementation of Wisconsin's strategic and operational plan for statewide HIE under the authority provided by Wis. Stat. ch. 153, subchapter II. The Wisconsin Statewide Health Information Network (WISHIN), a not-for-profit entity, was designated on December 21, 2010. The state's agreement with WISHIN was renewed on February 8, 2014.","source":"","source_url":"https://www.dhs.wisconsin.gov/contracts/health-information-exchange-hie.htm"},{"state":"Wisconsin","policy_lever":"Medicaid State Plan Amendments (SPA)","activity_status":"Actual","activity_description":"Wisconsin's health home state plan targets individuals with AIDS/HIV at risk of developing another chronic condition. The state will require health home providers to adopt health information technology including the use of electronic health records which interface with specialty and inpatient care providers for the provision of services. All contacts with health home members will be documented in the EHR; the record will be accessible  to all members of the patient's core team. The patient's treatment plan will be electronic and also must be accessible to all members of the patient's core team.","source":"Medicaid Approved Health Home State Plan Amendments  (Filter by State; Search term= Health Home)  WI  12-008 Approval Date 01/29/2013","source_url":"http://www.medicaid.gov/state-resource-center/medicaid-state-plan-amendments/medicaid-state-plan-amendments.html"},{"state":"Wisconsin","policy_lever":"State Appropriated Funds","activity_status":"Actual","activity_description":"As part of the Wisconsin Health Information Technology (HIT) strategic and operational planning and state Medicaid HIT planning, Wisconsin Medicaid assessed opportunities to leverage the state Health Information Exchange (HIE) to support enhanced health information sharing and retrieval capabilities for Wisconsin's Medicaid and public health programs. In July 2014, the Centers for Medicare & Medicaid Services approved a Medicaid Management Information Systems (MMIS)-Implementation Advanced Planning Document that Wisconsin submitted to obtain 90/10 funding for three health information sharing projects with the Wisconsin Statewide Health Information Network (WISHIN). The three projects include implementing a bidirectional interface from WISHIN to the Wisconsin Immunization Registry that is hosted and maintained in the MMIS enterprise, a hospital admission (inpatient and emergency department) notification service for Medicaid members to the Medicaid HMOs in Milwaukee (pilot), and the integration of Medicaid prescription fills in the state HIE community health record with twice daily updates.","source":"Wisconsin eHealth Program (for questions or more information, email ehealth@wi.gov)","source_url":""},{"state":"Wisconsin","policy_lever":"Advanced Primary Care Arrangements","activity_status":"Actual","activity_description":"Wisconsin's health home state plan targets individuals with AIDS/HIV at risk of developing another chronic condition. The state will require health home providers to adopt health information technology including the use of electronic health records which interface with specialty and inpatient care providers for the provision of services. All contacts with health home members will be documented in the EHR; the record will be accessible  to all members of the patient's core team. The patient's treatment plan will be electronic and also must be accessible to all members of the patient's core team.","source":"Medicaid Approved Health Home State Plan Amendments (Filter by State; Search term= Health Home)  WI  12-008 Approval Date 01/29/2013","source_url":"http://www.medicaid.gov/state-resource-center/medicaid-state-plan-amendments/medicaid-state-plan-amendments.html"}]