Category — Economic Stimulus

The Centers for Medicare and Medicaid Services will pay physicians four to eight weeks after they verify that they have satisfied conditions for meaningful use of electronic health records. That means that the soonest that CMS will issue incentives is in May.

Providers will not receive the incentive payments within that time frame, however, if they have not yet met the threshold of $24,000 for allowed charges in claims for covered services to Medicare beneficiaries during 2011, CMS said in an announcement April 28.

CMS launched meaningful use ehr attestation on April 18. Once met, a qualifying physician will receive $18,000 in incentives for fulfilling the first stage of meaningful use.

The payments to physicians for the Medicare EHR Incentive Program are based on 75 percent of the estimated allowed charges for their covered during the entire payment year.

If a physician does not reach the threshold by the end of 2011, CMS said it expects to pay the incentive to the provider in March 2012, after allowing 60 days beyond the end of the 2011 calendar year for all pending claims to be processed.

CMS will use a payment file contractor to generate electronic payment of the inventives through the same bank account that providers receive payment for their Medicare claims, according to the announcement

To receive the maximum amount of $44,000 in incentives over the five years of the program, physicians must begin participating in 2011 or 2012. Providers who supply services in a “health professional shortage area” may receive additional incentives, CMS said.The bonus will be separate lump-sum payments within 120 days after the end of the year.

EHR incentives for hospitals and cirtical access hospitals start with a $2 million base payment. They will receive initial and final payments.

States manage the Medicaid EHR Incentive Program, in which physicians can receive up to $63,750 over six years. Medicaid hospitals also begin with a $2 million base payment. Timing of the states’ payment of incentives varies according to their program, CMS said.

Source  :   http://www.govhealthit.com/news/cms-explains-how-get-paid-ehr-incentives

More than 21,000 health care providers have registered to participate in the electronic health record meaningful use program, Government Health IT reports.

About two-thirds of this group will be ready to prove they have met meaningful use ehr criteria when CMS launches attestation modules this spring.

Background

Under the 2009 economic stimulus package, health care providers who demonstrate meaningful use of certified EHRs can qualify for Medicaid and Medicare incentive payments (Mosquera, Government Health IT, 2/22).

Medicaid already has paid out more than $20 million in incentive payments (Conn, Modern Healthcare, 2/23).  The first Medicare incentive payments will be issued in May.

Current Numbers

The latest figures for participating health care providers were counted at the end of January. CMS officials cited steady increases in the number of registrants.

Attestation Modules

CMS will launch its attestation module through its website in April, according to Elizabeth Holland, director of health IT initiatives in the CMS Office of eHealth Standards and Services.

A separate test module will aid health care providers in measuring meaningful use readiness if they are not formally ready to attest (Government Health IT, 2/22).

Source  :   http://www.ihealthbeat.org/articles/2011/2/23/more-health-providers-sign-up-for-meaningful-use-incentive-program.aspx

The American Health Information Management Association recently sent a letter advising the Office of the National Coordinator for Health IT to address privacy and other issues carefully when finalizing Stage 2 criteria for meaningful use ehr, Modern Healthcare reports.

Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of electronic health records can qualify for incentive payments through Medicare and Medicaid.

Letter Details

AHIMA sent the letter to Joshua Seidman, ONC’s acting director of meaningful use.

The letter recommends that final Stage 2 criteria address several issues, including:

• Redisclosure laws, which vary by state and can affect health information exchanges; and
• Patients’ rights to control the privacy and security of their own health data (McKinney, Modern Healthcare, 2/25).

For the Stage 2 criteria, AHIMA also suggested that ONC:

• Address differences in how Stage 1 and Stage 2 criteria measure use of computerized provider order entry systems;
• Align the meaningful use program with federal health reform law programs, the transition to ICD-10 code sets and other regulatory initiatives with similar timeframes;
• Require health care providers to document reasons for declining to follow the guidance of clinical decision support systems (Goedert, Health Data Management, 2/25); and
• Retain the Stage 1 requirement that health care providers allow patients to download and view clinical summaries within three days, instead of the 24-hour window proposed for Stage 2 (Modern Healthcare, 2/25).

Premier Offers Comments on Stages 2, 3

In related news, health care provider alliance Premier recently submitted comments on the initial draft criteria for stages 2 and 3 of meaningful use, Health Data Management reports.

In the letter, Premier said that federal officials should refrain from adding new clinical quality measures to stages 2 and 3 until after completing an evaluation of health care provider performance for Stage 1.

The letter also expressed concern about the lack of structured formats available for certain data elements that patients would be able to view and download under stages 2 and 3 (Goedert, Health Data Management, 2/28).

Source    :    http://www.ihealthbeat.org/articles/2011/2/28/groups-voice-concerns-about-stages-2-3-of-meaningful-use.aspx

WASHINGTON – Federal officials released the final rule on meaningful use Tuesday, which will allow physicians and hospitals to qualify for thousands of dollars in stimulus funding incentives for the adoption of electronic health records.

The 864-page final rule, several weeks late from its anticipated delivery before June 21, outlines the specific qualifications providers must meet to achieve the meaningful use of electronic health records.

At a news conference Tuesday morning, federal healthcare officials praised the advance of electronic health records, while acknowledging the difficulties providers face at the onset of adoption.

According to David Blumenthal, MD, national coordinator for health information technology, the final rule differs from the proposed rule issued last January: It allows providers more flexibility in choosing which measures to use for qualifications.

According to Blumenthal, the proposed rule required doctors to comply with 23 measures, and hospitals 25 measures. The government received more than 2,000 comments on the rule, many of them asking for more flexibility in allowing clinicians to qualify.

Blumenthal said the final rule took those comments into account. The final rule requires doctors to comply with a set of 15 core objectives during the first year - or Stage 1- of adoption. Hospitals are required to comply with 14 core objectives. In addition to the core objectives, both hospitals and doctors will have to choose five more objectives from a “menu” of 10, he said. The remaining objectives will be deferred to Stage 2 of adoption.

The final rule also reduced the number of electronic prescriptions a doctor is required to make from 75 percent to 40 percent, Blumenthal said.

Kathleen Sebelius, Department of Health and Human Services Secretary, said the Federation of American Hospitals is an “enthusiastic supporter” of the new rule. The federal government hopes other groups will join them, she said.

Blumenthal, a physician, said he is confident the use of electronic health records will become a core professional competency among physicians, who will eventually lead the way in adoption. Until then, the government will encourage healthcare IT adoption through financial incentives, such as these set up under the meaningful use rule. The government will also supply “shoulder-to-shoulder” support for providers through the regional extension centers.

Key changes in the final CMS rule include:

• Greater flexibility with respect to eligible professionals and hospitals in meeting and reporting certain objectives for demonstrating meaningful use. The final rule divides the objectives into a “core” group of required objectives and a “menu set” of procedures from which providers may choose any five to defer in 2011-2012.  This gives providers latitude to pick their own path toward full EHR implementation and meaningful use.
• An objective of providing condition-specific patient education resources for both EPs (eligible providers) and eligible hospitals and the objective of recording advance directives for eligible hospitals, in line with recommendations from the Health Information Technology Policy Committee.
• A definition of a hospital-based EP as one who performs substantially all of his or her services in an inpatient hospital setting or emergency room only, which  conforms to the Continuing Extension Act of 2010
• CAHs (critical access hospitals) within the definition of acute care hospital for the purpose of incentive program eligibility under Medicaid.

A CMS/ONC fact sheet on the rules is available on the CMS Web site.

Source :  http://www.healthcareitnews.com/news/flexibility-built-final-rule-meaningful-use

More than 80 community colleges and universities this fall will begin training nearly 50,000 health IT workers as part of an HHS grant program that aims to help physicians and hospitals adopt electronic health records, ComputerWorld reports (Mearian, ComputerWorld, 7/16).

Source of Funding

HHS in April announced $144 million in grants to target health IT research and work force development.

Funding was disbursed through the 2009 federal economic stimulus package (iHealthBeat, 4/5).

Breakdown of Plans

For the training, HHS has designed a curriculum to educate individuals with a health care or IT background for 12 specific roles.

The programs fall into two groups:

• A six-month program; and
• A one- to three-year training program for more advanced administrative and technical roles, such as senior clinician leaders and privacy and security specialists.

Graduates will receive a certificate in their specialties, and each school will receive approximately $1 million to implement the curriculum.

Regional Extension Centers

A large focus of the effort will be dedicated to training staff to work at 60 regional extension centers, which will help rural institutions and small physician practices install EHR systems.

The centers are expected to employ up to 30 trained workers, who will:

• Assist health care providers with reimbursement procedures;
• Assess a facility’s health IT infrastructure;
• Suggest compatible EHR systems;
• Oversee system installation;
• Analyze workflow; and
• Determine if EHR deployment meets federal “meaningful use” standards (ComputerWorld, 7/16).

Source: http://www.ihealthbeat.org/articles/2010/7/16/groups-preparing-ways-to-use-hhs-grants-for-it-training-programs.aspx

On Tuesday, federal officials announced the release of the final rule defining how hospitals and health care providers can demonstrate “meaningful use” of electronic health records to qualify for federal incentive payments, Reuters reports (Lentz, Reuters, 7/13).

Officials also released the final rule describing the required standards and certification criteria for EHR technology. The new regulation updates the interim final rule on EHR certification that ONC released in January (Mosquera, Government Health IT, 7/13).

Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified EHRs will qualify for incentive payments through Medicaid and Medicare.

HHS Secretary Kathleen Sebelius, new CMS Administrator Donald Berwick, National Coordinator for Health IT David Blumenthal and Surgeon General Regina Benjamin announced the rules during a news conference (Health Imaging & IT, 7/13).

Core Meaningful Use Objectives

Blumenthal said the final meaningful use rule offers health care providers more flexibility than the proposed regulations released in January.

The final rule requires physicians to meet a set of 15 core objectives during the first stage of the incentive program. Hospitals are required to meet 14 core objectives for Stage 1. In addition, all health care providers will need to comply with five objectives out of a “menu” of 10 options (Manos, Healthcare IT News, 7/13).

The earlier proposed rule included 25 objectives for physicians and 23 objectives for hospitals.

One of the core objectives requires health care providers to transmit 40% of prescriptions electronically. The requirement was relaxed from the earlier proposed regulations, which called for a 75% electronic prescribing rate.

Health care providers also will need to enact a single measure to meet the clinical decision support requirement, down from five measures in the previous proposal.

In addition, CMS reduced the number of quality measures that health care providers must report on, deferring some measures to Stage 2 meaningful use requirements (Versel, FierceEMR, 7/13).

Another core objective requires hospitals and physicians to use computerized physician order entry systems to capture at least 30% of medication orders. Under the earlier regulations, hospitals would need to use CPOE systems for 10% of medication, laboratory and diagnostic orders, while doctors would need to use the systems for 80% of such orders (Robeznieks, Modern Healthcare, 7/13).

‘Menu’ of Additional Options

In addition to the core objectives, the final rule requires doctors and hospitals to comply with five objectives out of the menu of 10 options. Health care providers will need to comply with the remaining objectives as part of Stage 2 meaningful use requirements (Healthcare IT News, 7/13).

One of the new objectives in the menu calls for health care providers to offer patients condition-specific educational resources.

Clarifications on Eligibility

The final meaningful use rule defines a hospital-based eligible professional as someone who performs nearly all services in an inpatient hospital setting or emergency department.

The rule also expands the definition of acute-care hospital to include designated Critical Access Hospitals for the Medicaid incentive program (Health Imaging & IT, 7/13).

Additional Information in NEJM Piece

Blumenthal and Marilyn Tavenner, principal deputy administrator of CMS, offered additional explanations of the final meaningful use rule in a New England Journal of Medicine perspective piece.

In the perspective piece, Blumenthal and Tavenner explain that HHS weighed 2,000 outside comments before deciding on “significant changes” to the earlier meaningful use regulations.

The piece also includes a full list of the core objectives and the menu of options for the new final rule (Hobson, “Health Blog,” Wall Street Journal, 7/13).

In addition, Benjamin authored a companion piece that also appeared in the journal (FierceEMR, 7/13).

Next Steps

In January 2011, eligible health care providers and hospitals can begin registering for the EHR incentive program. CMS will manage the registration for both the Medicaid and Medicare incentive programs from one virtual location.

Federal officials expect to release additional information on the Stage 2 and Stage 3 meaningful use requirements over the next few years (Mearian, ComputerWorld, 7/13).

Source:http://www.ihealthbeat.org/articles/2010/7/13/final-rules-on-meaningful-use-ehr-standards-released-today.aspx

By Joseph Conn

HHS has sent its final meaningful-use rules and certification criteria for electronic health-record system testing to the Office of Management and Budget—typically one of the last bureaucratic hurdles before rules are released. The criteria are called for under the EHR subsidy program established by the American Recovery and Reinvestment Act of 2009.

OMB received a copy of the final rule of the “meaningful use” criteria from the CMS Monday, according to the posting on the website of its Office of Information and Regulatory Affairs.

The White House budget authority also received a copy of the final rule on an initial set of standards, implementation specifications and certification criteria from HHS on July 2.

Under the Medicare provisions of the stimulus law, to receive an estimated $14 billion to $27 billion in federal subsidies for EHR purchases, hospitals and qualifying office-based physicians must use certified EHRs in a “meaningful manner.”

Robert Tennant, the Washington, D.C.-based senior policy adviser to the Medical Group Management Association, Englewood, Colo., said he expects a quick turnaround on both rules.

“By law, they have 90 days in which to review, but I think in all practicality, OMB has been involved in the drafting of the final rules, so it’s no surprise when they get them,” Tennant said.

OMB has had HHS’ controversial final rule on the federal requirement on public and patient notification in the event of a breach of personally identifiable health information since May 15. Tennant said he expects both recently submitted rules to be released in a week or so, possibly even later this week.

Tennant also said a proposed healthcare IT privacy rule just left the OMB review list, so “it should be published in the next couple of days.”

Source:http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20100706/NEWS/307079976/1153#

The Office of the National Coordinator for Health IT has started accepting applications from organizations seeking to be named as testing and certification bodies for electronic health record systems, Modern Healthcare reports.

Under the 2009 federal economic stimulus package, health care providers who demonstrate “meaningful use” of certified EHR systems will qualify for federal incentive payments.

ONC issued the final rule on the temporary testing and certification program on June 18, and the rule appeared in the Federal Register on June 24.

The stimulus package gave ONC the option of retaining the Certification Commission for Health IT as the sole EHR certification group or recognizing a new organization, according to Modern Healthcare. ONC opted to expand its search for a new group, and CCHIT has joined a pool of applicants for the distinction.

Carol Bean, a standards harmonization analyst for ONC, said HHS to date has received about 40 application inquiries and 14 requests for applications. She said ONC has 30 days after receiving an application to decide whether the organization qualifies as an “authorized testing and certification body” under the temporary certification program.

The final rules for the permanent authorization program have not yet been released, although a proposed rule was issued in March (Conn, Modern Healthcare, 7/1).

Source:http://www.ihealthbeat.org/articles/2010/7/2/onc-starts-accepting-applications-for-ehr-certification-groups.aspx

Last Monday, CMS launched a new website intended to help health care providers better understand the criteria to meet federal requirements for the “meaningful use” of electronic health record systems, Government Health IT reports.

Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of EHRs will qualify for Medicare and Medicaid incentive payments (Mosquera, Government Health IT, 6/21).

Website visitors can download fact sheets detailing the proposed program requirements and the proposed definition of meaningful use.

The site also clarifies various terms, such as “eligible professional” and “certification,” that are included in the HITECH Act (McKinney, Modern Healthcare, 6/21).

In addition, the site includes:

• An overview of the incentive program;
• Information about what health care providers are eligible for incentive payments;
• Information on how to register for the program; and
• Guidance on what health care providers can do to prepare for meaningful use.

CMS also said that it would use the website to publicize EHR training and events related to the incentive program (Government Health IT, 6/21).

According to Modern Healthcare, the website will offer more specific information about the incentive eligibility requirements after CMS issues the final rule on the EHR incentive programs later this summer (Modern Healthcare, 6/21).

Source: http://www.ihealthbeat.org/articles/2010/6/22/cms-unveils-new-website-on-meaningful-use-incentives.aspx

By Jennifer Lubell

West Virginia has received $6 million in federal stimulus funds to establish a regional health information technology extension center.

The center has been designated as the statewide organization to provide education, training and support services to help the state’s primary-care providers implement and meaningfully use health information technology for the purpose of improving patient outcomes.

“It should be active this summer,” said an aide to West Virginia Gov. Joe Manchin, who along with other local and state officials announced on June 8 the effort to help primary-care doctors adopt electronic health.

The American Recovery and Reinvestment Act of 2009, also known as the stimulus law, mandates that providers meaningfully use an electronic health-record system to qualify for up to an estimated $27.3 billion in federal reimbursements.

To help physicians become eligible for these incentive payments, the center will, among other initiatives, provide assistance in the selection and purchasing of electronic health-record systems, project management and implementation services, and guidance on privacy and security matters.

“West Virginia remains a national leader in the adoption of health information technology, and this statewide health information-technology extension center will be another key component of our ongoing efforts to use technology to improve the health of our citizens,” Manchin said in a written statement. “This project is the latest example of how West Virginia is working to modernize its healthcare delivery system in order to improve overall healthcare, enhance efficiencies and facilitate greater information-sharing between physicians and patients,” he said.

Source:http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20100609/NEWS/100609949