North Carolina Behavioral Health EHR Funding Program Requirements

Criteria to Apply:

The North Carolina Department of Health and Human Services, the NC Health Information Exchange Authority (NC HIEA), the Division of Medical Assistance (DMA) and the NC Office of Rural Health (ORH) are launching a program to assist behavioral health, mental health, and intellectual development and disability practices with purchasing an Electronic Health Record (EHR) technology and establishing connectivity to the state-designated health information exchange, NC HealthConnex. The total funds available for this program are $2.5 million dollars and will be awarded to an eligible behavioral health practice based on the award amounts listed in Table 1.

Pursuant to North Carolina Session Law 2015-241, as amended by North Carolina Session Law 2017-57, health care providers who accept Medicaid reimbursement for the provision of health care services must connect to the designated state-wide health information exchange, which is operated by the NC Health Information Exchange Authority (NC HIEA) within theDepartment of Information Technology (DIT). Physicians, hospitals, and mid-level practitioners who receive Medicaid reimbursement and who currently have an electronic health record (EHR) must connect by June 1, 2018. All other providers who receive funds from the State for the provision of health care services must connect by June 1, 2019, even if they do not currently have an EHR system.

To further support the implementation of this statutory mandate, this program shall support health care practices that:

(i)are Medicaid-enrolled outpatient practices that have an active NPI number in NCTracks;

(ii)provide behavioral health, mental health, orintellectual and developmental disorder services (See Taxonomy list below);

(iii)attest that they have not received funding for EHR adoption or meaningful use;

(iv)attest that they do not have electronic health record technology orattest that they do have a practice management systemas of January 1, 2018 that could be upgraded to an electronic health record;

(v)for calendar year 2017, had behavioral health, mental health, orintellectual and developmental disorder services providers make up 75% of their affiliated healthcare providers based on NC TRACKS data.(See taxonomy list below)

Note: The NC HIEA strongly recommends that providers choose a vendor from among the list of those that are already engaged in the NC HealthConnex connection process to ensure that they meet the technical requirements for connectivity.

Potential Number of Eligible Behavioral Health Practices

DMA and the NC HIEA recently (Jan.2018) completed an analysis of potentially eligible Behavioral Health (BH) practices (including practices and providers with an active NC Medicaid NPI number, at least one taxonomy from the list below, and no previous Medicaid or Medicare EHR Incentive payment.) The report showed that there are approximately 2,748 eligible BH practices and providers that could apply for this program.

The recent report also showed that 28/156 (37%) of the Behavioral Health practices that already received EHR incentive funds are in the process or have already connected to the NC Health Information Exchange, NC HealthConnex. Technical Assistance may be necessary to connect the Behavioral Health practices with an EHR that have not yet signed a participation agreement with the NC HIEA. The participation agreement is the legal document governing the date use and exchange between the participant (or HIPAA covered entity) and the health information exchange (or HIPAA health information organization).

Process

Eligible practices shall submit applications to the ORH via the ORH website utilizing a Qualtrics survey application to self-attest using the defined program requirements. Applications will be accepted on a first come, first served basis.

The practices thatreceive funding under this program must connect to the state-wide health information exchange within agreed upon timeframes prior to the funds being distributed. Eligible practices will be reimbursed for the cost of EHR technology based on Table 1 below. The DMA Office of Health Information Technology (HIT)shall be responsible for validating program eligibilityutilizing NC TRACKS and HIT data. HIT will coordinate with ORH to obtain NC HIEA validationof the practice’s connection to NC HealthConnex, prior to reimbursement.

See process steps detailed below:

Funding:

Payments will be made to the practice, notindividualproviders. As outlined above,practices must apply to the program to be included on the request-for-funding list, thenDMA HIT must validate upon completion of the outlined criteria to determine practice eligibility to receive reimbursement. All payments will be made to practices on a first-come, first served basis:

(i)once connectivity to the State-designated health information exchange (HIE), NC HealthConnexhas been established,

(ii)or active HIE onboarding for over 30days, whichever comes first.

Each eligible practice will only receive one payment based on Table 1 for all service locations. Only one taxonomy code from the list is needed to apply.

Behavioraland Mental Health Provider Taxonomy Codes included in the program:

North Carolina Behavioral Health EHR Funding Program Requirements

261QD1600X

261QM0801X

261QM0850X

261QM0855X

261QM2800X

261QR0405X

251B00000X

251C00000X

251S00000X

101Y00000X

101YA0400X

101YM0800X

101YP2500X

102L00000X

103G00000X

103GC0700X

103K00000X

103T00000X

103TA0400X

103TA0700X

103TB0200X

103TC0700X

103TC1900X

103TC2200X

103TE1000X

103TF0000X

103TH0004X

103TH0100X

103TM1700X

103TM1800X

103TP0016X

103TP0814X

103TP2700X

103TP2701X

103TR0400X

103TW0100X

104100000X

1041C0700X

106E00000X

106H00000X

106S00000X

163WA0400X

163WC0400X

163WP0807X

163WP0808X

163WP0809X

167G00000X

171M00000X

172V00000X

174H00000X

2081P0301X

2084A0401X

2084B0040X

2084H0002X

2084P0005X

2084P0015X

2084P0301X

2084P0800X

2084P0802X

2084P0804X

2084P0805X

222Q00000X

225400000X

225C00000X

225CA2400X

225X00000X

225XE0001X

225XF0002X

225XG0600X

225XH1300X

225XN1300X

225XP0019X

363LP0808X

2080P0006X

2080P0008X

364SP0807X

364SP0808X

364SP0809X

364SP0810X

364SP0811X

364SP0812X

364SP0813X

405300000X

North Carolina Behavioral Health EHR Funding Program Requirements

Behavioral health, mental health, orintellectual development and disability practicesenrolled in this Program will be eligible to receive a one-time reimbursement payment to offset the cost ofpurchasing an EHR and establishing connectivity to NC HealthConnex, up to the following amounts[i]:

Table 1:

Eligible Practice with 26+ providers / up to $20,000
Eligible Practice with 12-25 providers / up to $15,000
Eligible Practice with 11 or fewer providers / up to $10,000

EHR reimbursement costs were determined by the NC HIEA based on the average EHR vendor costs to implement EHR technology by practice size.

Reimbursement will not exceed the total cost of behavioral health EHRimplementation and practices must submit a receipt and related EHR vendor contract to the NC Office of Rural Health as verification of EHR purchase.

If the amount of funds requested by eligible behavioral health applicants as of May 31, 2018, is less than the total available funds, the application window will be extended by one month then re-reviewed, with this cycle repeated until requested funds exceed total available funds.