Author: Kathie McDonald-McClure

Certified EHRs Expected to Transmit Data for Medicare’s New Hospital Inpatient Value-Based Purchasing Program

Kathie McDonald-McClure EHR Certification Standards, Electronic Health Records, Health care reform, Health Information Technology, HITECH Law, Meaningful Use , , , , , ,

On January 13, 2011, the Centers for Medicare and Medicaid Services (CMS) released its Proposed Rule on the Medicare Hospital Inpatient Value-Based Purchasing (VBP) Program. The VPB Program is being established per the directive of the Patient Protection and Affordable Access to Care Act of 2010 (PPACA). CMS is to begin making incentive payments under the VBP Program for discharges on or after October 1, 2012.

Seven years before PPACA required CMS to establish the VBP Incentive Program, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) gave CMS authority to establish the Hospital Inpatient Quality Reporting (IQR) Program. The clinical quality measures that CMS has adopted for the IQR Program will feed into the measures for the VBP Program.

The IQR Program measures were generally based on recommendations from the National Quality Forum (NQF), a voluntary consensus standard-setting organization with a diverse representation of consumer, purchaser, provider, academic, clinical, and other health care stakeholder organizations. The IQR measures began as a set of 10 quality indicators that have since expanded to 45 clinical quality measures for the FY 2011 IQR program payment determination. The FY 2011 IQR hospital measures focus on four topics: 1) Acute Myocardial Infarction (AMI); 2) Heart Failure (HF); 3) Pneumonia (PN); and 4) Surgical Care Improvement Project (SCIP).

So how does this relate to the Health Information Technology for Economic and Clinical Health Act (HITECH Act) and a hospital’s “meaningful use” of a “certified EHR“? Ahhh, there is a method to the madness. As the CMS VBP Proposed Rule points out, the Hospital IQR program and the Hospital VBP Program have “important areas of overlap and synergy with regard to the reporting of quality measures under the HITECH Act.”

CMS notes in the Proposed Rule that the certification standards for EHRs under the HITECH Act are directed at enabling EHR submission of quality measures. CMS is striving “to align the [VPB] measures with the adoption of meaningful use standards for health information technology (HIT), so the collection of performance information is part of care delivery.” As a result, CMS anticipates that hospitals will use their certified EHRs for the reporting of clinical quality measures under both the Hospital IQR program and the subsequent Hospital VBP Program.

The proposed initial measures for the FY 2013 Hospital VBP Program include 18 measures. Of these 18 measures, 17 measures will focus on the four clinical process of care topics set forth for the 2011 IQR Program (AMI, HF, PN, and SCIP), and will add Healthcare-Associated Infections (HAI). The 18th measure will include a measure from the Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS) that will fall under a patient experience of care domain.

The proposed performance period is to begin July 1, 2011 and will continue through March 31, 2012 for the FY 2013 payment determination. This is already less than five months away! Another reason for Eligible Hospitals under the HITECH Act to focus on implementation of a certified EHR. Did I hear someone ask how the VBP incentive payments will be funded? Answer: By a reduction of the Fiscal Year 2013 base operating DRG payments for each discharge of 1%. “What one hand giveth, the other hand taketh away.” (Unknown)

For more information about the IQR Program, visit QualityNet.  For additional details about the VBP Program, see the Proposed Rule.  CMS will accept comments on the VBP Proposed Rule until March 8, 2011.  CMS expects to issue a final rule in 2012.

CMS Posts Helpful EHR Incentive Program Registration Guides

Kathie McDonald-McClure Electronic Health Records, Health Information Technology, HITECH Law, Hospital EHR Stimulus, Physician EMR Stimulus , , , , , , , ,
CMS has posted very helpful Electronic Health Record (EHR) Registration User Guides, one for Eligible Hospitals and one for Eligible Professionals. The Guides provide an excellent overview of the path to receiving EHR Incentives available under the Health Information Technology for Economic and Clinical Health (HITECH) Act.  As I pointed out in my previous post, CMS is encouraging Eligible Hospitals and Eligible Professionals to go ahead and register in advance of making an attestation to meaningful use of a certified EHR.  CMS has set up the system so that registrants do not have to fear that registration alone could somehow subject them to penalties later for failing to follow through with implementing and making an meaningful use of an EHR.  This is evident by reviewing the way in which the registration system is broken down into four parts or “tabs”: Registration, Attestation,  Status and Account Management.
 
Registration Tab. Here is where hospitals and physicians (as well as other practitioners eligible for incentives under State Medicaid programs) can register for the EHR Incentive Program.  Registrants also will access this Tab to take one of the following actions: Continue an Incomplete Registration, Modify an Existing Registration, Resubmit a registration that was previously deemed ineligible, Reactivate a Registration, Switch Incentive Programs (Medicare/Medicaid), Switch Medicaid State, and Cancel Participation in the EHR Incentive Program.
 
Attestation Tab.  Under this Tab is where registrants can submit their Attestation of meaningful use when ready.  This Tab also provides options and instructions for Registrants wanting to: Continue an Incomplete Attestation, Modify an Existing Attestation, or Discontinue an Attestation.
 
Status Tab.  Here, registrants can view the status of Registration, Attestation and their EHR Incentive Payment.
Account Management Tab.  Here, registrants can Update Account Information, Request Access to Organizations, or Remove Access to Organizations.
 
The Hospital Guide can be accessed here and the Eligible Professional Guide can be accessed here.

CMS Opens Registration for EHR Incentives on January 3, 2011

Kathie McDonald-McClure Electronic Health Records, Eligible Professional Incentives, Health Information Technology, HITECH Law, Hospital EHR Stimulus , , , , ,

Hands on keyboard in circleThe U.S. Department of Health & Human Services Centers for Medicare & Medicaid Services (CMS) has updated its HITECH electronic health records webpage to include information about registration for the Medicare and Medicaid EHR Incentive Programs. Per CMS, registration opens on January 3, 2011 and a link will be available on the CMS HITECH website here. CMS encourages providers to register for the Medicare and/or Medicaid EHR Incentive Program(s) as soon as possible. Providers can register before they have a certified EHR.  CMS encourages providers to register even if they do not have an enrollment record in PECOS!

CMS also notes that although the Medicaid EHR Incentive Programs will begin January 3, 2011, not all states will be ready to participate on this date. As of this posting, registration will be available on January 3, 2011 for the following states:

Alaska — Iowa — Kentucky — Louisiana — Oklahoma — Michigan — Mississippi — North Carolina — South Carolina — Tennessee — Texas

Information on when registration will be available for Medicaid EHR Incentive Programs in specific States is posted here.  For more information from CMS about the EHR Incentive Program, click here.

Identity Theft and the FTC’s Red Flags Rule

Kathie McDonald-McClure Health Information Technology, Privacy & Security , ,
FTC Red Flags Alert Rule

Update: In a voice vote today, December 7, 2010, the House passed the Red Flag Program Clarification Act of 2010. The Act now goes to President Obama for signing.

On November 30, 2010, the U.S. Senate passed legislation that could exempt health care providers from the FTC’s Red Flag Rule. The Red Flag Program Clarification Act of 2010 amends the Fair Credit Reporting Act with regard to the applicability of identity theft guidelines to creditors. Under the amendment, a “creditor” will “not include a creditor . . . that advances funds on behalf of a person for expenses incidental to a service provided by the creditor to that person.” There is an identical companion bill before the House, which is expected to pass.  The Clarification Act may lift an impending compliance burden on businesses that do not collect payment for services at the time services are rendered, where there is no reasonably foreseeable risk of identify theft. Continue reading →

Health Care Reform & HITECH Update for Employers: Webinar

Kathie McDonald-McClure Electronic Health Records, Federal Law Resources, Health care reform, Health Information Technology, HITECH Law, Privacy & Security , , , , , , ,

The health care reform law is massive, and it will take time for employers to develop appropriate plans for compliance. The first transformative step in health care reform actually started with the American Recovery and Reinvestment Act of 2009 (ARRA), which included the Health Information Technology for Economic and Clinical Health Act (HITECH Act). The HITECH Act set the course for implementing a nationwide network of electronic health records (EHRs). One of the main goals of the HITECH Act is to ensure privacy and security.  Why might this be important to a business that is not a health care provider?  To find out, join the Kentucky Chamber’s webinar, Health Care Reform Update for Employers, on December 16, 2010, from 3:00 to 4:00 pm (EST). The first part of the webinar will focus on the employer and its HR department, looking at the new laws and discussing what decisions an employer must consider in light of these new laws. Jason Lee, Esq., a member of the Tax, Business & Personal Planning Service Team at Wyatt, Tarrant & Combs, LLP, will lead this discussion, which also will include an overview of tax credits and penalties, as well the changes in effect now and those coming in the future, for employers. The second part of the webinar will focus on the changes that occurred last year with the passage of the HITECH Act.   Kathie McDonald-McClure, Esq., Editor of the HITECH Law Blog and a partner with Wyatt, Tarrant & Combs, LLP, will lead this discussion. She will highlight certain provisions of the HITECH Act’s new privacy and security provisions that will have an immediate and direct impact on certain businesses, including those that do not directly provide any health care. For more information, and to sign up, click here.