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

November 30th Meaningful Use Deadline for Hospitals

clip_image002Saturday, November 30, 2013, is the last day for hospitals and critical access hospitals (CAHs) to register and attest to receive an incentive payment for FY2013 under the Medicare Electronic Health Record (EHR) Incentive Program.  In the flurry of Thanksgiving activities, holiday travel and Black Friday shopping, don’t forget to take advantage of this deal.  The Centers for Medicare and Medicaid Services (CMS) has posted a reminder of these deadlines on its Medicare & Medicaid EHR Incentive Program Registration & Attestation System webpage.
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Extension of EHR Safe Harbor? The Ball is Rolling …

clip_image002by Ann F. Triebsch

The anti-kickback “safe harbor” allowing hospitals to donate electronic health record (“EHR”) equipment to physicians who may refer patients to their facility is set to expire on December 31, 2013, but efforts have begun to have the safe harbor extended. The safe harbor, created in 2006, allows hospitals to donate EHR and electronic prescribing technology to practices for the purpose of setting up or improving EHR systems, provided that the practice covers 15% of the cost of the EHR technology, without risk of anti-kickback enforcement. The purpose was to incentivize the meaningful use of EHR systems, and Medicare incentive payments for EHR adoption will continue through 2016.

Rep. Jim McDermott (D-Wash.) sent a letter on March 28 to Greg Demske, chief counsel of the HHS Office of Inspector General, asking OIG to extend the safe harbor provision. He emphasized Washington’s goal of reducing healthcare costs and eliminating wasteful spending, and pointed out that an extension would further that goal. He called the safe harbor provision “a common-sense policy” that “encourages collaboration among providers, yet also contains rigorous requirements that providers must meet in order to protect the Medicare and Medicaid programs from the few unscrupulous providers who would donate electronic health record software in exchange for referrals.” Earlier this year, the Federation of American Hospitals also showed support for renewing the EHR safe harbor.

To read Rep. McDermott’s letter, click here.

To read the Federation of American Hospitals letter, click here.

Stay tuned for further action on an extension.

Final Rules for Stage 2 EHR Incentive Programs Released

First, the Centers for Medicare & Medicaid Services (CMS) released the long-awaited final rule to govern Stage 2 of the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. The rule specifies the Stage 2 criteria that eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) must meet in order to continue to participate in the EHR Incentive Programs.

  • Click here for the full text of CMS’s final rule.
  • Click here to see the fact sheet on CMS’s final rule.

Second,  the Office of the National Coordinator for Health Information Technology (ONC) also announced a related final rule, which specifies the technical capabilities and related standards and implementation specifications that Certified EHR Technology will need to include to support the achievement of meaningful use by EPs, eligible hospitals, and CAHs under the EHR Incentive Programs.

  • Click here for the full text of the ONC rule.
  • Click here  to read a fact sheet on ONC’s standards and certification criteria final rule.

Stay tuned.  We will be posting more about these final rules in the days to come.

Early Meaningful Users Promised Stage 2 Extension

On November 30, 2011, U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius issued a press release announcing proposed steps to encourage physicians and hospitals to adopt electronic health records (EHRs) this year and receive incentive payments made available under the Health Information Technology for Economic and Clinical Health (HITECH) Act), which was part of the American Recovery and Reinvestment Act of 2009 (ARRA). 

Under the HITECH Act, physicians and hospitals have the opportunity to earn financial incentives from Medicare and Medicaid if they demonstrate the adoption and meaningful use of certified EHRs in a series of three stages. Under the current rules, physicians and hospitals that adopt EHRs in 2011 and attest to meeting Stage 1 meaningful use standards by February 28, 2012 must meet Stage 2 standards in 2013. If they wait until 2012 to attest to Stage 1, providers could delay Stage 2 compliance until 2014. To encourage more providers to adopt EHRs in 2011, instead of waiting until 2012, HHS proposes to allow providers who qualify for Stage 1 meaningful use in 2011 an extension until 2014 to meet Stage 2 standards. HHS clarified that providers first attesting to meaningful use in 2011 qualify for both 2011 and 2012 incentive payments.

These proposed steps are consistent with June 2011 recommendations from the Health IT Policy Committee (HITPC).  As we reported this summer, HITPC advocated that providers who begin to attest to meaningful use in 2011 be provided an extra year “to phase in the stage 2 expectations (i.e., Stage 2 for those who attest in 2011 would begin in 2014).”  HHS listened!

HHS intends to publish this extension in the Stage 2 meaningful use Notice of Proposed Rulemaking (NPRM) in February 2012.

At the same time, HHS also released new data from the Centers for Disease Control and Prevention (CDC) showing increased adoption of EHRs by physicians.  The CDC report documented that physicians’ adoption of health information technology (IT) doubled in two years, and 52% of physicians intend to apply for meaningful use incentives, up from 41% in 2010.  Click here to access additional information about achieving meaningful use, including the CDC report.