Attestation Documentation Requirements

For Program Year 2016, Indiana requires that all providers participating in the Indiana Medicaid Electronic Health Records (EHR) Incentive Program submit documentation as outlined in the following table.

Providers Year 1 Years 2-6
Eligible professionals
  1. Acceptable documen-
    tation as proof of relationship between provider and EHR
    vendor *
  2. Documentation from the Office of the National Coordinator for Health IT (ONC) showing proof of certified EHR
    technology**
  3. Documentation that substantiates the reported numerator and denominator in the formula for calculating the Medicaid encounter volume***
  4. Providers attesting to meaningful use submit summaries of meaning-
    ful use measures produced from the EHR software, as a com-
    parison against attested measures****
  5. Providers attesting to public health objectives submit confirmation documentation issued by the Indiana State Department of Health (ISDH). Documentation must be uploaded to the attestation*****
  1. Documentation from the Office of the National Coordinator for Health IT (ONC­) showing proof of certified EHR
    technology**
  2. Documentation that substantiates the reported numerator and denominator in the formula for calculating the Medicaid encounter volume***
  3. Providers attesting to meaningful use submit summaries of meaning-
    ful use measures produced from the EHR software, as a com-
    parison against attested measures****
  4. Providers attesting to public health objectives submit confirmation documentation issued by the Indiana State Department of Health (ISDH). Documentation must be uploaded to the attestation*****
Eligible hospitals
  1. Medicare Cost Report spreadsheet
  2. Acceptable documen-
    tation as proof of relationship between provider and EHR
    vendor*
  3. Documentation from the Office of the National Coordinator for Health IT (ONC) showing proof of certified EHR
  4. Providers attesting to meaningful use submit summaries of meaning-
    ful use measures produced from the EHR software, as a com-
    parison against attested measures****
  5. Providers attesting to public health objectives submit confirmation documentation issued by the Indiana State Department of Health (ISDH). Documentation must be uploaded to the attestation*****
  1. Documentation from the Office of the National Coordinator for Health IT (ONC) showing proof of certified EHR technology**
  2. Providers attesting to meaningful use submit summaries of meaning-
    ful use measures produced from the EHR software, as a com-
    parison against attested measures****
  3. Providers attesting to public health objectives submit confirmation documentation issued by the Indiana State Department of Health (ISDH). Documentation must be uploaded to the attestation*****

Notes

* Acceptable documentation refers to the Certified Electronic Health Record Technology (CEHRT) by name and certification number, and includes financial or contractual commitment. Examples include the EHR contract, invoice, or receipt that includes the provider's name and point of contact; vendor's name and point of contact; and CEHRT name, version, and ONC-issued CEHRT ID.

** Proof must verify that the current CEHRT version meets program year requirements. A screen shot from the ONC website is acceptable proof.

*** Medicaid encounter volume percentage documentation:

Please attach a Microsoft Excel version of the encounter volume used to calculate the numerator and denominator of the encounter volume percentage that agrees with the attested percentage. The spreadsheet should include the following information:

  1. A summary by payer that clearly shows the total Medicaid patient volume and the total patient volume.
  2. A spreadsheet of detailed Medicaid encounter information that includes the following:
    • Patient name or unique patient identification number
    • Dates of service
    • Payer type (Medicaid/other)
    • Providers practicing at a federally qualified health center (FQHC) or rural health center (RHC) also need to identify "other needy" encounters, if the encounters are included in the numerator
    • Name of rendering providers; or provider's National Provider Identifier (NPI) or Legacy Provider Identifier (LPI)

**** Meaningful use documentation:

Please include a copy of the summary meaningful use (MU) measures produced directly from the CEHRT system in a portable document format (PDF). Documentation must also include:

  1. The name of the eligible professional whose data is being submitted for attestation
  2. The date range for which the data was produced
  3. The date the MU summary was produced (run date)
  4. The name or logo of the CEHRT vendor and product number

Other requirements for documentation include:

  1. All information in the documentation must be clearly legible
  2. The document should be free from any additions, deletions, or alterations not produced by the CEHRT system. If any of the previous documentation is not produced directly from the CEHRT, screen shots depicting the absent material from each measure should be included, in addition to the MU summary, and should not be substituted for the summary.
  3. Please note that all documentation regarding responses to yes/no questions and the election of exclusions must be maintained by the provider, even though this information is not requested during the attestation.

***** Providers that report public health measures will receive confirmation of registration or submission from the ISDH, and should scan and upload this confirmation as documentation for the EHR attestation.