Yesterday, Reps. Patrick Kennedy (D-R.I.) and Tim Murphy (R-Pa.) introduced a bill (HR 5025) that would allow behavioral, mental health and substance abuse treatment providers to qualify for incentive payments for the “meaningful use” of electronic health records, Healthcare IT News reports.

Under the 2009 federal economic stimulus package, hospitals and physicians who demonstrate meaningful use of EHRs can qualify for incentive payments through Medicaid and Medicare.

The new Health Information Technology Extension for Behavioral Health Services Act of 2010 would extend eligibility for the incentive payments to:

• Behavioral and mental health professionals and clinics;
• Substance abuse professionals and treatment facilities;
• Psychiatric hospitals; and
• Licensed psychologists and clinical social workers (Merrill, Healthcare IT News, 4/16).

Above article publish on http://www.ihealthbeat.org/articles/2010/4/16/bill-would-expand-eligibility-for-meaningful-use-incentives.aspx

By Healthcare IT News Staff

It has been an up-and-down year for healthcare informational technology. The biggest story, no doubt, was the impact that national recession had on healthcare investments – way back in January, the picture was bleak. But with the passage of the American Recovery and Reinvestment Act, the industry received a $19 billion shot in the arm from the new Obama Administration. While the money – to be used as incentives for adopting healthcare IT – doesn’t begin to flow in 2011, EHR adoption planning has already begun.

In the second half of the year, the top issue has been healthcare reform. The last sentences on that story have yet to be written, but on Dec. 24, the Senate finally passed its own bill. All that remains is reconciling the Senate and House versions and President Obama’s signature.

Below you’ll find the top issues of the last 12 months, selected by the editors of Healthcare IT News.

Privacy issues dog progess on NHIN

Privacy issues continue to keep the country’s planned nationwide health information network on the slow track, but government and community leaders say it won’t be a problem going forward. Yet things did not go exactly as the Office of the National Coordinator for Health Information Technology planned at a demonstration last month, where 19 cooperative organizations were scheduled to use real patient data to show how interoperability works. Instead, they used fictitious patient records to demonstrate greater depth in capabilities for interoperability than the initial trial run held in September.

IT pledge has market on pins and needles

President Barack Obama’s pledge to inject $50 billion into the healthcare field over the next five years to develop and support technology has many in the industry wondering how and where that money might be spent. On Jan. 22, 117 CEOs and business leaders sent a letter to House and Senate leaders supporting federal investment in healthcare information technology, broadband and energy smart grids, saying they “will provide our nation with a near-term stimulus and long-term comparative advantage.”

$19 billion to fuel healthcare IT

The $787 billion economic stimulus package signed by President Barack Obama on Feb. 17 includes $19 billion toward health information technology. While many healthcare IT industry insiders welcomed the spending as providing a needed impetus to pushing the healthcare system into the 21st Century, many also worried about getting IT done right. “I think it’s a terrible idea by the government to invest in healthcare IT – in EMR systems – without investing in standards,” said Marc Probst, CIO at Intermountain Healthcare in Salt Lake City.

HHS introduces new HIT Czar

Just as the April issue of Healthcare IT News was going to press, the Human Department of the Health and Services introduced David Blumenthal, MD, is Obama administration’s new National Coordinator for Health Information Technology. “I am humbled and honored to have the opportunity to serve President Obama and the American people in the effort to harness the power of health information technology,” Blumenthal said.

Hospitals shun life-saving IT

“Disappointing” and “disturbing” are two words Leah Binder chose to describe the results of a recent survey that revealed only 7 percent of hospitals across the country have adopted CPOE. CPOE, or computerized physician order entry, can reduce adverse events by 88 percent, according to Binder, the CEO of the healthcare watchdog organization The Leapfrog Group.

Obama budget reflects IT promise

President Barack Obama’s expanded fiscal year 2010 budget signals continued commitment to advancing healthcare IT as a way to cut healthcare costs and save lives. Obama’s $3.4 trillion federal budget, released May 8, expanded the outline he presented to Congress at the end of February.

Meaningful use draft approved

The federal health IT policy committee on July 16 approved long-awaited recommendations from its meaningful use workgroup on how providers can qualify to receive incentives through the new stimulus package. Measuring and improving outcomes is a key component.

Reform bill contains IT piece

The Senate Finance Committee health reform package, released Sept. 16, includes measures to advance healthcare IT. The committee’s reform bill has been the most controversial and the last proposal to come out of five Congressional committees that have jurisdiction over healthcare.

50,000 jobs: who will fill them?

The government’s piece of the stimulus package designed to encourage the adoption and use of healthcare information technology is expected to create 50,000 new jobs – maybe more.

Search is on for new CCHIT Chief

Key industry leaders are weighing in on the news that Mark Leavitt, MD, is retiring from his role as chairman of the Certification Commission for Health Information Technology.

Above article publish on http://www.healthcareitnews.com/news/newsmakers-year-review

Health care providers are gearing up to meet the privacy and security provisions of the federal economic stimulus law, Healthcare Informatics reports.

Under the health IT provisions of the federal stimulus package, all entities that handle protected health information must comply with HIPAA privacy regulations. In addition, the stimulus law calls for health care providers to:

• Notify all affected patients within 60 days of a security breach;
• Report security breaches to the HHS secretary and prominent media outlets if the incident affects more than 500 individuals;
• Track all personal health information disclosures; and
• Upon patient request, provide an account of every disclosure for the previous three years.

Experts say health care facilities could face serious penalties if they fail to comply with the new security provisions of the federal stimulus package.

Lisa Gallagher, senior director of privacy and security for the Healthcare Information and Management Systems Society, said health care facilities have focused on the funding aspects of the stimulus law instead of the security provisions. She said health care executives “need to devote time to creating additional policies, procedures and processes for meeting these requirements.”

Kate Healy, partner and chair of the health technology group at the law firm Verrill Dana, said, “Hospital executives need to stay engaged and have a few sources that can give them some of the nuts and bolts about the changes that the HITECH Act brings” (Gamble, Healthcare Informatics, July 2009).

Above article published on

http://www.ihealthbeat.org/Articles/2009/7/28/
Stimulus-Package-Steps-Up-Health-Data-Privacy-Security.aspx

The findings of a new Bridges to Excellence study suggest that more than two-thirds of U.S. physicians will respond to the health IT incentives included in the economic stimulus package because they are “significant” incentives, however, participation likely will be skewed toward practices with more than three physicians, Healthcare IT News reports (Merrill, Healthcare IT News, 5/7).

The stimulus package includes about $17 billion for Medicare and Medicaid incentive payments over five years for doctors and hospitals that use electronic health records (iHealthBeat, 3/16).

BTE, a national effort to recognize and reward high-performing physicians, assessed physician response rates to rewards using its Master Physicians Lists from each of its initial pilot sites — Louisville, Ky., Cincinnati, Albany, N.Y., and Boston. The analysis found that physicians’ participation largely depends on the size of the incentive or bonus for which they are eligible.

Because smaller physician practices are less likely to respond to the health IT provisions included in the federal stimulus package, BTE recommends that HHS support smaller practices with technical assistance in addition to the financial incentives to ensure widespread participation (Healthcare IT News, 5/7).

Above article published on

http://www.ihealthbeat.org/Articles/2009/5/7/Study-
Estimates-Success-of-Health-IT-Incentives-in-Stimulus-Package.aspx

In an interview with Modern Healthcare, Mark Leavitt, chair of the Certification Commission for Healthcare IT, discussed CCHIT’s current work and its potential role in developing certification criteria for determining which electronic health record systems will be eligible to receive funding under the economic stimulus law.

Although the federal stimulus law calls for the national coordinator for health IT to identify “a program or programs for the voluntary certification of health IT,” it does not specifically endorse CCHIT.

Because the economic stimulus package includes substantial federal subsidies for health care providers who adopt health IT, CCHIT’s certification criteria seek to ensure that “taxpayers’ money is not being wasted,” Leavitt said. He added, “Certification is basically a protection for the taxpayer.”

Leavitt said that he believes a single certification organization can best accomplish this task, because “the more organizations there are, the more likely it is” that substandard technology will gain approval.

Leavitt also discussed CCHIT’s future plans, which include releasing criteria for add-on features of EHRs used in child care and cardiology. The commission also aims to test and certify “stand-alone” electronic prescribing systems for the first time. Leavitt added that CCHIT will develop testing and certification programs “as fast as we can” for applications used by medical specialists.

Although some representatives from the open-source software community have questioned the compatibility of CCHIT’s certification program with open-source systems, Leavitt said the commission plans to work with open-source technologies to ensure that such systems are “not at a disadvantage” (Conn, Modern Healthcare, 5/28).

Above article published on

http://www.ihealthbeat.org/Articles/2009/5/29/
CCHIT-Chair-Discusses-Groups-Future-Role-Federal-Stimulus-Funding.aspx

Written by Patricia King

Editor’s note: Health care attorney Pat King outlines and explains provisions of the pending economic stimulus package that deal with electronic health records (EHR/EMR 1) use by physicians.

The American Recovery and Reinvestment Act of 2009 finally passed both houses of Congress this week. As this article is written, a final vote is expected on Saturday, February 14. While there are significant differences between the House² and Senate³ version in some areas, incentives for health information technology adoption by physicians and hospitals are substantially similar in both bills. The cost of incentives is estimated to be $17 billion in increased Medicare and Medicaid payments.

The Act uses the same “carrot and stick” approach adopted last year to encourage electronic prescribing. The incentive portion starts in 2011: a physician who is a “meaningful user” of electronic health records (EHR) is eligible to receive additional payments under the Medicare program that can extend over five years. The penalty portion starts in 2015, when physicians who are not meaningful EHR users will begin to see declines in their Medicare payments. Neither the incentive nor the penalty applies to hospital-based physicians.

Incentives for EHR use

For the first year that a physician qualifies as a meaningful EHR user, the physician is eligible for an incentive payment of 75% of his/her Medicare charges for the year, up to a maximum of $15,000 (the Senate bill provides that the ceiling is $18,000, if the first payment year is 2011 or 2012). The ceiling declines each year: $12,000 for the second year; $8,000 in the third year; $4,000 in the fourth year; $2,000 in the fifth year; and zero for subsequent years. Late adopters are penalized through phase down of the incentives: if the physician does not qualify as a meaningful user until 2014, then the payment ceiling for that physician’s first year is $12,000, the ceiling for the second year is $8,000, and so on. Under the House bill, there are no extra payments for physicians who do not qualify before 2015.

The Secretary of the Department of Health and Human Services (HHS) has discretion to determine whether the incentive payment will be paid in a single lump sum, or in installments. If the physician provides services to Medicare beneficiaries through more than one practice, HHS will determine how to allocate the incentive payment among the practices.

Penalties for not using EHR

Under the penalty provisions, physicians who are not meaningful EHR users in 2015 will see a 1% reduction in their fee schedule amount. The reduction increases to 2% in 2016, and 3% in 2017 and each subsequent year. If HHS finds that by 2017, the proportion of physicians who are meaningful EHR users is less than 75%, HHS may continue to ratchet down payments by 1% a year (but may not reduce payments below 95%). Hardship exceptions may be issued on a case-by-case basis, such as exceptions for physicians who practice in rural areas without adequate Internet access.

How to be considered an EHR user

To be a “meaningful EHR user”, the physician must satisfy three criteria:

• The physician must use “certified EHR technology” in a meaningful manner, including electronic prescribing. The law calls for creation of a health information technology (HIT) Policy Committee, and an HIT Standards Committee. The HIT Policy Committee will focus on development of a nationwide health information infrastructure, while the HIT Standards Committee will recommend standards, implementation specifications and certification criteria. The Office of the National Coordinator for Health Information Technology (ONCHIT) is to adopt an initial set of standards, implementation specifications and certification criteria before December 31, 2009.
• The physician must demonstrate that the certified EHR technology is connected in a manner that provides for the electronic exchange of health information to improve the quality of health care, such as promoting care coordination.
• The physician must submit information on clinical quality measures specified by HHS.

HHS will designate the way in which a physician is recognized as a meaningful user (through attestation, submission of claims with codes indicating that a patient encounter was documented using certified EHR technology, survey responses, submission of quality reports, or other means).

The Act also authorizes state Medicaid programs to provide additional payments to physicians, at least 30% of whose patient volume is services to Medicaid beneficiaries.

In addition to the incentive program, $2 billion is available to ONCHIT for implementation of the program, including grants to states to establish loan programs for physicians seeking to acquire certified EHR systems.

Above article published on http://www.netdoc.com/Physician-Practice-Articles/General-Medical
-Practice/Stimulus-package-and-EMR-use-by-physicians/