***Wyoming is currently onboarding to the Immunization Registry to meet the Public Health Reporting Measure.*** 

Documentation Required for EHR Attestation***

1. All providers allowing another person to complete the registration and attestation process in the Wyoming Medicaid EHR Program are required to complete and submit a “Provider Authorization Proxy” letter. This letter will be uploaded with other supporting documents during your attestation process. The letter must be renewed annually.
   
   Provider Authorization Proxy Form 
   
   
2. Proof of EHR – Must be a document showing a binding agreement between provider and vendor.
   a. Contract between entities
   b. Invoice showing payment (actual numbers can be blacked out)
   c. Purchase Order
   (A vendor letter is not acceptable)
   
   
3. Exact Name and Version of EHR system
   
   
4. Patient Volume Methodology, Final Rule 42 CFR §495.306
1. For Eligible Providers
• Date range must be from any, continuous, 90-day period from the prior calendar year.
1. For 2014 Payment year – volume is determined from 2013.
• Medicaid Patient Encounter volume equals
1. Total Medicaid encounters divided by total encounters during same time period.
2. Providers may include hospital encounters that are billed through clinic.
3. Encounters may be broken out from bundled charges.
4. Method used to determine Medicaid patient volume must be same the method used to determine total patient volume.
2. Needy Individual Patient Volume
• Date range must be from any, continuous, 90-day period from the prior calendar year.
1. For 2014 Payment year – volume is determined from 2013.
•  Medicaid Patient Encounter volume equals
1. Total needy individual patient encounters divided by total patient encounters during same time period.
3. Group Practice Volume
• Clinic or Group patient volume is appropriate as a patient volume methodology calculation for the EP.
• There is an auditable data source to support the clinic or group practice patient volume determination.
• ALL EPs in the group practice or clinic must use the same methodology for the payment year.
• The clinic or group practice uses the ENTIRE practice or clinic’s patient volume and does not limit patient volume in any way.
4. For Eligible Hospitals
• Date range must be from any, continuous, 90-day period from the FISCAL year preceding the hospitals’ payment year.
1. Will include Medicaid patients who are in-patients discharged from acute care AND
2. Medicaid Emergency Department encounters.
• Medicaid Patient Encounter volume equals
1. Total Medicaid encounters divided by total encounters during same time period.

***RHC’s / FQHCs that include needy individuals in patient encounters:

Proof of sliding fee scale with methodology used to determine needy individuals.

*** Hospitals Must Also Include:

• Most recent Cost Report
• Any other documents used for incentive calculation