Updated 1/3/12

Step By Step Registration for Tribal/Urban Health Programs

Medicare & Medicaid EHR Incentive Programs:

Eligible Professionals (EPs)

PART 1. CMS Registration – National level registry

When registering on the CMS website, have the following information available for each Eligible Professional (EP):

National Provider Identifier (NPI).

National Plan and Provider Enumeration System (NPPES) User ID and Password (see below).

Payee Tax Identification Number (if you are reassigning your benefits).

Payee National Provider Identifier (NPI) (if you are reassigning your benefits).

Third party “Proxy” I & A account which allows an EP to designate a third party to register and attest on his or her behalf (see below)

Be ready to choose which incentive program in which they wish to participate (Medicare or Medicaid)

Organization name, address, phone number, and email address

Completed? / Task
1. Create NPPES web user account: Each EP must create a NPPES web user account (linked to their NPI). This is the user ID/password they will use to log into the CMS R&A System:
2. Create a “Proxy” account: Users working on behalf of an EP must have an Identity and Access management system (I & A) web user account (User ID/Password). To create an I&A web user account, go to:
If you already have one, login at:

2.1. This account must then be associated to each EP’s NPI via an access request
2.2. To add EPs after creating a proxy account, click on “View/Modify I&A User Profile, click “Next” through several screens, then click on “Add Access Request”. From here follow the instructions in the CMS Registration User Guide referenced in number 3.1 below.
2.3. Each provider will then login to their NPPES account and accept the proxy's requestbefore the proxy can login and register on their behalf on the CMS site
2.4. Note: it may take a day or two for the providers to appear on the proxy’s CMS Registration list.
3. Register with CMS: Each EP (or his/her proxy) must start the registration process at the CMS Registration and Attestation (R&A) System:

3.1. The above steps and all registration steps are outlined in the CMS Registration User Guides (select the Registration User Guide (Medicare or Medicaid) for which the EP is registering):

Video: Medicare and Medicaid EHR Incentive Program Registration Webinar for Eligible Professionals
3.1.1. Medicare Registration user guide:

3.1.2. Medicaid Registration user guide:

4. After registering, print the “Successful Submission” page using the “print” button at the bottom of the page.

PART 2. Medi-Cal EHR Incentive Program-State Level Registry Registration

Status / Task
When applying on the Medi-Cal State Level Registry Portal, have the following information available for each Eligible Professional (EP):
Information submitted to the CMS R&A System for confirmation
Contact name, telephone number, and e-mail address of the preparer of the EP’s application, if not the EP
Whether or not the EP has any sanctions or pending sanctions with the Medicare or Medicaid programs and is licensed to practice in all states in which services are rendered
Required 90-day patient volume data (use the Individual or Group patient volume calculation to make sure the EP meets the threshold requirement)
The CMS EHR Certification Identification (ID) for the certified EHR technology that has been or is contractually obligated to be acquired from the Certified Health IT Product List (CHPL)
Web site:
  1. Create a State Level Registry (SLR) Account at:

  1. Complete Medi-Cal SLR Registration
Please refer to the Medi-Cal EHR Incentive Program State Level Registry (SLR) Quick Start Guide Quick Start Guide For Group/Clinic Representatives or go to
  1. Step 1: About Your Group
  2. Step 2: Group/Clinic Information
  3. Step 3: Manage Providers in Your Group
  4. Step 4: EHR Technology and Group Statement
  5. Step 5. Certified EHR Technology
  6. Step 6. Group Statement & Application Submission

  1. Eligible Providers in the group/clinic must individually review and attest to the validity of their application in the State Level Registry before payments can be made to them. This can be done after the Group Representative has submitted the group/clinic application, on or after 1/3/12 (delayed from 12/15/11)

  1. Group Volume and Listing of Eligible Providers
A new rule has just come to light with registering providers in your groups. Medi-Cal is requiring that group administrators include/list every eligible provider who contributed to the group's encounter rate, be it 90 days or a full year if using OSHPD data. If you do not list every provider and got audited later you could be liable for fraud and have to give the incentive payment back. If you have providers who, for example, no longer work for you and you attempt to list them in your group and you get an error message that the provider is not recognized in the Provider Master File (PMF), then you list that provider's name and NPI in a separate word document, PDF it, and upload that document with your group.
The reason for this requirement is that Medi-Cal is trying to ensure that there is no double dipping, a provider using his panel data in one place and the group using aggregate encounters that that provider contributed to in another.
For those of you who have started your groups, and perhaps even submitted, please re-open your group and add every provider necessary before March 31, 2012. For those of you who have not started please include every provider that contributed to the encounter rate.
Examples:
1) Health Center Site A
Prequalified for 30% Medi-Cal with OSHPD data
12 eligible professionals provided Medi-Cal encounters in 2010
List all 12 providers
2) Health Center B (three sites all registering under one organization)
90 days of Medi-Cal data June 12,2010- September 11, 2010
20 eligible professionals provided Medi-Cal encounters in 2010, but only 17 of them contributed encounters during the 90 day period chosen
List only the 17 EP’s that contributed.
IMPORTANT NOTES:
  • Eligible providers are required to register and create their own accounts on the CMS Registration and Attestation Site and on the State

  • FQHC, FQHC look-alike, Rural Health Center, or Indian Tribal Clinic Only click “Yes” to this question if the clinic is one of these types AND will need to count “Other Needy Individual Encounters” (in addition to Medi-Cal Encounters) in order to attain the >30% patient volume threshold. If the clinic will meet this threshold counting only Medi-Cal encounters do not click “Yes” to this box. Clicking the box limits the number of eligible providers in your clinic to those who practice predominantly in your clinic.

  • Provider Master File Some groups or clinics may receive the message “Provider information not found” when attempting to enter some providers into their group/clinic. This will usually result when the provider is not listed in DHCS’s Provider Master File because they have not established themselves as a billing or rendering provider for Medi-Cal Fee-for-Service. Most providers at CA tribal health programs are not Fee-for Service providers, but rather IHS MOA providers. In order to avoid problems, please register EP’s with the CMS National Level Registry before attempting to designate them as providers in your group/clinic at the Medi-Cal EHR State Level Registry. After you have registered your group/clinic in the SLR you can reopen your group/clinic to name additional members by contacting the Help Desk, however you will only be able to name providers who have subsequently either registered with the NLR (up to a 3 day process) or have become providers in the DHCS Provider Master File (potentially a several week process).

Important Deadlines
  • Until March 31, 2012 groups, clinics, and providers can choose to apply for the 2011 or 2012 payment year. After March 31, 2012 all SLR applications with be for the 2012 payment year and eligibility must be established on the basis of 2011(not 2010) patient encounter or patient panel data.
  • All certified EHR contracts must be in place by December 31, 2011 to qualify for Medi-Cal EHR incentives in 2011 using the 2010 patient volume. Otherwise, will have to attest for first incentive payment in 2012, using 90-days in 2011.

Group Registration and EHR Contracts If you upload your certified EHR contract or the AIU form and the relevant pieces of the contract to your group registration it will be associated with every provider in that group. If you do not want that to happen, then do not upload a contract with your group registration. Instead, provide your providers, or those of your choosing, with the certified EHR contract or relevant pieces so that they can include it with their individual provider registration.

Resources:

  • Video: CMS - Medicare and Medicaid EHR Incentive Program Registration Webinar for Eligible Professionals
  • “Proxy” User Id/Password for CMS R&A- Go to Identity and Access management System (I & A) new web user account (User ID/Password):
  • NPPES Login/Password retrieval-Contact the PECOS Help Desk if your provider cannot remember your password- (866) 484-8049/ TTY (866)523-4759,
  • Medi-Cal EHR Incentive Program State Level Registry (SLR) Quick Start Guide For Group/Clinic Representatives

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AIAN National HITECH REC (National Indian REC) is a federally-designated Regional Extension Center funded by the Office of the National Coordinator, Department of Health and Human Services, Award Number90RC0060/01.

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