ARRA News

CMS adopts proposed changes to e-Prescribing Incentive Program

The Centers for Medicare & Medicaid Services on Aug. 31 released a final rule modifying the Medicare Electronic Prescribing Incentive Program. Eligible physicians who fail to meet the program's e-prescribing requirements or obtain an exemption will be subject to a 1% payment penalty beginning in January.

The rule adopts the four new significant hardship exemption categories proposed for the 2012 payment adjustment, including one for eligible professionals who register to participate in the Medicare or Medicaid EHR Incentive Programs and adopt certified electronic health record technology. It also extends to Nov. 1 the deadline for eligible professionals and group practices to request a significant hardship exemption, and changes the e-prescribing measure to recognize adoption of certified EHR technology as a "qualified" system under the e-Prescribing Incentive Program.

Eligible professionals can use a web-based tool to request an exemption, while group practices must submit a letter to CMS. For more information, see the CMS announcement.

[ via AHA News Now ]

HIT panel pitches one vocabulary standard for all EHR domains

The HIT Standards Committee has unveiled one set of vocabulary standards and implementation guides for all EHR quality reporting domains, a feat deemed "momentous" by panel co-chairman Dr. John Halamka. The panel plans to ask the ONC to integrate the standards, which have been in the works for 10 years, into the second stage of meaningful use criteria for EHRs.

Read more here.

ONC Seeks Public Comment on Proposed Metadata Standards

The Office of the National Coordinator for Health IT is requesting public comment on a newly released advance notice of proposed rulemaking about the use of metadata standards to support health data exchange. The notice outlines a scenario in which metadata standards could be attached to a patient's summary of care record. The comment period ends Sept. 23.

Learn more here.

HITECH Act blocking smaller IT firms

Many small and midsize IT firms are sitting on the sidelines of the nation’s health IT transformation due to barriers caused mostly by government policies as they relate to education, security and privacy, and technical assistance, said authors of the CompTIA report, Health IT: The Essential Role of Small IT Solution Providers. The report contends that “several minor changes to existing policy” would help enable small IT products and services providers to play a bigger role in helping the nations tens of thousands of healthcare providers–especially smaller medical providers–transition to digitized patient records and other health IT enabled processes.

Read more from InformationWeek here.

CMS announces provider call on EHR meaningful use

The Centers for Medicare & Medicaid Services will host an Aug. 18 teleconference on the meaningful use requirements of the Medicare and Medicaid electronic health record incentive programs for hospitals and eligible providers. For details and to register for the call, click here.

[ via AHA News Now ]

HIE organizations identify factors that aid, impede success

A new report from the National eHealth Collaborative looks at the strategies and business models that can support or impede the success of regional health information exchange organizations by profiling 12 fully operational HIEs. "While every HIE project is unique, they all share the same problems of participation, value, security, growth and especially sustainability," said Mark Jones, chief operating officer for the Secure Medical Records Transfer Network (SMRTNET), an Oklahoma organization profiled in the report.

[ via AHA News Now ]

Free iPad-based EHR platform earns MU certification

An electronic health record application designed for the iPad has been certified as meeting meaningful use requirements by InfoGard, an ONC-authorized EHR accreditation body. Called drchrono, the free application could help providers demonstrate meaningful use and qualify for a maximum of $44,000 in federal incentives.

Read more here.

Hospitals, providers urged to make Stage 2 preparations now

A Computer Sciences Corp. report outlining measures that could be included in the next stage of meaningful use suggests that the final rule governing Stage 2 is likely to reflect the same standards in Stage 1 but with higher thresholds. Eligible hospitals and providers should begin their Stage 2 MU efforts now, said Erica Drazen, the report's author, who expects that the Stage 2 recommendations of the HIT Policy and Standards Committees will be followed.

Read more here.

States may get substantial power over health insurance exchanges

States will have leeway in determining who operates their health insurance exchanges and which health plans qualify for sale in the exchanges, among other state powers outlined in proposed guidelines unveiled July 11 by the Dept. of Health and Human Services.

Read more here.

CMS Provides Answers for 15 More FAQs on Meaningful Use Issues

Federal officials have posted responses to 15 more frequently asked questions about the meaningful use program, with many new FAQs relating to critical access hospitals. CMS now offers 175 FAQs on meaningful use.

Read more here.

CMS to allow provider MU attestation next year

The CMS announced it will let eligible providers attest that they have used electronic health records to obtain data on quality, and said it would develop a pilot program expected to pave the way for the online submission of data on clinical quality measures from EHRs. The decision to allow MU attestation in 2012 was prompted by the CMS being unprepared to receive quality data from providers via the Web.

Read more here.

Bill would ensure EHR incentive parity for multi-campus hospitals

Reps. Michael Burgess, M.D. (R-TX), Eliot Engel (D-NY), Kevin Brady (R-TX) and Charlie Rangel (D-NY) on July 12 introduced the Equal Access and Parity for Multi-Campus Hospitals Act (H.R. 2500), American Hospital Association-supported legislation to ensure that multi-campus hospitals are treated fairly under the Medicare and Medicaid electronic health records incentive programs authorized in the American Recovery and Reinvestment Act. Introduced with more than 50 bipartisan co-sponsors, the bill specifies that the EHR incentive payments should go to each campus of a multi-campus hospital system, as long as each campus meets the meaningful use requirements.

Currently, hospital systems with multiple campuses organized under a single Centers for Medicare & Medicaid Services certification number can only receive a single incentive payment. "This legislation is instrumental to delivering the promise of electronic health records to more Americans," said AHA President and CEO Rich Umbdenstock. "And with integrated electronic health records will come improved patient outcomes and efficiencies in care delivery to support better health and health care."

Mostashari Supports Delay for Next Stage of Meaningful Use

National Coordinator for Health IT Farzad Mostashari says he supports delaying Stage 2 of the meaningful use program by one year for health care providers attesting to Stage 1 this year. The delay is meant to give health care providers who attest to Stage 1 and health IT vendors more time to prepare for the next stage of the incentive payment program.

Read more here.

CMS drafts standards for e-claims, eligibility transactions

CMS Administrator Dr. Donald Berwick has unveiled an interim final rule meant to allow more efficient processing of inquiries related to the status of insurance claims and patients' eligibility for health plans. The rules, set to be released in the Federal Register on July 2 and based in part on standards already set by the Council for Affordable and Quality Healthcare's Committee on Operating Rules for Information Exchange, could help providers and insurers streamline their operations and cut costs, he said.

Read more here.

Meaningful Use: The Trojan Horse of Healthcare Reform

On July 13, Amerinet will host a FREE webinar, Meaningful Use: The Trojan Horse of Healthcare Reform, from 1:15 p.m. until 2:15 p.m. The instructor will be Bryant Hoyal, PMP.

The program will outline the basic goals of the HITECH Act and the important role this legislation has in healthcare reform. During this session you will explore the bigger impact of the HITECH Act and explain why Meaningful Use is a real change agent when it comes to health reform. Topics include an introduction to the HITECH Act, program basics, strategies for achieving Meaningful Use of an EHR, and the ongoing influence this program will have on the healthcare industry.

This educational series, Meaningful Knowledge for Meaningful Use, is brought to you by Amerinet and Maestro Strategies. Everyone is invited to attend. There is no charge to participate. The series will be held over the next several months. There are no CE contact hours for this program.

For more informaton or to register, click here.

The costly flaws in U.S. digital health-data plan

The aim of the Health Information Technology for Economic and Clinical Health Act was simple: Make it so that any patient can walk into any emergency room in the U.S. and have their entire medical history summoned instantly, via computer. Today, the healthcare industry is spending billions to create electronic health records, but the much-vaunted goal of quick access to patient information may never come to pass.

Read the full article from MarketWatch.

 

July 3 is deadline for hospitals to begin MU reporting

Critical-access facilities and eligible hospitals have until July 3 to launch a 90-day schedule for reporting on EHR meaningful use to qualify for incentives in fiscal 2011. Hospitals can verify meaningful use through Nov. 30.

Read more here.

CMS expands website to add details on patient requests for EHR data

The CMS has updated the FAQ page on its electronic health record incentive program website to include data on providing patients with electronic copies of their health data. According to the information, providers must supply health data gleaned from EHRs within three business days of a request from the patient.

Read more here.

HIT panel backs delay in Stage 2 MU implementation

A federal work group's proposal to put off implementation of the second stage of meaningful use through 2014 has been approved by the HIT Policy Committee. The one-year delay would affect early adopters who are eligible for Stage 1, but would give providers and vendors sufficient time to develop and test EHR systems, work group chairman Dr. Paul Tang said.

Read more here.

Work Group Recommends Delay for Stage 2 of Meaningful Use

The Health IT Policy Committee's meaningful use work group is recommending delaying by one year implementation of the next stage of the meaningful use program for health care providers who meet Stage 1 criteria in 2011. According to the panel, retaining the planned Stage 2 timeline could pose "insurmountable" challenges.

Read more here.

Task force to recommend ways to align HIT, delivery system reform

The Bipartisan Policy Center on June 2 launched a public-private collaborative on delivery system reform and health information technology. Led by former Senate Majority Leaders Tom Daschle (D-SD) and Bill Frist (R-TN), the task force will identify ongoing efforts and best practices for encouraging coordinated, patient-centered and accountable care, and make recommendations for aligning health IT efforts to support new care delivery models.

A report released June 2 by the center’s Health IT Initiative offers recommendations for leveraging health IT to address health care system challenges, such as integrating lessons learned from early implementation efforts.

[ via AHA News Now ]

HHS issues proposal to implement HITECH 'accounting of disclosures' mandate

The Department of Health and Human Services' Office for Civil Rights on May 31 published a proposed rule implementing the HITECH Act mandate to provide patients with an accounting of disclosures of protected health information for treatment, payment and health care operations if the disclosures are though an electronic health record. The proposed rule imposes a significant new obligation that covered entities provide patients with information about who has accessed their electronic PHI in a "designated record set."

Additionally, it substantially revises the existing requirements to provide more detailed information about disclosures of patient information in a "designated record set," whether electronic or hard copy, outside the covered entity. Comments on the proposed rule will be accepted through Aug. 1.

 

ONC Releases Proposed Rule on Permanent Certification Program

The Office of the National Coordinator for Health IT has published a proposed rule for the approved accreditor of certification bodies under the permanent electronic health record certification program. The rule addresses how to handle instances when the accreditor does not properly carry out its duties.

Read more here.

Five New FAQs Posted on Electronic Health Record Meaningful Use

Five New FAQs on meaningful use have been added to the CMS website:

• For the meaningful use objective of “capability to exchange key clinical information” for the Medicare and Medicaid EHR Incentive Programs, does exchange of electronic information using physical media, such as USB, CD-ROM, or other formats meet the measure of this objective?  Read the answer.
• For the Medicare and Medicaid EHR Incentive Programs, how should an eligible professional (EP) who orders medications infrequently calculate the measure for the “computerized provider order entry (CPOE)” objective if the EP sees patients whose medications are maintained in the medication list by the EP but were not ordered or prescribed by the EP?  Read the answer.
• How should patients in swing beds be counted in the denominators of meaningful use measures for eligible hospitals and critical access hospitals (CAHs) for the Medicare and Medicaid EHR Incentive Programs?  Read the answer.
• How should nursery day patients be counted in the denominators of meaningful use measures for eligible hospitals and CAHs for the Medicare and Medicaid EHR Incentive Programs?  Read the answer.
• What lab tests should be included in the denominator of the measure for the “incorporate clinical lab-test results” objective under the Medicare and Medicaid EHR Incentive Programs?  Read the answer.

For more information about meaningful use and its requirements, take a look at the Meaningful Use page of the EHR website.

Want more information about the EHR Incentive Programs?  Visit the CMS EHR Incentive Programs website for the latest news and updates on the EHR Incentive Programs; also sign up for the EHR Incentive Programs email update listserv.

CMS issues first Medicare EHR incentive payments, proposed e-Rx rule

The Medicare electronic health record incentive program recently issued its first round of payments, totaling $75 million, to providers who signed up in the first two weeks that payments were available, the Centers for Medicare & Medicaid Services announced May 26. The list of several hundred recipients represents a relatively slow start to the program, given that CMS estimates more than 42,600 eligible professionals and hospitals have registered for the Medicare and Medicaid incentive programs to date, and 485,000 are potentially eligible to participate.

Beginning April 18, hospitals and physicians eligible to participate in the Medicare EHR incentive program could, if they choose, begin attesting that they meet the program's meaningful use requirements. Hospitals wishing to attest in FY 2011 must report on the meaningful use measures for a 90-day period during the federal fiscal year, which ends Sept. 30.

However, hospitals need not attest to meaningful use in FY 2011 to benefit fully from Medicare EHR incentive payments. Medicaid EHR incentive programs are being implemented on a state-by-state basis.

According to CMS, 15 states have initiated their Medicaid EHR incentive programs since January, issuing about $83 million in incentive payments to qualified Medicaid providers to date.

Also on May 26, CMS issued a proposed rule for Medicare’s electronic prescribing incentive program. The rule would allow physicians and other eligible providers who meet meaningful use requirements to apply for a waiver from the 1.0% e-prescribing penalty that will take effect Jan 1, 2012.

House members urging colleagues to cosponsor EHR multi-campus bill

Reps. Michael Burgess (R-TX), Eliot Engel (D-NY), Kevin Brady (R-TX) and Charles Rangel (D-NY) plan to introduce legislation clarifying that electronic health record incentive payments under Medicare and Medicaid should go to each campus of a multi-campus hospital system, and in a letter May 26 asked House members to support it. The Centers for Medicare & Medicaid Services final rule for meaningful use of electronic health records required incentive payments to be delivered on the basis of Medicare provider numbers, not physical campuses.

According to the letter, the bill “would give hospitals affected by this regulation an opportunity to recover some of the payments Congress intended they receive.” The American Hospital Association and Association of American Medical Colleges support the measure.

For more on the proposed legislation, contact Erik Rasmussen, AHA senior associate director of federal relations, at erasmussen@aha.org or 202-626-2981.

Digital health system will hinge on interoperability

Achieving the federal goal of a digital health care system will require "seamless interoperability," according to an Institute of Medicine report. The report also identifies IT systems that are more user-friendly and that enable point-of-care delivery of clinical decision support as keys to success.

Read more from Modern Healthcare here.

AHA launches revamped ‘meaningful use’ resource

The American Hospital Association on May 25 unveiled a new and improved web-based resource devoted to helping hospital leaders better understand the Medicare and Medicaid electronic health records incentive programs and their associated “meaningful use” requirements. This streamlined resource is intended to provide members with all of the information they need on the programs in one place and contains links to both AHA and government resources.

“This resource provides members with a one-stop source of information on the EHR programs,” said AHA Director of Policy Chantal Worzala. “We believe they will find it useful as they navigate the programs’ requirements and seek to achieve meaningful use.”

Only 13 RHIOs meet meaningful use criteria

There are 75 operational RHIOs (regional health information organizations) across the U.S. but only 13 of them meet the most basic criteria for meaningful use of health information technology, according to a 2009 study by a group of Harvard University researchers. With grant support from the federal government, RHIOs provide hospitals and physicians with a single connection to swap clinical data with other participating providers such as labs and public health departments.

Read more from HealthLeaders Media here.

Panel considers Stage 2 EHR requirements, timing

The Health IT Policy Committee met May 11 to consider both the timing of and requirements for Stage 2 of "meaningful use" under the Medicare and Medicaid electronic health record incentive programs. Stage 2 is currently planned to start for hospitals on Oct. 1, 2012, which the American Hospital Association and other organizations have been concerned will not give hospitals and physicians sufficient time to implement new functionalities or vendors sufficient time to upgrade their products.

The committee considered three options: maintaining the current timeline, limiting the first year of the Stage 2 reporting period to 90 days, and delaying the start of Stage 2 for one year, as has been recommended by the AHA. In the discussion on timing, Marc Probst, chief information officer at Intermountain Healthcare, provided a cautionary note that hospital CIOs are feeling "undue pressure" from multiple policies that will be implemented in the next couple of years, including meaningful use, ICD-10, and health reform initiatives.

The committee also contemplated a number of proposals that would significantly raise the bar in Stage 2, such as requiring that hospitals implement patient portals with download capacity and that hospitals serving as reference labs electronically send lab results to physician offices in structured formats. The committee will meet June 8 to finalize recommendations.

Larry Wolf, health IT strategist for Kindred Healthcare, recommended that the committee come back to the conversation with "parsimony in mind. How much do we want to expand the scope of requirements versus achieving exchange of the information we have?"