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Centers for Medicare & Medicaid Services (CMS)

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Welcome to the State Level Registry (SLR) for the Medi-Cal Electronic Health Record Incentive Program

Important Information

2016 Attestation Deadline Extension

The deadline for attesting for Program year 2016 has been extended to May 23, 2017 at 6 PM. Providers are urged to complete and submit attestations by 4 PM on that day. Providers experiencing technical problems that prevent attestation should be sure to file a ticket with the SLR Help Desk (866-879-0109 or before the deadline. Program year 2016 is the last year that professionals and hospitals can start the Medi-Cal EHR Incentive Program. Applications from hospitals that have not successfully participated in the program in 2016 will not be accepted for 2017 and subsequent years. Applications from professionals who have not successfully participated in program year 2016 or a prior program year will not be accepted for 2017 and subsequent years.

2016 Changes

• Professionals, groups/clinics, and hospitals can choose to use a 90-day representative period in the 12 months prior to attestation or in the last calendar year (2015).
• Professionals can qualify for the program using the eligibility of a group/clinic if the professional delivered at least one Medicaid patient encounter with the group/clinic in either the 12 months prior to attestation or in the previous calendar year (2015).
• Contracts and other binding agreements for adopting, implementing, or upgrading certified EHR technology do not need to be signed by December 31, 2016, and can be signed in 2017 as long as they are signed before attestation in the SLR for AIU.
• The meaningful use reporting period for all professionals and hospitals will be 90 continuous days within the 2016 calendar year.

2017 Attestations

Program year 2017 attestations will open after program year 2016 closes in the SLR at 6 PM on May 23, 2017. Program year 2017 MU attestations should be available by the morning of May 24, 2017. AIU attestations will no longer be accepted beginning in program year 2017. MU attestations initially will be available only for Stage 2. All providers will be able to attest to Stage 2 in 2017 regardless of how many prior years of Stage 2 attestations they may have submitted. All providers will have the option to attest to Stage 3 in 2017, However, in order to do so providers will have to wait until the fall of 2017 when DHCS anticipates that the State Level Registry will be able to accept Stage 3 attestations. All providers will be able to use a 90-day reporting period for objectives in 2017. However, providers who have previously attested to MU will be required to use a full year reporting period for CQMs. Providers who have not previously attested to MU will be able to use a 90-day reporting periods for both CQMs and objectives. DHCS has requested that the reporting periods for objectives and CQMs be 90 days for all providers, but to date has not received permission from CMS to do so.

2017 Groups

Although membership in groups for 2017 can currently be entered into the SLR, DHCS strongly recommends against doing this at least until May 23, 2017. This is for two reasons:

1. If a group needs to reopen their 2016 attestation for any reason (such as to add providers) the SLR will require that the 2017 attestation also be reopened, resulting in a great deal of work and data reentry for the group administrator and SLR staff.
2. Group administrators will not be able to enter a 90-day representative period for 2017 using the “last 12 months” option until May 23, 2017, when new code is deployed for 2017 MU attestations. Because of a SLR programming issue, only the “last calendar year” option for the 90-day representative period will be available until May 23, 2017.

DHCS also strongly recommends that groups delay submission of their 2017 group attestations until most of their provider attestations have been reviewed and approved for 2016, so that they are relatively certain that it will not be necessary to reopen their 2016 group attestation. As stated above, reopening of a 2016 group attestation could result in the necessity to reopen and reenter data for the group’s 2017 attestation.

Medicare Payment Adjustments

Providers who attested to meaningful use (MU) with the Medi-Cal EHR Incentive Program for program year 2015 are exempt from Medicare Payment Adjustments in 2017. Because of the late closure of applications for MU for the 2015 program year on December 13, 2016, DHCS was not able to send information to CMS regarding 2015 MU attestations until late in December 2016. For this reason, some Medi-Cal providers are now erroneously receiving letters from CMS warning that they are subject to Medicare Payment Adjustments in 2017 because of not attesting to MU in 2015. These letters offer providers the option of filling out and sending in a “reconsideration form” to CMS to avoid the payment adjustments. DHCS has received assurance from CMS that all providers who attested to MU with the Medi-Cal EHR Incentive Program for 2015, even as late as December 13, 2016, will not be subject to Medicare payment withholds in 2017. Submission of the “reconsideration form” should not be necessary because CMS has now removed the names of all providers who had attested to MU for 2015 with the Medi-Cal EHR Incentive Program from the list of providers subject to payment adjustments in 2017. Click here for the names and NPIs of providers who attested to MU in 2015.


DHCS is required to conduct audits of hospitals and professionals who receive EHR incentive payments for adopt, implement, or upgrading (AIU) or meaningful use (MU). Hospitals and professionals should retain documentation supporting their attestations for at least 7 years to be used in case of audit.

Hospitals: DHCS began auditing eligible hospital AIU incentive payments in September, 2015. DHCS is scheduling these EHR audits in the same manner as the Medi-Cal cost report audits. To the extent possible, the EHR audits will be combined with the cost report audits to minimize disruption to the hospital’s operations and staff.

Professionals: DHCS is currently conducting ongoing audits of a sample of eligible professionals who have received incentive payments for AIU.

Medi-Cal EHR Incentive Program--As a result of the American Recovery and Reinvestment Act of 2011, Medi-Cal is able to offer eligible professionals and hospitals in California substantial financial incentives to adopt, implement, upgrade, and meaningfully use certified electronic health record technology. Professionals can receive $21,250 in the first year and $8,500 in five subsequent years. Hospital incentive payments vary between $0.5 to 8 million over 4 years. The last year for professionals and hospitals to start the program is 2016. As of November, 2015, the program has distributed over $1 billion to professionals and hospitals in California. For detailed information you may access CMS’s website by clicking here or by clicking on the links to guidance documents in the right hand column of this page

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

Important Web Resources (all links open in new window)

Connecting California for Better Health