CMS Proposed Rule on Hospital EHR “Electronic Patient Event Notifications”

By Kathie McDonald-McClure and Margaret Young Levi

Doctor Speaking with PatientSummary: CMS proposes new Medicare Conditions of Participation for hospitals (including psychiatric and critical access hospitals) that will require the hospital EHR to send electronic event notifications to other providers when a patient has been admitted, discharged or transferred.  What must hospitals do, and how much time is needed, to operationalize the new CoPs, considering a process will need to be developed that identifies providers who should and can receive these event notices? What will be required, and how much time is needed, to reconfigure EHRs to send the notifications and demonstrate compliance with the multiple facets of the CoP?  CMS is seeking stakeholder input on the proposal, including a reasonable time frame for implementation.  UPDATE: On April 19, 2019, CMS extended the comments deadline from May 3, 2019 until June 3, 2019.

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KHIE issues June Newsletter

HCP with stethoscope using phone while on laptopThe Kentucky Health Information Exchange (KHIE) has issued its June 2014 Newsletter, The KHIE Connection.  This month’s issue includes a summary of the Centers for Medicare and Medicaid Services (CMS) Notice of Proposed Rule Making (NPRM) that, if finalized, would allow providers to meet Stage 1 or Stage 2 Meaningful Use with electronic health records (EHRs) that are certified to HHS ONC’s 2011 or 2014 Edition criteria or a combination of both Editions.  Comments to the NPRM must be received by July 21, 2014.  The newsletter also addresses Medicare’s scheduled payment adjustments for 2015 that will impact eligible hospitals and providers who do not timelyattest to Meaningful Use of certified EHRs.  Guidance on attesting to Meaningful Use also is included.

AHIMA Issues Guidance on Appropriate Use of Copy and Paste in EHRs

16354859As we have written about in previous posts, the Office of Inspector General (OIG) for the United States Department of Health and Human Services (HHS) has been critical of the copy/paste function that is available in electronic health record (EHR) technology developed by software vendors.  (See “Electronic Health Records in OIG’s Sights for 2013“, October 20, 2012; “OIG recommends fraud safeguards in hospital EHR technology“, December 11, 2013; “OIG Report on CMS’ EHR Audit Practices Concludes The Practices Are Not Very Sophisticated“, February 11, 2014)  As our February 11, 2014 post concludes, while turning off the copy/paste functionalities are not the immediate solution to preventing a misuse of the function, health care providers should implement standards for its use.  The American Health Information Management Association (AHIMA) recently issued guidance, “Appropriate Use of the Copy and Paste Functionality in Electronic Health Records,” dated March 17, 2014, discussing the availability and appropriate use of the copy and paste function.

AHIMA supports maintaining the copy/paste functionality in ONC’s EHR certification standards and allowing for its use in CMS Conditions of Participation.  AHIMA encourages CMS to augment provider education and training materials on the appropriate use of copy/paste in order to reduce the risk that it may pose to quality of care, patient safety and fraudulent documentation.  Importantly, AHIMA recommends that health care providers implement policies and procedures to guide users of EHRs on the proper use of copy/paste functionalities.  To read the AHIMA guidance, click here.

CMS Issues EHR Meaningful Use Hardship Exceptions for Health Care Providers Subject to 2015 Medicare Reimbursement Reduction (Includes Automatic One-Year Reprieve for 2013 Meaningful Users)

EHR Meaningful Use Hardship ExemptionOn February 28, 2014, we posted an article about ICD-10 and Stage 2 Meaningful Use (MU) announcements by the Centers for Medicare & Medicaid Services (CMS) at the 2014 HIMSS annual conference.  At that conference, while CMS refused to extend the deadlines for ICD-10 and Stage 2 MU, it promised to be more flexible about providing hardship exemptions on Stage 2 MU for providers and vendors truly struggling to meet the incentive program’s requirements.  CMS said that guidance would be forthcoming.  Yesterday, March 10, 2014, CMS issued such guidance.  The Guidance is directed solely at providers experiencing EHR vendor issues.  Importantly, the Guidance gives an automatic, one-year reprieve for certain providers who demonstrated MU for 2013. Continue reading

No Further Extensions for ICD-10 and MU Stage 2

strike before midnightUpdate:  On April 1, 2014, President Obama signed into law the “Doc Fix” bill, Public Law 113-93, which extends the deadline for ICD-10 for an additional year.  Section 212 of this law prohibits the Secretary of Health and Human Services from adopting ICD-10 code sets prior to October 1, 2015.

Everyone is a-twitter (pun intended) about the announcement on Thursday, February 27, 2014, from Marilyn Tavenner, the Administrator for the Centers for Medicare & Medicaid Services (CMS), that the deadline for adoption of ICD-10 will not be extended. Tavenner was the keynote speaker at the HIMSS14 conference, and numerous tweets from HIMSS attendees highlighted her assertion that CMS will stand firm on the October 1, 2014 deadline. All entities covered by the Health Insurance Portability and Accountability Act (HIPAA) must be prepared to use ICD-10 codes on transactions by this date.

Tavenner also affirmed that the deadlines for Stage 2 Meaningful Use (MU) will not be extended. Providers who are not meaningful users of Certified Electronic Health Record (EHR) Technology under the Medicare EHR Incentive Programs will face a penalty, in the form of Medicare payment adjustments. These payment adjustments will be applied beginning on January 1, 2015. Continue reading