Massachusetts eHealth eQualityIncentive Program RFP
(Solicitation No.2015-MeHI-04)
Questions and Answers
ADDED ON: May 15, 2015
38. / Could you please provide more information on the Direct connect option to the HIway - what does XDR and/or SMTP/SMIME stand for on the ‘Mass HIway Connection Options’ webpage?/ XDR (eXternal Data Representation) is a standard for the description and encoding of data, used to communicate data between many diverse machines.
SMTP (Simple Mail Transfer Protocol) is an Internet standard for e-mail transmission.
S/MIME (Secure/Multipurpose Internet Mail Extensions) is a standard for public key encryption and signing of MIME data.
A provider organization should talk to their EHR vendor about Direct connection options to determine what the product supports, and which options were used to achieve their certification.
ADDED ON: May 14, 2015
37. / Is there an open enrollment period for the eQIP Grant, or are organizations bound by the May 21st deadline? / To be eligible for the eQIP Grant, organizations must submit an electronic copy of their application by May 21st, 2015 at 3pm. Hard copies of the application are due May 22nd, 2015 at 3pm. MeHI/MTC does not accept late applications.38. / Is an organization that provides some direct clinical services, but uses non-clinical workers under supervision to provider other clinical services (e.g., medication administration) eligible for the eQIP grant? / Yes.Services can be provided by either licensed clinicians or by staff authorized to provide direct patient care under the supervision of a licensed professional.
39. / Does the EHR System in use at an organization have to be certified at time of application? The vendor is in the process of obtaining certification and expects to have it relatively soon. / An organization does not need CEHRT, or any EHR, to apply for the Grant, or to meet Milestone 1.
See also, Q. 26: Program eligibility does not require an organization to have an interoperable EHR. To complete Milestones 2, 3 & 4, a certified EHR technology must be used to achieve the functions necessary to meet the required measures.
40. / Is there a timeframe associated with each milestone? Or as long as they reach milestone 4 by the two year program period end they will be okay? / Milestone 1 must be completed within 90 days of contracting. The other milestones have no specific time frame, but must be completed by the end of the grant program period.
41. / Does our organization apply for the Grant under our behavioral health division, or as the parent agency? This will effect what revenue tier we fall into. / The organization is the Applicant (not an individual division, facility or location) and the Organization must meet all of the eligibility criteria.
Eligibility Criteria #3 requires that the organization provide primarily BH services in Massachusetts – defined as, more than 50% of the annual total organizational revenue must be PSR from the provision of BH services in the Commonwealth.
The total payment amount tier is based on annual total organizational revenue.
ADDED ON: May 11, 2015
30. / Could you please expand on the operational definition of “Eligible Providers” (EPs)? / Eligible Professionals or Eligible Providers (EPs) refers specifically to those Providers that are listed as eligible to participate in the Medicare & Medicaid Incentive Payment Program created by the HITECH Act of 2009. The full list of EPs is available (see link in Solicitation) but is generally limited to physicians, dentists, and, in some cases, nurse practitioners and a certified nurse-midwife.31. / How is “clinical staff” defined? / The term “Clinical Staff” is defined as BH Providers (see definition in the Solicitation) that provide direct patient care and are either licensed clinicians or clinical staff authorized to provide direct patient care under the supervision of a licensed BH professional.
32. / Our organization receives hovers around 50% PSR from public payer. Should we qualify and be accepted for the Grant, would we be disqualified should this percentage fall below 50% during the period of performance? / The grant agreement provides as follows (emphasis added):
Grantee commits to meeting the intent of the Program and all Incentive Program Milestones to which it is eligible. Grantee attests that it meets each of the eligibility criteria set forth in the Solicitation (see Section 2.3.2).If at any time during the period of this Task Order 15-1 Grantee ceases to meet the eligibility criteria, Grantee shall provide written notice to Mass Tech Collaborative with said notice to be provided within five (5) business days of Grantee’s learning of the change in eligibility status. (See Solicitation, Attachment F, Form of Task Order, Section 8 (c).)
33. / Some of our patients are funded through public payers in MA as well as outside of MA, however, we only see these payments as ‘tuition’ in our financial statements. How can we show that we meet the criteria stating 50% PSR in MA is public payer? / Applicants are required to substantiate that they meet each of the eligibility criteria.
For Eligibility Criteria #5 (more than 50% of PSR generated from facilities located in MA is public payer), applicants must submit Uniform Financial Statements and Independent Auditor's Report (UFR), or a similar audited report, that demonstrates that portion of PSR that is public payer.
Applicants are required to tie the stated PSR back to the source document (UFR page number, schedule name, revenue line item numbers, etc.) that correspond to the amounts listed.
34. / Will the connection to Mass HIway described below impact our eligibility of the eQIP grant?
A HISP to HISP connection between Mass HIway and Medicity in order that providers that use Mass HIway for their HISP can send CCDs to PCC, who uses Medicity for their HISP. / Using a HIway connection via the Medicity HISP to HIway HISP interface is acceptable for the eQIP grants.
If accepted, however, your organization will need to describe that same pathway in its use case development form and not some other webmail, as an example, pathway.
35. / Please can you elaborate further on roles (below) that each of the individuals, for whom you have requested contact information, will play and, if possible, examples of the types of interactions each person will be responsible for. This will help ensure that we provide the best/correct person in each role.
- Project Manager
- Liaison to Mass Tech Collaborative (for contact and communications)
- Program Director (authorized to negotiate and contractually-bind the applicant)
1.Project Manager: The person with overall responsibility for accomplishing project objectives. Leads the organization’s project team and ensures the successful planning, design and execution of elements necessary to meeting eQIP Milestones (e.g., CIO).
2.Liaison: The person with primary responsibility for eQIP reporting requirements, Milestone status updates, attending webinars and in-person meetings, etc. Must be part of the project team and may be the same person as the Project Manager.
3.Program Director: The person the Organization has authorized to sign contracts and other legal documents that legally bind the entity (e.g., CEO, CFO).
36. / Our organization has a MA DPH license to provide clinical care. Since we are not a third-party biller, we sub-contract the billing of clinical care through a foundation. Does this make our organization ineligible for eQIP? / Applicants must meet all of the eQIP eligibility criteria, including providing BH clinical care services and substantiating that their PSR from those services is more than 50% public payer.
If those criteria are met by the applicant organization, it should not be relevant that the billing is sub-contracted to a third party.
ADDED ON: May 1, 2015
10. / Can we still apply if our EHR vendor’s certification is only for 2011 and not 2014? / Yes. MeHI will allow grantees to use 2011 Edition Certified Electronic Health Record Technology (CEHRT) to meet eQIP milestones.MeHI is aware of the recent ONC changes and is considering how best to incorporate those changes while maintaining the goal of interoperability.
11. / If our EHR vendor is not ready to transmit to the HIway by end of grant period, are there any repercussions to the grantee? For example, testing has occurred and there are technical issues preventing active transactions on the HIway. / MeHI will address any such issues on a case-by-case basis, if the failure to meet Milestone 4 requirements is caused by Mass HIway technical issues that could not reasonably have been anticipated by the organization and/or its vendor.
12. / Does Milestone 4 require the participant to use query & retrieve capabilities, or just send and receive? / Milestone 4 requires a grantee to connect to and use the Mass HIway, or an HIE that connects to the Mass HIway, to exercise the organization’s use case in production with at least one unaffiliated trading partner.
It does not require use of the HIway’s query and retrieve capabilities.
13. / Does this have anything to do with the Virtual Gateway? / No. The Virtual Gateway is an internet portal designed by EOHHS for online access to health and human services.
The Mass HIway is the statewide electronic HIE that enables secure sending of health information from one user to another, offering healthcare organizations a way to securely and seamlessly transmit vital data electronically.
14. / Is the eQIP BH2 Grant only for organizations funded during the 2014 eQIP Behavioral Health Round I grant? / No – the eQIP Behavioral Health (“BH”) Round 2 Solicitation is open to BH Organizations that were not accepted for funding in Round 1.
If your organization meets the eligibility criteria, we encourage you to apply.
15. / Are organizations with over $25M in PSR eligible to apply? / Yes – the $25 million cap applies only to organizations that are part of an acute care hospital system or have EPs (see Solicitation 2.3.2 Eligibility Criteria #4 & #6).
16. / Where may we find more information on the A-EMRAM model, specifically on the various stages? / Follow this link: to the HIMSS website and click ‘PDF Preview’ for more information.
17. / If our organization did not submit a NOI by April 23rd, may we still apply? / Yes, applications will be accepted even if the organization did not submit an NOI by the April 23, 2015 deadline. In addition, organizations that missed the NOI deadline are still encouraged to submit an NOI as soon as possible.
18. / Our accounting is done on a CY basis and not off of state FY. Is it possible to submit any financials required in this solicitation based on CY instead of state FY? / If your organization’s Fiscal Year is the Calendar Year, you may submit an audited report for the most recent Calendar Year.
19. / Our CPA provides us with a “Compilation of financial statements” annually. Does this suffice as documentation to satisfy the 5th eligibility requirement – Uniformed Financial Statements and Independent Auditors Report? / While MeHI will consider other certifiable documentation that clearly substantiates that an organization meets all Eligibility Criteria, organizations are required to substantiate the revenue calculations used to demonstrate meeting Eligibility Criteria #3 and #5 by submitting supporting documentation that clearly shows the revenue figures in the source that correspond to the amounts listed.
20. / We are a BH provider that is affiliated with an acute care medical center, but it is not a ‘parent.’ Are we eligible for eQIP? / MeHI is unable to determine specific eligibility from the facts presented.
In general, organizations that are affiliated with a system that includes an acute care hospital (see Solicitation §2.2.1 Definitions and §2.3.2 Eligibility Criteria) are not eligible for eQIP.
There are 2 exceptions:
(1)If the annual organizational revenue of the parent org/system is less than$25 million; or
(2) If the system holds a minority ownership interest in the organization; the system does not exercise governance or management control; and the organization’s financial statements are not consolidated with those of system
If the organization has a relationship with an acute care hospital – or a system with an acute care hospital – it must provide a copy of all relevant agreement(s) between the organization and the hospital system or component thereof.
Note that any confidential provisions in such agreements should be redacted prior to submission.
In lieu of submitting the entire agreement(s), the organization may extract and submit the portions of such agreement(s) that describe the management relationship between the entities and the nature of the ownership interest in the organization.
It is incumbent on the applicant to disclose the relationship and explain why it does not meet the Solicitation’s definition of affiliated.
21. / Not all of our locations provide BH services – are we still eligible to apply? / The organization is the Applicant (not each facility or location) and must meet all of the eligibility criteria.
Eligibility Criteria #3 requires that the organization provide primarily BH services in Massachusetts – defined as, more than 50% of the annual total organizational revenue must be PSR from the provision of BH services in the Commonwealth.
22. / We are a large organization with multiple sites. Is it possible to submit an application only for our mental health clinic even though the Tax ID is the same as the larger organization? / No. The organization is the Applicant (not an individual clinic), and the organization must meet all of the eligibility criteria.
See answer to #21, above.
23. / Federal grants & contracts (public payers) often cover BH services not covered by other payers. Are federal grants/contracts for patient BH services provided in MA included in Patient Services Revenue? If not, why not? / MeHI will consider federal grants/contracts to provide BH services to public payer clients as PSR if the services provided meet the definition of BH Services under this Solicitation.
24. / How important and necessary for this funding and approval is the "interoperability" component, the intended use of the Mass HIway for exchange of info with trading partners? What is considered a trading partner? Is this a fundamental component that MUST be in place to be approved for funding? / EHR system interoperability and transacting on the Mass HIway are goals of the eQIP program, not a requirement for eligibility. While having a trading partner is not a requirement at the time of application, the grantee will need to identify a trading partner to achieve milestone 1.
The Incentive Program is intended to assist eligible BH provider organizations to adopt and effectively use certified EHRs – including interoperability and integration with the Mass HIway. Incentive payments are granted for reaching advanced health IT integration.
25. / We already have an EHR; do we still need to do the Transformation Plan? / Yes. All grantees are required to complete the requirements of Milestone 1.
The eQIP program is more than acquiring an EHR. The Program is designed to incent eligible BH organizations to an increasingly sophisticated use of health IT in an effort to improve the quality and efficiency of healthcare in the Commonwealth, while containing costs.
26. / We have an existing EHR; however it is not interoperable and has significant issues. We are adopting a new CEHRT system, are we eligible for the grant? / Yes. Program eligibility does not require an organization to have an interoperable EHR. To complete Milestones 2, 3 & 4, a certified EHR technology must be used to achieve the functions necessary to meet the required measures.
27. / Do you need the UFR be send directly from our auditors, or can we print it and send it with our application? / The Organization may send the UFR, it does not need to come from an auditor.
The UFR and other supporting documentation must accompany both the electronic application and the hard copy; and must clearly show the revenue figures in the source that validate the amounts listed in the attestation.
28. / How will we receive up-to-date information on any changes to the Solicitation? / It is the Respondent’s responsibility to check the MeHI website (or the MassTech and COMMBUYS websites) for updates, addenda or modifications to the Solicitation.
Except for typographical or transcription modifications, the website will clearly display any changes, modifications or updates.
Questions and requests for clarifications may be e-mailed to:
29. / Could we get clarification on Eligibility Criteria #5 that states "more than 50% of PSR generated from facilities located in MA is public payer"?
Does that mean a MA public payer or from any state?
All our revenues are generated from facilities located in MA but revenue comes from many states. / Any public payer revenue may be included, including Medicare, Medicaid, CHIP and revenue under any state or local contract to provide BH services (as defined in the Solicitation) to public payer clients may be used.
/ QUESTION / ANSWER
Where can I find more information about health IT terminology? / For more information and understanding about health IT terminology, please visit the Office of the National Coordinator for Health Information Technology’s (ONC) website:
ONC Health IT Terms
ONC Glossary
Our organization uses non-CEHRT EHR product. Are we still eligible for the eQIP grant? / Achievement of Milestone 1 does not require an organization to have an EHR; however, to complete Milestones 2, 3 & 4, certified EHR technology must be used to achieve the functions necessary to meet the required measures. We are, however, open to requests for exception (e.g., when no viable certified product exists for the function).
The eQIP grant may be used to upgrade to a CEHRT model and/or add modules to become CEHRT. Details of how the organization plans to do so must be incorporated into the application proposal.
Is funding available for those organizations that have already begun implementation, or already operate using an EHR? / Using an EHR does not preclude program eligibility. Organizations who have do not have an EHR; are in the process of procuring and implementing an EHR; and who already have an EHR currently in use may apply for eQIP.
The Incentive Program is intended to assist eligible BH provider organizations to adopt and effectively use certified EHRs – including integration with the Mass HIway. Incentive payments are granted for reaching advanced health IT integration.
Grantees are required to complete the HIMSS survey to determine their baseline EMRAM score. This will determine what milestone payments the grantee is eligible to receive (see Solicitation: Section 2.3.3 Milestones). For example, if a grantee receives a score that indicates attainment of EMRAM Stage 3, the grantee will have already met milestone 2 and thus is not be eligible for that milestone payment. The Applicant, however, may be eligible for the other milestones.
While grantees cannot get paid for Milestones 2 or 3 if they completed that work prior to submitting an Application, they may still receive incentive payments under this solicitation. In this situation, the milestone payment for Milestone 2 or 3 (but not both) will be allocated to another Milestone. MeHI reserves the right to adjust total payments based upon a grantee’s baseline.
How do we learn of the Mass HIway Use Case? / There are many educational resources, including the MeHI website: (
MeHI also plans to have a series of instructional sessions for grantees. We welcome your use of the MeHI Use Case Library: While new and evolving, this will provide examples of uses of the HIway. Additionally, you can read the HIE stories we published over the last few months: (
How much will it cost my organization to connect to the HIway as required for Milestone 4? / It depends on the size of the organization and method of connection.
See link below for the HIway rate card:
What type of documentation would serve to demonstrate that we are not an Eligible Hospital? / A letter, signed by the director or an officer of the Organization, attesting that the Organization is not an Eligible Hospital (EH) and that its providers are not Eligible Professionals (EPs) under the HITECH Act will serve as appropriate documentation.
Please refer to the link below regarding the parameters and the criteria to qualify as an Eligible Hospital published by CMS under the EHR Incentive Programs (e.g., an acute care hospital, CAH, cancer hospital or children's hospital, as defined under CMS Program regulations): - see
A few clinicians at my organization qualify for MU incentives. Does this preclude the organization from eligibility for eQIP? / An organization may be eligible if the number of EPs total less than 30% of the Organization’s clinical staff AND the Organization is either independent or total organizational revenue of parent organization is <$25M. [See Solicitation Section 2.3.2]
What should be in the organizational approval letter? In addition to stating the organization is in support of the grant/project, are there additional critical elements? / The organizational approval letter should be signed by the CEO or other officer and confirm that the organization supports the eQIP grant application and efforts to achieve Program Milestones.
The letter may include additional supporting statements regarding organizational commitment to fulfilling grant goals.
Re: eligibility criteria #5, (more than 50% of the organization’s PSR in MA must be public payer), could you clarify if these payers must be Medicare, Medicaid and CHIP?
For example, would BH contracts with DYS, DOC, etc. be applicable? / Any public payer revenue may be included, including Medicare, Medicaid and CHIP.
Revenue under any state or local contract to provide BH services to public payer clients may be used.
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