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 Joseph Conn

The CMS has announced the awarding of a total of just over $9 million in matching funds to be used by four states to plan for their Medicaid programs to subsidize provider purchases and the use of electronic health-record systems under the American Recovery and Reinvestment Act of 2009, also known as the stimulus law.

The states and their grant amounts are: New Jersey, $4.93 million; Louisiana, $1.85 million; Maryland, $1.37 million; and Minnesota, $1.04 million.

Since November 2009, 39 states, Puerto Rico and the U.S. Virgin Islands have shared nearly $67.6 million in planning grants, according to news release information on the CMS website.

The stimulus law provides a 90% federal match to cover the cost of state planning efforts for the Medicaid EHR subsidy programs. According to federal estimates, the government estimates it could spend as much as $27.3 billion on the EHR subsidies under Medicaid, Medicare and Medicare Advantage programs.

Above article publish on http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20100511/NEWS/100519988

By Neil Versel

If nothing else, it should at least be easy to register to receive federal incentive payments for meaningful use of EMRs.

CMS has awarded a $1.6 million contract to CGI Federal, a Fairfax, Va.-based unit of Montreal-based technology consulting firm CGI Group, to revise the existing Provider Enrollment Chain Ownership System (PECOS) so physicians and hospitals can attest to meeting the requirements for meaningful use that will qualify them for Medicare bonuses. PECOS currently manages and verifies enrollment of Medicare providers and vendors.

Build-out of the online system to accommodate EMR incentive enrollment should take about 10 months, CMS says. Hospitals, however, could be eligible for the bonuses as soon as the end of December, since the rules for meaningful use, as currently proposed, only requires providers to meet the standards for 90 consecutive days in 2011. Medicare Part A, which applies to inpatient care, follows the federal fiscal year, which begins Oct.1.

For more information:
- see this Government Health IT story
- read this CMS notice about the contract award

Above article publish on http://www.fierceemr.com/story/providers-will-attest-meaningful-use-cms-registration-system/2010-04-22

On Thursday, CMS awarded federal stimulus funding to six state Medicaid programs for planning activities related to the implementation of an electronic health record incentive program, AHA News reports.

Under the American Recovery and Reinvestment Act of 2009, states can receive a 90% federal match for planning activities to:

• Administer EHR incentive payments to Medicaid providers;
• Ensure proper payments through audits; and
• Promote interoperability and “meaningful use” of EHRs (AHA News, 3/25).

According to CMS’ announcement of the awards:

• Colorado will receive $798,000;
• Mississippi will receive $1.47 million;
• Nevada will receive $1.05 million;
• North Carolina will receive $2.29 million;
• Utah will receive $396,000; and
• Wyoming will receive $596,000 (Monegain, Healthcare IT News, 3/25).

Since November, CMS has awarded matching funds to 32 states and territories (AHA News, 3/25).

Above article publish on http://www.ihealthbeat.org/articles/2010/3/26/six-states-get-federal-matching-funds-for-ehr-incentive-programs.aspx

CMS must pay special attention to ensure that the final version of the proposed “meaningful use” rule for electronic health records fits with other rules for standards and certification, as well at the interim final rule for the certification of EHRs, Government Health IT reports.

Earlier this year, CMS published a notice of proposed rulemaking describing how health care providers can demonstrate meaningful use of certified EHRs to qualify for incentive payments under the 2009 federal economic stimulus package.

The Office of the National Coordinator for Health IT also published an interim final rule describing required certification standards for EHR technology.

Tony Trenkle, CMS director of e-health and standards, recently stressed how the interplay between different regulations will be important in determining what health care providers will need to demonstrate to qualify for the incentive payments.

ONC policy analyst Steve Posnack said that CMS and ONC are coordinating their regulations to ensure that the standards set for determining meaningful use are in step with rules governing certification of EHRs (Mosquera, Government Health IT, 3/18).

Above article publish on http://www.ihealthbeat.org/articles/2010/3/19/cms-aims-to-coordinate-meaningful-use-rules-with-other-regulations.aspx

The American Academy of Family Physicians is calling for significant changes to “meaningful use” criteria that will be used to determine whether health care providers are eligible for federal subsidies for health IT usage, Modern Healthcare reports.

In a seven-page letter to acting CMS Administrator Charlene Frizzera, Ted Epperly, chair of AAFP’s board of directors, wrote that the group agrees with many of the criteria’s stated goals, but urged CMS to reconsider:

• Requirements to report computerized physician order entry measures that he maintains could force health workers to manually enter results from laboratories that do not have an interoperable interface;
• A requirement that a patients’ health information be shared with them within 48 hours; and
• Language that requires physicians to meet all of the proposed requirements to receive incentive payments.

In addition, Epperly asserts that the term “health information” is used throughout the proposed criteria but is never defined explicitly (Robeznieks, Modern Healthcare, 3/7).

Above Article Publish on http://www.ihealthbeat.org/articles/2010/3/8/aafp-asks-cms-for-significant-changes-to-meaningful-use-criteria.aspx

Practices that have been waiting for CMS to define the term “meaningful use” are finally in luck. But as is always the case when the feds are involved, don’t look for a quick one-sentence definition.

The American Recovery and Reinvestment Bill of 2009 (ARRA) offers annual bonuses to practices that show “meaningful use” of electronic health records, and in 2015, practices that aren’t showing meaningful use will face penalties.

On Dec. 29, CMS and the Office of the National Coordinator for Health Information Technology announced that the definition was finally available for public comment. “CMS’s proposed regulation would define and specify how to demonstrate ‘meaningful use’ of EHR technology, which is a prerequisite for receiving the Medicare incentive payments,” said Charlene Frizzera, CMS’s acting administrator, in a Dec. 30 statement.

25 measures: Stage 1 of the meaningful use criteria (which begins in 2011) includes 25 objectives/measures for eligible professionals (most Part B practices fall under this category) and 23 objectives/measures for eligible hospitals. To be considered a meaningful EHR user, you must meet all of the criteria set forth.

For example: The following includes just a sampling of what you’ll find in the list of 25 meaningful use criteria for stage one of the incentive program. To read the complete list, check out the proposal in the Federal Register.

• Use a computer physician order entry (CPOE)
• Implement drug-drug, drugallergy, drug-formulary checks
• Maintain an up-to-date problem list of current and active diagnoses based on ICD-9 or SNOMED CT
• Generate and transmit permissible prescriptions electronically
• Maintain an active medication list
• Maintain an active medication allergy list
• Record demographics (preferring language, insurance type, gender, race, ethnicity, and date of birth)
• Record and chart changes in vital signs
• Record smoking status for patients age 13 and older
• Incorporate clinical lab test results into EHR as structured data
• Generate lists of patients by specific conditions
• Report ambulatory quality measures to CMS
• Send reminders to patients for preventive follow-up care (per patient preference)
• Implement five clinical decision support rules relevant to specialty or high clinical priority
• Check insurance eligibility electronically from payers
• Submit claims electronically.

Keep in mind: You can not only qualify for a financial bonus if you use EHRs — but you could also boost your practice’s efficiency, CMS says. “Widespread adoption of electronic health records holds great promise for improving health care quality, efficiency, and patient safety,” said David Blumenthal, MD, national coordinator for health information technology, in a Dec. 30 statement.

CMS will accept public comments on the rule for 60 days, either electronically or by mail (CMS, Department of Health and Human Services, Attention: CMS-0033-P, P.O. Box 8013, Baltimore, MD 21244-8013). If you do submit comments, refer to ID CMS-0033-P.

Article publish on http://hitnews.inhealthcare.com/fact-finder/hitech-physicians-must-meet-25-criteria-to-achieve-meaningful-use/?dynamic_id=2086766482

The Centers for Medicare & Medicare Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) encourage public comment on two regulations issued today that lay a foundation for improving quality, efficiency and safety through meaningful use of certified electronic health record (EHR) technology. The regulations will help implement the EHR incentive programs enacted under the American Recovery and Reinvestment Act of 2009 (Recovery Act).

A proposed rule issued by CMS outlines proposed provisions governing the EHR incentive programs, including defining the central concept of “meaningful use” of EHR technology. An interim final regulation (IFR) issued by ONC sets initial standards, implementation specifications, and certification criteria for EHR technology. Both regulations are open to public comment.

“Widespread adoption of electronic health records holds great promise for improving health care quality, efficiency, and patient safety,” said, National Coordinator for Health Information Technology David Blumenthal, M.D., M.P.P. “The Recovery Act’s financial incentives demonstrate Congress’ and the Administration’s commitment to help providers adopt and make meaningful use of EHR technology so they can give better care and their patients’ experience of care will improve. Over time, we believe the EHR incentive program under Medicare and Medicaid will accelerate and facilitate health information technology adoption by more individual providers and organizations throughout the health care system.”

“These regulations are closely linked,” said Charlene Frizzera, CMS acting administrator. “CMS’s proposed regulation would define and specify how to demonstrate ‘meaningful use’ of EHR technology, which is a prerequisite for receiving the Medicare incentive payments. Our rule also outlines the proposed payment methodologies for the Medicare and Medicaid EHR incentive programs. ONC’s regulation sets forth the standards and specifications that will enhance the interoperability, functionality, utility and security of health information technology.”

CMS and ONC worked closely to develop the two rules and received input from hundreds of technical subject matters experts, health care providers, and other key stakeholders. Numerous public meetings to solicit public comment were held by three Federal advisory committees: the National Committee on Vital and Health Statistics (NCVHS), the Health IT Policy Committee (HITPC), and the Health IT Standards Committee (HITSC). HITSC presented its final recommendations to the National Coordinator in August 2009. These recommendations, along with all other input were considered to help inform the development of the regulations announced today.

The IFR issued by ONC describes the standards that must be met by certified EHR technology to exchange healthcare information among providers and between providers and patients. This initial set of standards begins to define a common language to ensure accurate and secure health information exchange across different EHR systems. The IFR describes standard formats for clinical summaries and prescriptions; standard terms to describe clinical problems, procedures, laboratory tests, medications and allergies; and standards for the secure transportation of this information using the Internet.

CMS provides a 60-day comment period on the proposed rule. “The definition and requirements for demonstrating meaningful use of EHR technology are proposals. CMS welcomes and will give serious consideration to comments that improve our proposal while achieving the goals Congress established for the EHR incentive programs,” Frizzera said.

The CMS proposed rule and fact sheets, may be viewed at http://www.cms.hhs.gov/Recovery/11_HealthIT.asp

ONC’s interim final rule may be viewed at http://healthit.hhs.gov/standardsandcertification. In early 2010 ONC intends to issue a notice of proposed rulemaking related to the certification of health information technology.

Above article publish on http://www.hhs.gov/news/press/2009pres/12/20091230a.html

Last week, CMS released proposed regulations defining the “meaningful use” of electronic health records, Reuters reports (Wutkowski/Heavey, Reuters, 12/31/09).

In addition, the Office of the National Coordinator for Health IT released an interim final rule describing the required certification standards for EHR technology (Simmons, HealthLeaders Media, 12/31/09).

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.

Officials will offer a 60-day public comment period after both regulations are published in the Federal Register on Jan. 13. The interim final rule on EHR certification is scheduled to take effect 30 days after publication (Goedert, Health Data Management, 12/30/09).

Phased Approach to Meaningful Use

CMS’ plan proposes phasing in meaningful use requirements over three stages between now and 2013.

The first stage of the meaningful use criteria emphasizes:

• Collecting electronic health data in coded formats;
• Implementing clinical decision support tools;
• Reporting clinical quality measures and public health data; and
• Using EHR data to track conditions and coordinate care (Monegain, Healthcare IT News, 12/30/09).

The criteria call for physicians to submit at least 80% of their orders electronically and for hospitals to submit at least 10% of orders electronically. The proposed rules also call for health care providers to use EHRs to check for potential drug interactions (Perrone, AP/San Francisco Chronicle, 12/30/09).

In addition, the rule requires health care providers to provide patients with electronic copies of their medical records within 48 hours of a request (Hensley, “Shots,” NPR, 12/31/09).

A list of Stage 1 criteria for physicians and a list of Stage 1 criteria for hospitals are available from Healthcare IT News (Healthcare IT News, 12/30/09).

The Stage 2 criteria are expected to focus on structured data exchange and continuous quality improvement. CMS is scheduled to release the second phase criteria by the end of 2011.

The Stage 3 criteria are expected to center on advanced decision support and population health. CMS is scheduled to publish the third phase criteria by the end of 2013.

Certification Criteria for EHRs

ONC’s interim final rule outlines the technical standards and features that EHR systems must include to receive certification for meaningful use.

The rule includes:

• Standard formats for clinical summaries and prescriptions;
• Standard terms to describe clinical problems, laboratory tests, medications and procedures; and
• Standards for secure transmission of online data.

The rule focuses solely on standards for certified EHRs. Later in 2010, ONC is scheduled to release additional guidance on the process for EHR certification.

Reduced Budget for Incentive Payments

When federal officials released the two new regulations, they also announced that the government might distribute less money than anticipated for the incentive payment program.

Initially, the Congressional Budget Office estimated that total federal incentive payouts could reach $34 billion (Mosquera, Government Health IT, 12/30/09).

However, officials last week said the outlays are likely to range from $14.1 billion to $27.3 billion.

They added that the government might pursue further budget revisions after evaluating the popularity of the incentive payment program (Schulte/Schwartz, Huffington Post Investigative Fund, 12/30/09).

Above article publish on http://www.ihealthbeat.org/articles/2010/1/4/officials-announce-meaningful-use-ehr-certification-criteria.aspx

After federal officials publish an interim rule on the “meaningful use” of electronic health records, the Health IT Standards Committee will use public comments to shape a final version of the rule, according to John Halamka, vice chair of the committee, Government Health IT reports.

Halamka spoke last week during the panel’s final meeting of the year.

The Office of the National Coordinator for Health IT is scheduled to release interim certification standards on meaningful use by the end of the month. In addition, CMS is expected to publish guidance on the federal incentive payment programs.

During the standards panel meeting, Halamka said the committee strove to recommend meaningful use standards that would be amenable to health care organizations of different sizes and types.

The committee also pushed for data protection standards that align with the HIPAA privacy and security rule. The recommendations call for electronic health systems to authenticate identities, create an audit trail, encrypt and decrypt information and restrict access to authorized users.

When the committee returns to work in 2010, the group will continue its efforts to develop data standards, facilitate EHR adoption and reduce barriers to health IT, Halamka said (Mosquera, Government Health IT, 12/22).

Above article publish on http://www.ihealthbeat.org/articles/2009/12/23/public-comments-will-help-shape-meaningful-use-rule.aspx