Maryland Primary Care Program (MDPCP) Application Release 2.0 Center for Medicare & Medicaid Innovation (CMMI) User Manual Version 2.0 1/29/2019 Contract Number: HHSM-500-2014-00082U
Maryland Primary Care Program (MDPCP) Application Release 2.0
Center for Medicare & Medicaid Innovation (CMMI) User Manual
Version 2.0
1/29/2019
Contract Number: HHSM-500-2014-00082U
CMS XLC Table of Contents
CMMI UM Version 2.0 ii MDPCP Release 2.0
Table of Contents
1. Introduction.................................................................................................................... 1
1.1 MDPCP Application Overview............................................................................... 1 1.2 MDPCP Application Business Functions Overview ............................................. 1
1.3 Intended Audience ................................................................................................. 2
2. Overview......................................................................................................................... 3
2.1 Conventions ........................................................................................................... 3 2.2 Cautions & Warnings ............................................................................................. 3
3. Getting Started .............................................................................................................. 4
3.1 Set-up Considerations ........................................................................................... 4 3.1.1 General Set-up Considerations ...................................................................... 4 3.1.2 Section 508 Compliance/Accessibility............................................................ 4
3.2 User Access Considerations ................................................................................. 5 3.3 Accessing the System ........................................................................................... 5
3.3.1 New Enterprise Identity Management (EIDM) User Registration ................. 5 3.3.2 Requesting IC Application Role...................................................................... 5
3.3.3 Requesting MDPCP Application Role ............................................................ 5 3.3.4 Accessing the MDPCP Application ................................................................ 6
3.4 System Organization & Navigation ....................................................................... 6 3.4.1 Main Menu ....................................................................................................... 6
3.4.2 Page Navigation .............................................................................................. 8 3.5 Exiting the System ................................................................................................. 9
4. Using the System ........................................................................................................ 10
4.1 Home .................................................................................................................... 10
4.1.1 Maryland Primary Care Program (MDPCP) Practice Home ....................... 10 4.1.2 Maryland Primary Care Program (MDPCP) CTO Home............................. 11
4.2 My Practice Info ................................................................................................... 11 4.2.1 Demographic Information.............................................................................. 11
4.2.2 Practice Information ...................................................................................... 13 4.2.3 Composition ................................................................................................... 15 4.2.4 Request History ............................................................................................. 20 4.2.5 Documents..................................................................................................... 27
4.3 Practice Reporting ............................................................................................... 28 4.3.1 Dashboard – Practice Reporting .................................................................. 28 4.3.2 Dashboard – CTO Reporting ........................................................................ 29 4.3.3 Overview ........................................................................................................ 30
4.3.4 Function 1 ...................................................................................................... 31 4.3.5 Function 2 ...................................................................................................... 36 4.3.6 Function 3 ...................................................................................................... 44 4.3.7 Function 4 ...................................................................................................... 49
4.3.8 Function 5 ...................................................................................................... 53
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4.3.9 General .......................................................................................................... 55 4.3.10 CTO Reporting .............................................................................................. 56
4.4 Payment & Attribution .......................................................................................... 58
4.4.1 Practice Payment & Attribution ..................................................................... 58 4.5 CTO Info ............................................................................................................... 61
4.5.1 Demographic Information.............................................................................. 61 4.5.2 CTO Information ............................................................................................ 62
4.5.3 Payment & Attribution ................................................................................... 64 4.5.4 CTO Documents............................................................................................ 66
4.6 Reports ................................................................................................................. 66 4.6.1 Status Reports ............................................................................................... 66
4.6.2 Other Reports ................................................................................................ 74 4.7 Resources ............................................................................................................ 86
4.7.1 MDPCP Resources ....................................................................................... 86 4.7.2 Helpful Links .................................................................................................. 87
5. Troubleshooting & Support....................................................................................... 88
5.1 Special Considerations ........................................................................................ 88 5.2 Support ................................................................................................................. 88
Appendix A: Record of Changes.................................................................................... 89
Appendix B: Acronyms.................................................................................................... 90
Appendix C: Glossary ...................................................................................................... 92
Appendix D: Referenced Documents ............................................................................ 93
Appendix E: Approvals .................................................................................................... 94
List of Figures
Figure 1: MDPCP Main Menu .............................................................................................. 6
Figure 2: MDPCP Practice Home – My Practice(s) Summary ......................................... 10
Figure 3: MDPCP CTO Home – My CTO(s) Summary .................................................... 11
Figure 4: Demographic Information ................................................................................... 12
Figure 5: Practice Information ............................................................................................ 14
Figure 6: Composition ........................................................................................................ 16
Figure 7: Practitioner Roster .............................................................................................. 17
Figure 8: Staff Roster ......................................................................................................... 18
Figure 9: Practitioner Information....................................................................................... 18
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Figure 10: Staff Information................................................................................................ 19
Figure 11: Practice Request History .................................................................................. 20
Figure 12: Add New Practitioner Request ......................................................................... 21
Figure 13: Withdraw Practitioner Request......................................................................... 23
Figure 14: Add New Staff Request .................................................................................... 24
Figure 15: Delete Staff Request......................................................................................... 25
Figure 16: TIN Change Request ........................................................................................ 26
Figure 17: Request for Extension or Correction................................................................ 27
Figure 18: Practice Documents .......................................................................................... 28
Figure 19: Practice Reporting Dashboard ......................................................................... 29
Figure 20: CTO Reporting Dashboard............................................................................... 30
Figure 21: Practice Reporting Overview............................................................................ 31
Figure 22: Empanelment .................................................................................................... 32
Figure 23: 24/7 Access ....................................................................................................... 33
Figure 24: Continuity of Care ............................................................................................. 34
Figure 25: Enhanced Access and Communication ........................................................... 35
Figure 26: Risk Stratification .............................................................................................. 37
Figure 27: Identifying Beneficiaries for Care Management .............................................. 39
Figure 28: Care Management Staffing .............................................................................. 41
Figure 29: Identifying Hospitals and EDs Your Beneficiaries Use ................................... 42
Figure 30: Beneficiary Follow-Up - Hospital and ED Discharge ...................................... 43
Figure 31: Coordinated Referral Management with Specialists ....................................... 45
Figure 32: Identifying and Communicating with Hospitals and EDs Your Beneficiaries Use................................................................................................................................. 46
Figure 33: Behavioral Health Integration ........................................................................... 47
Figure 34: Linkages with Social Services .......................................................................... 48
Figure 35: Coordinating with Social Service Resources .................................................. 49
Figure 36: Engaging Beneficiaries and Caregivers in Your Practice ............................... 50
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Figure 37: Self-Management Support for Selected Conditions........................................ 52
Figure 38: Team-Based Care............................................................................................. 54
Figure 39: General Information .......................................................................................... 56
Figure 40: CTO Reporting .................................................................................................. 57
Figure 41: Practice Payment & Attribution ........................................................................ 59
Figure 42: Request for Personally Identifiable Information for Attributed Beneficiaries . 60
Figure 43: Demographic Information ................................................................................. 62
Figure 44: CTO Information ............................................................................................... 63
Figure 45: CTO Payment & Attribution .............................................................................. 65
Figure 46: CTO Documents ............................................................................................... 66
Figure 47: Composition Approval/Rejection Report: Daily ............................................... 68
Figure 48: Composition Approval/Rejection Status Report: Real-time............................ 69
Figure 49: Composition Report: Daily................................................................................ 70
Figure 50: Composition Report: Real-time ........................................................................ 71
Figure 51: CTO Reporting Completion Report: Daily ....................................................... 72
Figure 52: Health IT Details Report: Daily ......................................................................... 73
Figure 53: Practice Reporting Completion Report: Daily.................................................. 74
Figure 54: CTO Payment & Attribution Report: Quarterly ................................................ 76
Figure 55: CTO Roster Report: Daily ................................................................................ 77
Figure 56: CTO Summary Report: Daily ........................................................................... 79
Figure 57: Payment & Attribution Report – Track 1: Quarterly ........................................ 81
Figure 58: Payment & Attribution Report – Track 2: Quarterly ........................................ 83
Figure 59: Practice Roster Report: Daily ........................................................................... 84
Figure 60: Practice Summary Report: Daily ...................................................................... 86
Figure 61: MDPCP Resources........................................................................................... 87
Figure 62: Helpful Links ...................................................................................................... 87
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List of Tables
Table 1: MDPCP Main Menu Features................................................................................ 7
Table 2: MDPCP Page Navigation Features....................................................................... 8
Table 3: Support Points of Contact .................................................................................... 88
Table 4: Record of Changes .............................................................................................. 89
Table 5: Acronyms .............................................................................................................. 90
Table 6: Glossary................................................................................................................ 92
Table 7: Approvals .............................................................................................................. 94
CMS XLC Introduction
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1. Introduction
The State of Maryland received a five-year performance period approval from the Centers for Medicare & Medicaid Services (CMS) in 2014 for a new hospital payment model waiver based on global hospital budgets and quality targets called the All-Payer Model (APM).
To date, in Phase I of the APM, Maryland has been successful in achieving reduced hospital costs, reduced hospital-acquired conditions, and reduced readmissions. While hospital costs have been decreasing in Maryland, future total healthcare cost savings will need to be realized by aligning and integrating both the hospital and non-hospital Providers in a coordinated system of care. The interplay between the need for decreases in preventable hospital use and non-hospital use trends is important to understand and manage, particularly as Maryland moves to the second term of the APM, slated to begin in January 2019.
The Maryland Total Cost of Care (TCOC) Model includes three programs: Hospital Payment Program, Care Redesign Program (CRP), and the Maryland Primary Care Program (MDPCP) . This user manual applies to MDPCP. MDPCP is built upon the foundations of CMS’s Comprehensive Primary Care Plus (CPC+) Model, which was designed to support practices along the continuum of transformation to deliver better care to patients and promote smarter spending. MDPCP is both a care delivery and payment redesign model. Similar to CPC+, there will be two tracks for practices to choose that involve different care delivery requirements and payment options. As in CPC+, Maryland will allow practices to apply for one of two program tracks, with increasing payment and care redesign expectations as Providers move from Track 1 to Track 2. However, in MDPCP, practices will have an opportunity to partner with a Care Transformation Organization (CTO) to fulfill program goals. Practices are not required to have a CTO.
1.1 MDPCP Application Overview
MDPCP serves as an internet-facing web application, which is accessed through the CMS Enterprise Portal (ePortal) Landing Page and Innovation Center (IC) Application. The application will be accessed via the widget called “Maryland Primary Care Program- MDPCP”. MDPCP provides participating practices and CTOs with tools to assist with providing information pertaining to their demographic, practice and organization information and composition , and their reporting of practice and quality milestones, as well as provid ing a platform where participating practices and CTOs can download reports essential to their success in this initiative. The Centers for Medicare & Medicaid for Innovation (CMMI) and contractors supporting the initiative will use MDPCP to monitor the progress and compliance of participating practices and CTOs.
1.2 MDPCP Application Business Functions Overview
CMMI and its contractors distribute implementation guides and educational materials to MDPCP stakeholders about the requirements and timeline with which MDPCP practices must report data to CMS via the MDPCP Application. Any changes to the data maintained in the MDPCP Application is managed through a change control process.
Availability of information in the MDPCP Application is dependent on a user’s role-based access permissions.
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1.3 Intended Audience
The intended audience for this User Manual is the CMMI User. The CMMI User will use this document to understand how to use the MDPCP Application to access information needed for metrics, education, and guidance for stakeholders. The User Guide serves as a reference to the steps needed to execute functionality.
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2. Overview
The MDPCP Application allows for the exchange of data and information between the MDPCP stakeholders. The main features of this application are updating practice information and providing access to resources and information relevant to MDPCP stakeholders.
2.1 Conventions
This document provides screenshots and corresponding narrative to describe how to use the MDPCP Application.
2.2 Cautions & Warnings
When signing in to the application, a warning screen will display with the Terms & Conditions for use of the CMS.gov ePortal, content, and applications. The message should be read thoroughly as it explains the penalties and consequences of misusing the system(s) and its contents. The screens that display in the system may differ slightly from the sample images used in this document.
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3. Getting Started
3.1 Set-up Considerations
3.1.1 General Set-up Considerations
CMS screens are designed to be viewed at a minimum screen resolution of 800 x 600. The minimum system requirements to access the CMS ePortal effectively are:
Windows
1.4GHz Intel® Pentium® 4 or faster processor (or equivalent) for Microsoft® Windows® XP, Windows 7, or Windows 8; 2GHz Pentium 4 or faster processor (or equivalent) for Windows Vista®
Windows 8 (32-bit/64-bit), Windows 7 (32-bit/64-bit), Windows Vista, Windows XP
512MB of RAM (1GB recommended) for Windows XP, Windows 7, or Windows 8; 1GB of RAM (2GB recommended) for Windows Vista
Microsoft Internet Explorer (IE) 11, Mozilla Firefox, Google Chrome
JavaScript and cookies must be enabled
Mac Operating System (OS)
1.83GHz Intel Core™ Duo or faster processor
512MB of RAM (1GB recommended)
Mac OS X 10.7.4, 10.8
Mozilla Firefox, Google Chrome
JavaScript and cookies must be enabled
Linux
Ubuntu 11.04, 12.04; Red Hat Enterprise Linux 6; openSuSE 11.3
Mozilla Firefox
JavaScript and cookies must be enabled
3.1.2 Section 508 Compliance/Accessibility
CMS.gov is committed to making its electronic and information technology (EIT) accessible to people with disabilities. We strive to meet or exceed the requirements of Section 508 of the Rehabilitation Act (29 U.S.C. 794d), as amended in 2017 (82 FR 5790).
If any content or use of any features on this website cannot be accessed due to a disability, please contact our Section 508 Team via email at [email protected].
For more information on CMS.gov Accessibility and Compliance with Section 508, please go to: https://www.cms.gov/About-CMS/Agency-Information/Aboutwebsite/Policiesforaccessibility.html.
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3.2 User Access Considerations
MDPCP stakeholders can access the MDPCP Application through the CMS.gov ePortal. Authorized users have access to modules and functionality based on their assigned role. Security for the MDPCP Application will adhere to the CMS Information Services (IS) Acceptable Risk Safeguards (ARS) guidelines, and the system will comply with the CMS minimum security requirements (CMSR). Security enforcement spans across tiers leveraging CMS infrastructure, which provides network-layer security systems such as firewalls, intrusion detections systems, and link encryptions. The CMS infrastructure security will be maintained for the data throughout the loading process onto the CMS mainframe and throughout the loading process into the MDPCP Application. The CMS mainframe system access is limited to Individuals Authorized for Access to CMS Computer Systems (IACS).
3.3 Accessing the System
The following subsections provide instructions on how to gain access to the MDPCP Application.
3.3.1 New Enterprise Identity Management (EIDM) User Registration
This section provides information on how to register and create a user ID and password through the EIDM process to obtain access for the Innovation Center (IC) Application by accessing the CMS ePortal at https://portal.cms.gov/.
For step-by-step instructions, please refer to Section 4 – Registering for CMS Enterprise Portal in the CMS Enterprise Portal User Manual.
3.3.2 Requesting IC Application Role
In order to request the Innovation Center Privileged User role, you must successfully complete the Remote Identity Proofing (RIDP) process and register your Multi-Factor Authentication (MFA) device.
For step-by-step instructions, please refer to Section 10.3 – Requesting a Role in the CMS Enterprise Portal User Manual.
Note: If you fail the RIDP process, please contact the Help Desk by phone at 1-844-711-2664, Option 7, or by email at [email protected] for assistance.
3.3.3 Requesting MDPCP Application Role
In order to request the Maryland Primary Care – MDPCP – MDPCP_CMMI_USER role, you will need to log out and then login using your credentials and security code.
For step-by-step instructions, please refer to Section 4.1 – Request Access in the Innovation Center (IC) User Manual (see attachment below).
CICDIMICR14UserM
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3.3.4 Accessing the MDPCP Application
In order to access the MDPCP Application, you must follow the step-by-step instructions listed below.
1. Access https://portal.cms.gov/.
2. Login using your User ID, Password, and Security Code.
3. Select Innovation Center under the menu items on the My Portal Home page.
4. Select Application Console from the Innovation Center drop-down list.
5. Select the Maryland Primary Care - MDPCP link on the IC Home tab.
3.4 System Organization & Navigation
This section provides detailed information on how to navigate within the MDPCP Application and use common features.
3.4.1 Main Menu
This subsection describes the main navigation features available in the MDPCP Application.
Figure 1: MDPCP Main Menu
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Table 1: MDPCP Main Menu Features
Feature Name Description
Top Navigation Bar/Secondary Navigation Bar
Allows you to access one of the following modules with the associated submodules (tabs and subtabs):
Home (default) o Practice Home
o CTO Home
My Practice Info o Demographic Information
o Practice Information
o Composition
o Request History
o Documents
Practice Reporting
o Dashboard
o Function 1
o Function 2
o Function 3
o Function 4
o Function 5
o General
o CTO Reporting
CTO Info o Demographic Information
o CTO Information
o Payment & Attribution
o Documents
Payment & Attribution o Payment & Attribution
Reports o Status Reports
o Other Reports
Resources o MDPCP Resources
Left Navigation Menu Allows you to access the pages within the selected submodules (subtabs).
Yr/Qtr Drop-down Allows you to select the applicable Program Year (Yr) and Quarter (Qtr).
Track Drop-down Allows you to select Track 1 or Track 2.
Change Display Button Allows you to change the display based on the selected Yr/Qtr and Track drop-down values.
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Feature Name Description
Breadcrumb Navigation Shows your current location within the application and provides links to the previously accessed pages.
Practice Drop-down Allows you to select a Practice ID.
CTO Drop-down Allows you to select a CTO ID.
Switch Practice Button Allows you to change the display based on the selected Practice drop-down value.
Switch CTO Button Allows you to change the display based on the selected CTO drop-down value.
Print/Print All Icon Allows you to print saved content for related pages in Portable Document Format (PDF).
Help Icon Displays detailed information relevant to the current page.
Print Icon Allows you to print saved content for related pages in Portable Document Format (PDF).
3.4.2 Page Navigation
This subsection describes the page navigation features available in the MDPCP Application.
Table 2: MDPCP Page Navigation Features
Feature Name Description
Update Information Hyperlink
Allows you to edit information on a page.
Show More Hyperlink Expands a collapsed section(s).
Hide Hyperlink Collapses an expanded section(s).
Show Entries Drop-down Allows you to select the number of entries shown in the table.
Search Text Field Allows you to enter desired search criteria.
Search Button Allows you to search the content within a table.
Table Sort Icon Sorts table information in ascending or descending order for a specific column.
Download Icon Allows you to download the corresponding file.
First Hyperlink Navigates to the first page of a table.
Previous Hyperlink Navigates to the previous page of a table.
Next Hyperlink Navigates to the next page of a table.
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Feature Name Description
Last Hyperlink Navigates to the last page of a table.
Save Button Allows you to save newly added information to the content of a page.
Clear Button Clears information entered in editable fields, the file selected for upload, or remarks.
Cancel Button Allows you to cancel the request to update existing information in the application.
Export Button Exports table content in Excel format.
Previous Button Navigates to the previous page
Next Button Navigates to the next page
3.5 Exiting the System
If you want to log out of the portal, select the Log Out hyperlink in the upper right portion of the page.
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4. Using the System
The following subsections provide detailed, step-by-step instructions on how to use the various functions or features of the MDPCP Application.
4.1 Home
The Home tab provides access to the Practice Home and CTO Home subtabs. The pages accessed via these subtabs are described in the following section.
4.1.1 Maryland Primary Care Program (MDPCP) Practice Home
The Maryland Primary Care Program (MDPCP) Practice Home page is the default landing page and is accessed via the Practice Home subtab. The Maryland Primary Care Program (MDPCP) Practice Home displays information for practices, including the Practice ID and Practice Name, Practice Reporting Completion Status, and CTO Reporting Completion Status within the My Practice(s) Summary table.
If you want to navigate to a Practice’s Demographic Information page:
1. Select the desired Practice ID hyperlink.
2. The system navigates to the Demographic Information page.
If you want to navigate to the Practice Reporting Overview page:
1. Select the progress bar from the Practice Reporting Completion Status.
2. The system navigates to the Overview page.
If you want to navigate to the CTO Reporting page for a practice that is associated to a CTO:
1. Select the progress bar from the CTO Reporting Completion Status.
2. The system navigates to the CTO Reporting page.
Figure 2: MDPCP Practice Home – My Practice(s) Summary
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4.1.2 Maryland Primary Care Program (MDPCP) CTO Home
The Maryland Primary Care Program (MDPCP) CTO Home page is accessed via the CTO Home subtab and displays information for CTOs, including the CTO ID and CTO Name, within the My CTO(s) Summary table.
If you want to navigate to a CTO’s Demographic Information page:
1. Select the desired CTO ID hyperlink. 2. The system navigates to the Demographic Information page.
Figure 3: MDPCP CTO Home – My CTO(s) Summary
4.2 My Practice Info
The My Practice Info tab provides access to the Demographic Information, Practice Information, Composition, Request History, and Documents pages for a practice. These pages are detailed in the following sections.
4.2.1 Demographic Information
The Demographic Information page allows you to view the selected practice’s demographic, organization contact, primary contact, secondary contact, clinical leader contact, health information technology (HIT) contact, and CTO contact information.
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Figure 4: Demographic Information
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4.2.2 Practice Information
The Practice Information page allows you to view a practice’s HIT details and organization details for the selected practice.
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Figure 5: Practice Information
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4.2.3 Composition
The Composition page allows you to view the practice composition, practitioner roster, and staff roster for a practice.
If you want to export a practitioner roster or staff roster information:
1. Select Export.
2. Open or Save the T#MD####_PractitionerRoster or T#MD####_StaffRoster in Excel file format.
Note: The file should reflect the content from the respective roster’s table.
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Figure 6: Composition
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Practitioner Roster
The Practitioner Roster displays the details of each practitioner associated with a practice, including the Practitioner Name, Primary Specialty, Individual National Provider Identifier (NPI), Practitioner Status, Employment Status, Estimated Weekly Hours, and Date Withdrawn.
If you want to view information for a practitioner in Active or Withdrawn status:
1. Select the Practitioner Name hyperlink from the table.
2. The system navigates to the Practitioner Information page. Refer to Section 4.2.3.1 for actions you can execute on this page.
If you want to view information for a practitioner in Pending Add or Incomplete Add status:
1. Select the Practitioner Name hyperlink from the table.
2. The system navigates to the Add New Practitioner – Request ID ##### page. Refer to Section 4.2.4.1 for actions you can execute on this page.
If you want to view information for a practitioner in Pending Withdraw or Incomplete Withdraw status:
1. Select the Practitioner Name hyperlink from the table.
2. The system navigates to the Withdraw Practitioner – Request ID ##### page. Refer to Section 4.2.4.2 for more information on the Withdraw Practitioner Request page.
Figure 7: Practitioner Roster
Staff Roster
The Staff Roster displays the details of the associated staff, including the staff name, title/position, if the individual works in direct patient care, employment status, and estimated weekly hours.
If you would like to view the Staff Information page for a staff member:
1. Select the Staff Name hyperlink from the table.
2. The system navigates to the Staff Information page. Refer to Section 4.2.3.2 for more information on the Staff Information page.
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Figure 8: Staff Roster
4.2.3.1 Practitioner Information
The Practitioner Information page allows you to view the details for an Active or Withdrawn Practitioner.
Figure 9: Practitioner Information
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4.2.3.2 Staff Information
The Staff Information page allows you to view the details of the staff.
Figure 10: Staff Information
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4.2.4 Request History
The Practice Request History page allows you to view the following types of requests by selecting the Request ID from the Request History table:
Add New Practitioner
Add New Staff
Delete Staff
Request for Extension or Correction
Taxpayer Identification Number (TIN) Change
Withdraw Practitioner
If you want to export the Practice Request History information:
1. Select Export button.
2. Open/Save the T#MD####_PracticeRequestHistory_YYYY_MM_DD in Excel file format.
Note: The file should reflect the content from the Request History table.
Figure 11: Practice Request History
4.2.4.1 Add New Practitioner Request
The Add New Practitioner – Request ID ##### page allows you to view the details of a practice’s submitted request to add a new practitioner to their practice.
The Add New Practitioner Request may be in one of the following statuses:
Pending – Awaiting approval from MDPCP Support.
Incomplete – Awaiting updated request information from the practice.
Approved – Approved by MDPCP Support.
Rejected – Rejected by MDPCP Support.
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Figure 12: Add New Practitioner Request
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4.2.4.2 Withdraw Practitioner Request
The Withdraw Practitioner – Request ID ##### page allows you to view the details of a practice’s submitted request to withdraw an active practitioner from their practice .
The Withdraw Practitioner Request may be in one of the following statuses:
Pending – Awaiting approval from MDPCP Support.
Incomplete – Awaiting updated request information from the practice.
Approved – Approved by MDPCP Support.
Rejected – Rejected by MDPCP Support.
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Figure 13: Withdraw Practitioner Request
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4.2.4.3 Add New Staff Request
The Add New Staff - Request ID ##### page allows you to view the details of a practice’s newly added staff to a practice. The request status for the Add New Staff Request is always Complete as no approval from MDPCP Support is required.
Figure 14: Add New Staff Request
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4.2.4.4 Delete Staff Request
The Delete Staff Request ID - ##### page allows you to view the details for deleted staff from a practice.
The Delete Staff Request always displays in Completed status. You are able to view the request details, but cannot make any changes.
Figure 15: Delete Staff Request
4.2.4.5 TIN Change Request
The TIN Change – Request ID ##### page allows you to view the details of a practice’s submitted TIN Change Request.
The TIN Change Request may be in the following statuses:
Pending – Awaiting approval from MDPCP Support
Incomplete – Awaiting updated request information from the Practice
Approved – Approved by MDPCP Support
Rejected – Rejected by MDPCP Support
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Figure 16: TIN Change Request
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4.2.4.6 Request for Extension or Correction
The Request for Extension or Correction page allow you to view the details of a practice’s Request for Extension or Correction for a practice.
The Request for Extension or Correction Request may be in the following statuses:
Pending – Awaiting approval from MDPCP Support
Incomplete – Awaiting updated request information from the practice
Approved – Approved by MDPCP Support
Rejected – Rejected by MDPCP Support
Figure 17: Request for Extension or Correction
4.2.5 Documents
The Practice Documents page provides access to the documents for a practice within Track 1 or Track 2. The following documents are available for download:
Letter of support from Clinical Leadership
Letter of support from Parent of Owner organization
Letter certifying connectivity to Health Information Exchange (HIE)
Participation Agreement (signed)
The Practice Documentation table displays the File Name, File Type, Date Added, and the option to download.
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Figure 18: Practice Documents
4.3 Practice Reporting
The Practice Reporting tab provides access to the Dashboard, Overview, Function , General, and CTO Reporting pages.
4.3.1 Dashboard – Practice Reporting
The Dashboard page displays the Practice Status Counts by Function and Practice Status Details information for Practice Reporting.
If you want to navigate to the Dashboard for Practice Reporting:
1. Select the Practice Reporting from the Reporting Type dropdown.
2. Select the Apply button.
3. The system will navigate to the Dashboard page for Practice Reporting.
If you select a value from the Practice Status Counts by Function table, the Practice Status
Details table displays the practices with the selected status for the related module. Alternatively,
you can select the desired Practice Reporting Type, Status, and Track from the drop-downs and select Apply to update the content in the table.
Note: By default the Reporting Type drop-down is set to Practice Reporting.
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Figure 19: Practice Reporting Dashboard
4.3.2 Dashboard – CTO Reporting
The Dashboard page displays the CTO Status Counts and CTO Status Details information for CTO Reporting.
If you want to navigate to the Dashboard for CTO Reporting:
1. Select the CTO Reporting from the Reporting Type drop-down.
2. Select the Apply button.
3. The system will navigate to the Dashboard page for CTO Reporting.
If you select a value from the CTO Status Counts table, the CTO Status Details table displays
the CTOs with the selected status. Alternatively, you can select the desired CTO Status Type from the drop-down and select Apply to update the content in the table.
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Figure 20: CTO Reporting Dashboard
4.3.3 Overview
The Overview page displays the Practice Reporting Progress Summary information for the selected practice. This page contains a table for each of the five Functions and General Information, which displays all of the pages contained in the sub-module and their respective completion status. You may also initiate a Request for Extension or Correction from this page.
If you want to navigate to one of the Function or General pages:
1. Select the page name from the Practice Reporting Progress Summary.
2. The system will navigate to the selected page.
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Figure 21: Practice Reporting Overview
4.3.4 Function 1
Function 1 allows a practice to report information pertaining to the type of access and continuity of care provided by the practice.
4.3.4.1 Empanelment
The Empanelment page allows the practice to identify how it empanels beneficiaries, count of panels, count of empaneled attributed beneficiaries, count of attributed beneficiaries , and the active beneficiary lookback period. In addition, this page allows the practice to give details of assistance provided by a state practice coach, an outside contractor, a consultant, or a CTO. This page is view-only and applicable for all quarters.
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Figure 22: Empanelment
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4.3.4.2 24/7 Access
The 24/7 Access page allows a practice to identify access to its Electronic Health Record (EHR) and if a practitioner or care team member provides 24/7 coverage. In addition, this page allows the practice to give details of assistance provided by a state practice coach, an outside contractor, a consultant, or CTO. This page is view-only and applicable for Quarter 1 and Quarter 3.
Figure 23: 24/7 Access
4.3.4.3 Continuity of Care
The Continuity of Care page allows a practice to identify how it tracks continuity of care and the scheduling strategies used. In addition, this page allows the practice to give details of
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assistance provided by a state practice coach, an outside contractor, a consultant, or a CTO. This page is view-only and applicable for Quarter 1 and Quarter 3.
Figure 24: Continuity of Care
4.3.4.4 Enhanced Access and Communication
The Enhanced Access and Communication page allows the practice to report how often it is able to provide access and communication services to beneficiaries. The practice is also able to identify the types of alternative approaches to care it provided in the last quarter, the amount of beneficiaries who received alternative care, and who provided the alternative care. Additionally, Track 2 practices may also provide information on the ways they used MDPCP Payments to increase non-traditional office visits. In addition, this page allows the practice to give details of assistance provided by a state practice coach, an outside contractor, a consultant, or a CTO. This page is view-only and applicable for all quarters.
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Figure 25: Enhanced Access and Communication
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4.3.5 Function 2
Function 2 allows a practice to report information pertaining to care management for high-risk, high-need beneficiaries who receive care at their practice.
4.3.5.1 Risk Stratification
The Risk Stratification page allows the practice to identify if it risk stratifies its empaneled beneficiaries, the types of data-driven algorithm and clinical intuition factors used for risk stratification, what prompts reassessment of a beneficiary’s risk stratification, and if risk stratification is integrated with the electronic health record (EHR). In addition, this page allows the practice to give details of assistance provided by a state practice coach, an outside contractor, a consultant, or a CTO. This page is view-only and applicable for Quarter 1 and Quarter 3.
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Figure 26: Risk Stratification
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4.3.5.2 Identifying Beneficiaries for Care Management
The Identifying Beneficiaries for Care Management page allows the practice to categorize how its beneficiary population is risk stratified and report how the practice identifies beneficiaries for episodic care management. In addition, this page allows the practice to give details of assistance provided by a state practice coach, an outside contractor, a consultant, or a CTO. This page is view-only and applicable for all quarters.
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Figure 27: Identifying Beneficiaries for Care Management
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4.3.5.3 Care Management Staffing
The Care Management Staffing page allows the practice to identify the clinicians or staff primarily responsible for care management and coordination activities. In addition, this page allows the practice to give details of assistance provided by a state practice coach, an outside contractor, a consultant, or a CTO. This page is view-only and applicable for Quarter 1 and Quarter 3.
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Figure 28: Care Management Staffing
4.3.5.4 Identifying Hospitals and Emergency Departments (EDs) Your Beneficiaries Use
The Identifying Hospitals and EDs page allows the practice to identify up to three of the top hospitals and emergency departments used most by its beneficiaries over the current quarter. If available, the practice’s responses from the previous quarter are carried over to the current quarter. In addition, this page allows the practice to give details of assistance provided by a
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state practice coach, an outside contractor, a consultant, or a CTO. This page is applicable for all quarters.
Figure 29: Identifying Hospitals and EDs Your Beneficiaries Use
4.3.5.5 Beneficiary Follow-up – Hospital and ED Discharge
The Beneficiary Follow-Up for Hospital and ED Discharge page allows a practice to identify the count of beneficiaries discharged from the ED and/or hospital during the current quarter. The practice is required to provide information on beneficiaries who received follow-up contact within one week after discharge from the ED and within two business days after discharge from the hospital. In addition, this page allows the practice to give details of assistance provided by a state practice coach, an outside contractor, a consultant, or a CTO. This page is applicable for all quarters.
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Figure 30: Beneficiary Follow-Up - Hospital and ED Discharge
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4.3.6 Function 3
Function 3 allows a practice to report information pertaining to comprehensiveness and coordination at the practice.
4.3.6.1 Coordinated Referral Management with Specialists
The Coordinated Referral Management with Specialists page allows the practice to identify the formal coordinated referral management agreements made with high-cost specialists and health care organizations In addition, this page allows the practice to give details of assistance provided by a state practice coach, an outside contractor, a consultant, or a CTO This page is view-only and applicable for all quarters.
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Figure 31: Coordinated Referral Management with Specialists
4.3.6.2 Identifying and Communicating with Hospitals and EDs Your Beneficiaries Use
The Identifying and Communicating with Hospitals and EDs Your Beneficiaries Use page allows the practice to provide information regarding coordination and communication with hospitals and emergency department where its patients seek care. In addition, this page allows the practice to identify details of assistance provided by a state practice coach, an outside
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contractor, a consultant, or a CTO. This page is view-only and applicable for Quarter 1 and Quarter 3.
Figure 32: Identifying and Communicating with Hospitals and EDs Your Beneficiaries Use
4.3.6.3 Behavioral Health Integration
The Behavioral Heath Integration page allows the practice to provide information on its primary behavioral health strategy and identify the mental health conditions targeted by that strategy and the types of targeted tactics available to beneficiaries. In addition, this page allows the practice to give details of assistance provided by a state practice coach, an outside contractor, a consultant, or a CTO. This page is view-only and applicable for Quarter 1 and Quarter 3.
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Figure 33: Behavioral Health Integration
4.3.6.4 Linkages with Social Services
The Linkages with Social Services page allows the practice to report if it routinely screens its beneficiaries for unmet social needs, what type of screening tools are used, and if those tools are integrated with the EHR. The practice must also indicate which social needs it has prioritized. In addition, this page allows the practice to identify details of assistance provided by a state practice coach, an outside contractor, a consultant, or a CTO. This page is view-only and applicable for Quarter 1 and Quarter 3.
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Figure 34: Linkages with Social Services
4.3.6.5 Coordinating with Social Service Resources
The Coordinating with Social Service Resources page allows the practice to specify how frequently its inventory of social service resources is updated, if the inventory is integrated with the EHR, and with which resources it has established relationships to address prioritized areas. In addition, this page allows the practice to identify details of assistance provided by a state
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practice coach, an outside contractor, a consultant, or a CTO. This page is view-only and applicable for Quarter 1 and Quarter 3.
Figure 35: Coordinating with Social Service Resources
4.3.7 Function 4
Function 4 allows a practice to report information pertaining to beneficiary and caregiver engagement at the practice.
4.3.7.1 Engaging Beneficiaries and Caregivers in Your Practice
The Engaging Beneficiaries and Caregivers in Your Practice page allows the practice to report how frequently it engages beneficiaries and caregivers in activities and provides information to its Patient and Family Advisory Council (PFAC). In addition, this page allows the practice to give details of assistance provided by a state practice coach, an outside contractor, a consultant, or a CTO. This page is view-only and applicable for all quarters.
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Figure 36: Engaging Beneficiaries and Caregivers in Your Practice
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4.3.7.2 Self-Management Support for Selected Conditions
The Self-Management Support for Selected Conditions page allows the practice to select conditions for which it provides self-management support, identify and how it selects beneficiaries for self-management support, and report how frequently it implements aspects of self-management support. In addition, this page allows the practice to give details of assistance provided by a state practice coach, an outside contractor, a consultant, or a CTO. This page is view-only and applicable for all quarters.
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Figure 37: Self-Management Support for Selected Conditions
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4.3.8 Function 5
Function 5 allows a practice to report information pertaining to planned care and population health at the practice.
4.3.8.1 Team-Based Care
The Team-Based Care page allows the practice to identify how often care teams have structured huddles and scheduled meetings, how often clinical activities are delegated to members of the care team, and how often care teams review quality improvement data. In addition, this page allows the practice to give details of assistance provided by a state practice coach, an outside contractor, a consultant, or a CTO. This page is view-only and applicable for Quarter 1 and Quarter 3.
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Figure 38: Team-Based Care
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4.3.9 General
The General sub-module allows a practice to report general information.
4.3.9.1 General Information
The General Information page allows the practice to rate how useful it finds each MDPCP communication type and estimate the number of hours spent collecting and inputting care delivery data. The practice is required to list the primary point of contact (PPOC) for completing the Practice Reporting and certify the accuracy of the information provided. This page is view-only and applicable for all quarters.
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Figure 39: General Information
4.3.10 CTO Reporting
The CTO Reporting sub-module allows you to view the CTO’s verification of assistance provided to a partner practice for each Function page.
4.3.10.1 CTO Reporting
The CTO Reporting page allows you to view the CTO Information, Practice Assistance Verification, CTO Information Verification, Reporting Point of Contact, and Confirmation. This page is applicable for all quarters.
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Figure 40: CTO Reporting
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4.4 Payment & Attribution
The Payment & Attribution tab provides access to the Payment & Attribution subtab. The Payment & Attribution subtab provides access to the Practice Payment & Attribution page and Beneficiary Attribution Report.
4.4.1 Practice Payment & Attribution
The Practice Payment & Attribution page displays the selected practice’s payment information. In addition, this page allows you to access the Beneficiary Attribution Report, if available. This page is read-only and maintained quarterly.
If you want to download a Beneficiary Attribution Report:
1. Select the corresponding Download icon for the desired report.
2. Open or save the T#MD####_BeneAttrRpt_CY####_Q#_YYYYMMDD file in Excel file format.
If you want to view the signed Health Insurance Portability and Accountability Act (HIPAA) agreement for a practice’s Beneficiary Attribution Report:
1. Select the hyperlink in the HIPAA Submission column of the table.
2. The system navigates to the completed Request for Personally Identifiable Information for Attributed Beneficiaries page, which is displayed as read-only (see Section 4.4.1.1).
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Figure 41: Practice Payment & Attribution
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4.4.1.1 Request for Personally Identifiable Information (PII) for Attributed Beneficiaries
The Request for Personally Identifiable Information for Attributed Beneficiaries page allows practice users to request access to a Beneficiary Report by acknowledging the HIPAA agreement.
If you want to view a signed HIPAA agreement:
1. Select the hyperlink under the HIPAA Submission.
2. View the details of the signed HIPAA Submission form.
Figure 42: Request for Personally Identifiable Information for Attributed Beneficiaries
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4.5 CTO Info
The CTO Info tab provides access to the Demographic Information, CTO Information, Payment & Attribution, and Documents subtabs for a CTO. The pages accessed via these subtabs are described in the following sections.
4.5.1 Demographic Information
The Demographic Information page allows you to view the selected CTO’s demographic, organization contact, secondary contact, clinical leader contact, and HIT contact.
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Figure 43: Demographic Information
4.5.2 CTO Information
The CTO Information page allows you to view and maintain a CTO’s HIT and/or organization details for the selected CTO.
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Figure 44: CTO Information
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4.5.3 Payment & Attribution
The Payment & Attribution page allows you to view your CTO’s payment information. This page is read-only and maintained quarterly.
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Figure 45: CTO Payment & Attribution
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4.5.4 CTO Documents
The CTO Documents page provides access to the documents for a CTO. The following documents are available for download:
Letter of support from clinical leadership
Letter of support from practice
Participation agreement (signed)
The CTO Documentation table displays the File Name, File Type, Date Added, and the option to download.
Figure 46: CTO Documents
4.6 Reports
The Reports tab provides access to the available reports for download in Excel format.
If you want to view or save a scheduled report:
1. Select the desired status report type from the left navigation menu.
2. Select the corresponding Download icon for the desired report.
3. Open or save the downloaded Excel file.
If you want to generate a real-time report:
1. Enter the Practice ID.
2. Select the desired status(es).
3. Select Generate Report.
4. Open or save the Excel file.
4.6.1 Status Reports
The Status Reports submodule allows you to download the following:
Composition Approval/Rejection Report: Daily
Composition Approval/Rejection Report: Real-time
Composition Report: Daily
Composition Report: Real-time
CTO Reporting Completion Report: Daily
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Health IT Details Report: Daily
Practice Reporting Completion Report: Daily
To download your report, use the left navigation menu to select the type of report you want to view.
4.6.1.1 Composition Approval/Rejection Report: Daily
The Composition Approval/Rejection Report: Daily page captures composition changes pertaining to Add New Practitioner and Withdraw Practitioner requests for all practices on a daily basis.
The file naming convention for the report is as follows:
YYYY-MM-DD_HH-MM_CompositionApprovalRejectionReportDaily.xlsx
The report displays the following information:
Practice ID
Practice Name
CTO ID
CTO Name
Request ID
Request Type
Request Date
Request Status
Practitioner Name
Individual National Provider ID (NPI)
Effective Date of Joining Practice
Resident or Intern
Practitioner Type
Primary Specialty
Employment Status
Estimated Weekly Hours
MD Board of Physician License Number
Date Withdrawn
Last Updated
Last Comments
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Figure 47: Composition Approval/Rejection Report: Daily
4.6.1.2 Composition Approval/Rejection Report: Real-time
The Composition Approval/Rejection Report: Real-time page captures composition changes pertaining to Add New Practitioner and Withdraw Practitioner requests for selected status(es) for a practice at the time you generate the report.
The file naming convention for the report is as follows:
T#MD####_CompositionApprovalRejectionReportRealtime_YYYY-MM-DD.xlsx
The report displays the following information:
Practice ID
Practice Name
CTO ID
CTO Name
Request ID
Request Type
Request Date
Request Status
Practitioner Name
Individual National Provider ID (NPI)
Effective Date of Joining Practice
Resident or Intern
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Practitioner Type
Primary Specialty
Employment Status
Estimated Weekly Hours
MD Board of Physician License Number
Date Withdrawn
Last Updated
Last Comments
Figure 48: Composition Approval/Rejection Status Report: Real-time
4.6.1.3 Composition Report: Daily
The Composition Report: Daily page captures composition details of practitioners and staff members for all practices on a daily basis.
The file naming convention for the report is as follows:
YYYY-MM-DD_HH-MM_CompositionReportDaily.xlsx
The report displays the following information:
Practice ID
Practice Name
CTO ID
CTO Name
Practitioner Name
Practitioner Status
Individual National Provider ID (NPI)
Effective Date of Joining Practice
Resident or Intern
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Practitioner Type
Primary Specialty
Employment Status
Estimated Weekly Hours
MD Board of Physician License Number
Date Withdrawn
Figure 49: Composition Report: Daily
4.6.1.4 Composition Report: Real-time
The Composition Report: Real-time page captures composition details of practitioners for a selected practice at the time you generate the report.
The file naming convention for the report is as follows:
T#MD####_CompositionReportRealtime_YYYY-MM-DD.xlsx
The report displays the following information:
Practice ID
Practice Name
CTO ID
CTO Name
Practitioner Name
Practitioner Status
Individual National Provider ID (NPI)
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Effective Date of Joining Practice
Resident or Intern
Practitioner Type
Primary Specialty
Employment Status
Estimated Weekly Hours
MD Board of Physician License Number
Date Withdrawn
Figure 50: Composition Report: Real-time
4.6.1.5 CTO Reporting Completion Report: Daily
The CTO Reporting Completion Report: Daily page captures CTO Reporting completion details of CTOs for a selected practice, at the time you generate the repor t.
The file naming convention of the report is as follows:
T#MD####_CTOReportingCompletionReportDaily_YYYY-MM-DD.xlsx
The report displays the following information:
CTO ID
Practice ID
CTO Name
Practice Name
Track ID
Are you the primary contact for CTO reporting? (Yes/No)
Reporting Contact - First Name
Reporting Contact - Last Name
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Reporting Contact - Title
Reporting Contact - Email
Reporting Contact - Telephone Number
Reporting Contact - Ext. (Optional)
First Name
Last Name
Position with MDPCP CTO Site
Date and Time Stamp
Status
Figure 51: CTO Reporting Completion Report: Daily
4.6.1.6 Health IT Details Report: Daily
The Health IT Details Report: Daily page captures Health IT completion details for a selected practice, at the time you generate the report.
The file naming convention of the report is as follows:
T#MD####_HealthITDetailsReportDaily_YYYY-MM-DD.xlsx
The report displays the following information:
Practice ID
Practice Name
CTO ID
CTO Name
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Vendor Name
Product Name
Product Version
CMS EHR Certification ID
Will your practice be using certified EHR technology by January 1, 2019?
Figure 52: Health IT Details Report: Daily
4.6.1.7 Practice Reporting Completion Report: Daily
The Practice Reporting Completion Report: Daily page captures Practice Reporting completion details for a selected practice, at the time you generate the report.
The file naming convention of the report is as follows:
T#MD####_PracticeReportingCompletionReportDaily_YYYY-MM-DD.xlsx
The report displays the following information:
Practice ID
Practice Name
CTO ID
CTO Name
Track ID
Function 1
Function 2
Function 3
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Function 4
Function 5
General Questions (Yes/No)
Are you the primary contact for Practice reporting? (Yes/No)
Reporting Contact - First Name
Reporting Contact - Last Name
Reporting Contact - Title
Reporting Contact - Email
Reporting Contact - Telephone Number
Reporting Contact - Ext. (Optional)
First Name
Last Name
Position with MDPCP Practice Site
Date and Time Stamp
Status
Figure 53: Practice Reporting Completion Report: Daily
4.6.2 Other Reports
The Other Reports submodule allows you to download the following:
CTO Payment & Attribution Report: Quarterly
CTO Roster Report: Daily
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CTO Summary Report: Daily
Payment & Attribution Report – Track 1: Quarterly
Payment & Attribution Report – Track 2: Quarterly
Practice Roster Report: Daily
Practice Summary Report: Daily
To download your report, use the left navigation menu to select the type of report you want to view.
4.6.2.1 CTO Payment & Attribution Report: Quarterly
The CTO Payment & Attribution Report: Quarterly page provides the payment and attribution details for CTOs.
The file naming convention for the report is as follows:
YYYY-MM-DD_HH-MM_PY####_Q#_CTOPaymentAndAttributionReportQuarterly.xlsx
The report displays the following information:
CTO ID
CTO Name
Total Amount Paid this Quarter
Care Management Fee (CMF) Paid this Quarter
Performance Based Incentive Payment (PBIP) Paid this Quarter
Beneficiaries Attributed this Quarter
Low Risk Benes
Low Risk Range
Medium-Low Risk Benes
Medium-Low Risk Range
Medium-High Risk Benes
Medium-High Risk Range
High Risk Benes
High Risk Range
Complex Risk Benes
Complex Risk Range
CMF Amount Before Debit
CMF Debit Amount
Total CMF
Total PBIP
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Adjustments
Total Amount Calculated
Cumulative CMF Paid (since 01/01/2019)
Cumulative PBIP Paid (since 01/01/2019)
Cumulative Adjustments (since 01/01/2019)
Cumulative Total Paid (since 01/01/2019)
Cumulative Beneficiaries Attributed (since 01/01/2019)
Figure 54: CTO Payment & Attribution Report: Quarterly
4.6.2.2 CTO Roster Report: Daily
The CTO Roster Report: Daily page captures changes made to CTO Demographic Information and CTO Information for all CTOs, including the previous and current values for the updated fields.
The file naming convention for the report is as follows:
YYYY-MM-DD_HH-MM_CTORosterReportDaily.xls
The report displays the following information:
CTO ID
CTO Name
Impacted Data Field
Previous Value
Current Value
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Date and Time Stamp
Note: The CTO Roster Report is scheduled daily, and it will be generated only if the user made updates to the CTO Demographic Information and/or CTO Information pages within the last 30 days.
Figure 55: CTO Roster Report: Daily
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4.6.2.3 CTO Summary Report: Daily
The CTO Summary Report: Daily page provides a summary of the CTO Demographic Information and CTO Information for all CTOs.
The file naming convention for the report is as follows:
YYYY-MM-DD_HH-MM_CTOSummaryReportDaily.xlsx
The report displays the following information:
CTO ID
CTO Status
CTO Site Name
CTO DBA Name
Street Address 1
Street Address 2
City
State
Zip Code
Phone Number
Ext.
Organization Name
CTO Organization Contact Name
CTO Organization Contact Phone Number
CTO Organization Contact Ext.
CTO Organization Contact Email
HIT Contact Name
HIT Contact Phone Number
HIT Contact Ext.
HIT Contact Email
TIN
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Figure 56: CTO Summary Report: Daily
4.6.2.4 Payment & Attribution Report – Track 1: Quarterly
The Payment & Attribution Report – Track 1: Quarterly page captures the payment and attribution details for Track 1 practices.
The file naming convention for the report is as follows:
YYYY-MM-DD_HH-MM_PY####_Q#_PaymentAndAttributionReportTrack1Quarterly.xlsx
The report displays the following information:
Practice ID
Practice Name
CTO ID
CTO Name
Total Amount Paid this Quarter
Care Management Fee (CMF) Paid this Quarter
Performance Based Incentive Payment (PBIP) Paid this Quarter
Beneficiaries Attributed this Quarter
Low Risk Benes
Low Risk Range
Medium-Low Risk Benes
Medium-Low Risk Range
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Medium-High Risk Benes
Medium-High Risk Range
High Risk Benes
High Risk Range
Complex Risk Benes
Complex Risk Range
CMF Amount Before Debit
CMF Debit Amount
Total CMF
Total PBIP
Adjustments
Total Amount Calculated
Cumulative Beneficiaries Attributed (since 01/01/2019)
Cumulative CMF Paid (since 01/01/2019)
Cumulative PBIP Paid (since 01/01/2019)
Cumulative Adjustments (since 01/01/2019)
Cumulative Total Paid (since 01/01/2019)
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Figure 57: Payment & Attribution Report – Track 1: Quarterly
4.6.2.5 Payment & Attribution Report – Track 2: Quarterly
The Payment & Attribution Report – Track 2: Quarterly page provides the payment and attribution details for Track 2 practices.
The file naming convention for the report is as follows:
YYYY-MM-DD_HH-MM_PY####_Q#_PaymentAndAttributionReportTrack2Quarterly.xlsx
The report displays the following information:
Practice ID
Practice Name
CTO ID
CTO Name
Total Amount Paid this Quarter
Care Management Fee (CMF) Paid this Quarter
Comprehensive Primary Care Payment (CPCP) Paid this Quarter
Performance Based Incentive Payment (PBIP) Paid this Quarter
Beneficiaries Attributed this Quarter
Low Risk Benes
Low Risk Range
Medium-Low Risk Benes
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Medium-Low Risk Range
Medium-High Risk Benes
Medium-High Risk Range
High Risk Benes
High Risk Range
Complex Risk Benes
Complex Risk Range
CMF Amount Before Debit
CMF Debit Amount
Total CMF
CPCP %
CPCP Amount Before Debit
CPCP Debit Amount
Total CPCP
Total PBIP
Adjustments
Total Amount Calculated
Cumulative CMF Paid (since 01/01/2019)
Cumulative CPCP Paid (since 01/01/2019)
Cumulative PBIP Paid (since 01/01/2019)
Cumulative Adjustments (since 01/01/2019)
Cumulative Total Paid (since 01/01/2019)
Cumulative Beneficiaries Attributed (since 01/01/2019)
CMS XLC Using the Sy stem
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Figure 58: Payment & Attribution Report – Track 2: Quarterly
4.6.2.6 Practice Roster Report: Daily
The Practice Roster Report: Daily page captures changes made to Demographic Information and Practice Information for all practices, including the previous and current values for the updated fields.
The file naming convention for the report is as follows:
YYYY-MM-DD_HH-MM_PracticeRosterReportDaily.xls
The report displays the following information:
Practice ID
Practice Name
CTO ID
CTO Name
Impacted Data Field
Previous Value
Current Value
Date and Time Stamp
Note: The Practice Roster Report is scheduled daily, and it will be generated only if the user made updates to the Demographic Information and/or Practice Information pages within the last 30 days.
CMS XLC Using the Sy stem
CMMI UM Version 2.0 84 MDPCP Release 2.0
Figure 59: Practice Roster Report: Daily
4.6.2.7 Practice Summary Report: Daily
The Practice Summary Report: Daily page provides a summary of the Demographic Information and Practice Information for all practices.
The file naming convention for the report is as follows:
YYYY-MM-DD_HH-MM_PracticeSummaryReportDaily.xlsx
The report displays the following information:
Practice ID
Practice Name
CTO ID
CTO Name
Practice Status
Practice “doing business as” (DBA) Name
Street Address 1
Street Address 2
City
State
Zip Code
Phone Number
Ext.
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Practice Parent Organization Name
Primary Contact Name
Primary Contact Phone
Primary Contact Email
Clinical Leader Contact Name
Clinical Leader Contact Phone Number
Clinical Leader Contact Phone Ext.
Clinical Leader Contact Email
HIT Contact Name
HIT Contact Phone Number
HIT Contact Phone Ext.
HIT Contact Email
CTO Contact Name
CTO Contact Phone Number
CTO Contact Phone Ext.
CTO Contact Email
TIN1
TIN2
TIN3
TIN4
TIN5
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Figure 60: Practice Summary Report: Daily
4.7 Resources
The Resources tab provides access to the MDPCP Resources page, which contains links to helpful resources outside the MDPCP Application that are pertinent to participation.
4.7.1 MDPCP Resources
The MDPCP Resources page allows you to view and download Resource Documents and access helpful links.
4.7.1.1 Resource Documents
The Resource Documents table displays the File Name, File Type, and Date Added, and provides the option to download the following files, if available:
CMS 588 Form
CMS 588 Form – Instructions
CMS 588 Form – Frequently Asked Questions (FAQs)
CMS 855R Form – Medicare Enrollment Application
CMS Non-Data Use Agreement (DUA) Tracking Form Completion Instructions
Enterprise Privacy Policy Engine (EPPE) Batch Processing Template
MDPCP Identity Practice Portal Proofing Form
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CMMI UM Version 2.0 87 MDPCP Release 2.0
Figure 61: MDPCP Resources
4.7.2 Helpful Links
The Helpful Links section allows you to view the following external links:
MDPCP Connect Website
CQM Aligned Population Health Reporting Tool
Figure 62: Helpful Links
CMS XLC Troubleshooting & Support
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5. Troubleshooting & Support
5.1 Special Considerations
Not applicable.
5.2 Support
For any issues pertaining to the MDPCP Application, please contact the CICDIM Service Desk. Refer to the table below for contact information.
Table 3: Support Points of Contact
Contact Organization Phone Email Role Responsibility
MDPCP Support Team
Innovation Sites Business Operations Support Contract (IBOSC)
1-844-711-2664
Support MDPCP General Support
CMS XLC Appendix A: Record of Changes
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Appendix A: Record of Changes
Table 4: Record of Changes
Version Number
Date Author/Owner Description of Change
0.1 12/10/2018 Adedamola Adenikinju
Draft for Release 2.0
0.2 12/10/2018 Sravanthi Vakada Peer Review
0.3 12/19/2018 Sam Peterson QA review of highlighted changes
0.4 12/21/2018 Barb Miller Responded to QA
1.0 12/21/2018 Sam Peterson QA cleanup & final
1.1 01/7/2019 Barb Miller Draft – update section 3.3
1.2 01/10/2019 Sravanthi Vakada Peer Review
1.3 01/11/2019 Jennie Cairney QA Review of 3.3
1.4 01/11/2019 Barb Miller Addressed QA comments and changes
1.5 01/11/2019 Jennie Cairney Missing information, I believe, needs to be added
1.6 01/11/2019 Barb Miller Added missing information
2.0 01/11/2019 Jennie Cairney Final
CMS XLC Appendix B: Acrony ms
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Appendix B: Acronyms
Table 5: Acronyms
Acronym Literal Translation
APM All-Payer Model
ARS Acceptable Risk Safeguards
CMF Care Management Fee
CMMI Center for Medicare and Medicaid Innovation
CMS Centers for Medicare and Medicaid Services
CMSR CMS Minimum Security Requirements
CPC+ Comprehensive Primary Care Plus
CPCP Comprehensive Primary Care Payment
CRISP Chesapeake Regional Information System for our Patients
CRP Care Redesign Program
CTO Care Transformation Organization
DBA Doing Business As
DUA Data Use Agreement
EFT Electronic Funds Transfer
EIDM Enterprise Identity Management
EIT Electronic and Information Technology
ePortal Enterprise Portal
EPPE Enterprise Privacy Policy Engine
FAQ Frequently Asked Questions
HIE Health Information Exchange
HIPAA Health Insurance Portability and Accountability Act
HIT Health Information Technology
IBOSC Northrop Grumman's Innovation Sites Business Operations Support Contract
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Acronym Literal Translation
IC Innovation Center
IE Internet Explorer
IS Information Services
IT Information Technology
LOA Level of Assurance
MDPCP Maryland Primary Care Program
MFA Multi-Factor Authentication
NPI National Provider Identifier
OS Operating System
PBIP Performance Based Incentive Payment
PDF Portable Document Format
PII Personally Identifiable Information
PV Privileged
Qtr Quarter
RIDP Remote Identity Proofing
SSN Social Security Number
TCOC Total Cost of Care
TIN Taxpayer Identification Number
Yr Program Year
CMS XLC Appendix C: Glossary
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Appendix C: Glossary
Table 6: Glossary
Term Acronym Definition
Data Use Agreement DUA Agreement between CMS and data requestors that ensures data requestors adhere to CMS privacy and security requirements, as well as data release policies.
Enterprise Privacy Policy Engine
EPPE System that tracks all disclosures of CMS data.
Health Insurance Portability and Accountability Act
HIPAA Legislation that provides data privacy and security provisions for safeguarding medical information.
CMS XLC Appendix D: Referenced Documents
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Appendix D: Referenced Documents
Not applicable.
CMS XLC Appendix E: Approv als
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Appendix E: Approvals
The undersigned acknowledge that they have reviewed the User Manual and agree with the information presented within this document. Changes to this User Manual will be coordinated with, and approved by, the undersigned, or their designated representatives.
Table 7: Approvals
Document Approved By Date Approved
Dawn Alley, Business Owner, CMMI State Innovations Group TBD
Rebecca VanAmburg, Business Owner (Rep), CMMI State Innovations Group TBD
Katie Shannahan, Business Owner (Rep), CMMI State Innovation Group TBD
Velda L. McGhee, IT Lead, CMMI Business Services Group TBD
Don Rocker, OIT PMO, CMS Office of IT TBD
Diane Gray, Project Manager, ActioNet TBD
Ankit Gupta, Technical Project Manager TBD
Sravanthi Vakada, Lead Business Analyst TBD
Murali Goriparthi, Lead Architect TBD