CMS NPI Lookup Tool for MIPS 2017 Eligibility Status

CMS has followed up the MIPS Notification letters with a helpful tool to look up provider eligibility by individual NPI. To access the NPI lookup tool, go to and click on the green “Check Now >” button as seen in the screenshot below.

Green Button MIPS

From there, you can enter the provider’s individual NPI to check their eligibility. This tool should help anyone who is unsure about their provider’s status with MIPS for 2017. If CMS data reflects that the provider is required to submit data to MIPS, the following screen will state” “Included in MIPS; (Providers Name) must submit data to MIPS by March 2018″ along with a new green button labeled “What Can I Do Now?”.

If the provider isn’t required to submit data to MIPS for 2017, the screen will show: “Exempt from MIPS; (Provider Name) is not required to submit data to MIPS for 2017″ and there will not be a green button for next steps.

Our experts at Kentucky REC are here to answer your questions. Contact us at 859-323-3090.

Reserve your spot for our webinar about the new 2017 PCMH standards

Posted May 8th in Education, Event, PCMH


Join us Wednesday, May 24 for our webinar highlighting the new 2017 PCMH standards

On April 3, 2017, the National Committee for Quality Assurance (NCQA) released new Patient-Centered Medical Home (PCMH) standards.

On May 24th at Noon (EST), Kentucky REC’s Certified Content Experts will host a FREE webinar to highlight the new 2017 PCMH standards, including changes in criteria and updated scoring.

PCMH is an excellent practice transformation model for practices committed to access, communication, and care coordination. Now is also the perfect time to pursue recognition since your organization can receive full points in the Improvement Activities category of the Merit-Based Incentive Payment System under the Medicare Access and CHIP Reauthorization Act (MACRA).

Register Here

2017 Medicaid Meaningful Use Webinar

Posted April 28th in Education, Meaningful Use


Meaningful Use continues until 2021 for EPS who are participating in the Medicaid EHR Incentive Program.

The 2017 Program Year brings some changes in the Medicaid Meaningful Use reporting requirements for certain Modified Stage 2 Objectives. Also, in 2017, EPs can choose to report on Stage 3 Objectives instead of Modified Stage 2.

Join us for our “Meaningful Use: Preparing for 2017 and First Look at Stage 3” Webinar on Tuesday, May 16 at Noon EST.

During this webinar, we’ll provide a side-by-side comparison to help with your decision making process.

Register now to learn more about Medicaid Meaningful Use reporting for 2017.

Register Here

CMS Announces MIPS Participation Status Letters to Arrive Soon

Posted April 27th in Value Based Payment/MACRA

cms-logo-smallThe Centers for Medicare & Medicaid Services is reviewing claims and letting practices know which clinicians need to take part in MIPS, the Merit-based Incentive Payment System. MIPS is an important part of the new Quality Payment Program. In late April through May, practices will get a letter from the Medicare Administrative Contractor that processes Medicare Part B claims. This letter will tell the participation status of each MIPS clinician associated with the Taxpayer Identification Number or TIN in a practice.

Clinicians should participate in MIPS for the 2017 transition year if they bill more than $30,000 in Medicare Part B allowed charges a year AND provide care for more than 100 Part B-enrolled Medicare beneficiaries a year.

The Quality Payment Program intends to shift reimbursement from the volume of services provided toward a payment system that rewards clinicians for their overall work in delivering the best care for patients. It replaces the Sustainable Growth Rate formula and streamlines the “Legacy Programs” Physician Quality Reporting System (PQRS), the Value-based Payment Modifier (VM), and the Medicare Electronic Health Records (EHR) Incentive Program. During this first year of the program CMS is committed to diligently working with you to streamline the process as much as possible. Our goal is to further reduce burdensome requirements so that you can deliver the best possible care to patients. Learn more about the Quality Payment Program.

Contact the Kentucky REC with your questions. Our advisors are here to help you navigate healthcare IT, regulatory issues and more. 859-323-3090




No Business Associates Agreement? $31K Mistake

Posted April 25th in HIPAA Information

Stethoscope-MoneyFrom the HHS Office of Civil Rights on April 20, 2017: No Business Associate Agreement? $31K Mistake

The Center for Children’s Digestive Health (CCDH) has paid the U.S. Department of Health and Human Services (HHS) $31,000 to settle potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule and agreed to implement a corrective action plan. CCDH is a small, for-profit health care provider with a pediatric subspecialty practice that operates its practice in seven clinic locations in Illinois.

In August 2015, the HHS Office for Civil Rights (OCR) initiated a compliance review of the Center for Children’s Digestive Health (CCDH) following an initiation of an investigation of a business associate, FileFax, Inc., which stored records containing protected health information (PHI) for CCDH. While CCDH began disclosing PHI to Filefax in 2003, neither party could produce a signed Business Associate Agreement (BAA) prior to Oct. 12, 2015.

The Resolution Agreement and Corrective Action Plan may be found on the OCR website at

For more information on Business Associate Agreements, please visit

To learn more about non-discrimination and health information privacy laws, your civil rights, and privacy rights in health care and human service settings, and to find information on filing a complaint, visit

Don’t let this happen to you! Contact the Kentucky REC with your questions. Our security advisors are here to help you. 859-323-3090