Just to recap where we are today, the U.S. Health & Human Services Department (HHS) Office of National Coordinator for Health Information Technology (ONC) has authorized three organizations to perform complete EHR and/or EHR module testing and certification under the Temporary Certification Program Rules. Certification means that the EHR or EHR module has the capabilities necessary to support the efforts of eligible hospitals and eligible professionals in meeting the Meaningful Use requirements under Final Rule issued by Centers for Medicare and Medicaid Services (CMS) for Meaningful Use. The three ONC-Authorized Testing & Certification Bodies (ATCBs) to date are Certification Commission for Health Information Technology (CCHIT), Drummond Group, Inc. (Drummond), and InfoGuard Laboratories, Inc. (InfoGuard). For additional information about the ONC process for achieving ATCB status, as well as more information about Standards & Certification generally, see the ONC webpage.
Electronic Health Records
CMS Issues HITECH IT Guidance to State Medicaid Directors
On August 17, 2010, the Centers for Medicare and Medicaid Services (CMS) issued a 4-page letter plus attachments to State Medicaid Directors giving guidance on the implementation of Medicaid EHR incentive programs under the Health Information Technology for Economic and Clinical Health Act (HITECH) and the recently published CMS Final Rule under HITECH. HITECH mandates that the Federal government provide 100% funding to States for the incentives available to eligible professional and hospitals who participate in HITECH’s Medicaid incentive program, and 90% funding to States for the administration of such Medicaid incentives. States, however, must qualify for the 90% administrative Federal funding participation (FFP) by:
- Administering the Medicaid incentive payments to eligible professionals and hospitals;
- Overseeing the Medicaid incentive program, including tracking “meaningful use” attestations and reporting mechanisms; and
- Pursuing initiatives that encourage the adoption of certified EHR technology for the promotion of health care quality and the electronic exchange of health information.
Importantly, States must use the HIT Implementation Advance Planning Document (IAPD) in order to request the FFP and must receive approval before implementing proposed activities and services or acquiring equipment. CMS points out that some activities may be more appropriately reimbursed through the existing Medicaid Management Information Systems and that other administrative expenditures may not be eligible for any Federal funding. States must have a State Medicaid Health Information Technology Plan (SMHP) outlining the State’s current and future HIT landscape and plans for implementation of the Medicaid EHR incentives. CMS made available a SMHP template for States to outline their Medicaid EHR incentive implementation plans and timeline, referenced here.
The guidance documents CMS included with its letter are: A) Administering the Medicaid EHR Incentive Program; B) Oversight of the Medicaid Incentive Program; C) Guiding Principles for the Use of the 90% FFP for EHR Promotion; and D) SMHP/IAPD Review Process. For additional CMS information for states, click here.
Commercial Payors Implementing EHR Meaningful Use Criteria in P4P Programs
Update: On August 9, 2010, Humana, Inc. and athenahealth, Inc. announced their collaboration to provide physicians access to a practice management/EHR software system combined with a rewards program related to quality measures. For more information, click here.
On August 5, 2010, four major commercial health insurance payors participated in the Health Industry Forum in Washington, D.C., to discuss private industry collaboration with the United States Health & Human Services Department (HHS) to support providers in the adoption of certified electronic health records (EHRs). Leading the Forum’s panel discussion was David Blumenthal, M.D., Chief of the Office of National Coordinator of HIT. All four payors will include the Meaningful Use criteria in their pay for performance (P4P) programs.
Electronic Health Record Incentives for Multi-Campus Hospitals Act of 2010
Update: The text of HR 6072 is now available on the Library of Congress webpage here.
On Friday, July 30, 2010, Rep. Zack Space (D-OH) and several other representatives, introduced HR 6072, the Electronic Health Record Incentives for Multi-Campus Hospitals Act of 2010 (Multi-campus Hospital Act). If passed, this Act would reduce the disparity in payment of electronic health record (EHR) incentives between multi-hospital systems that file a Medicare cost report for the entire system under one CMS Certification Number (CCN) and systems that file a Medicare cost report for each hospital in the system with a separate CCN. A multi-hospital system in the latter group, under the current CMS Final Rule for Meaningful Use (MU), would receive, in the aggregate, a proportionately larger EHR incentive amount than a system in the first group.
CMS Holds Training Teleconference on EHR Final Rules
On Thursday, July 22, 2010, the Centers for Medicare and Medicaid Services (CMS) held a publicly available teleconference to give an overview of the 800+ page Final Rule on Meaningful Use (MU) under the HITECH Act, as well as an overview of the Final and Proposed Rules on Temporary & Permanent Certification Program and the Final Rule on the Standards and Certification Criteria for electronic health records (EHRs). CMS is making an “encore recording” of the 90-minute teleconference available until 11:00 pm, Saturday, July 24, 2010. Call toll-free, 1-800-642-1689 and enter the conference ID 87841621 to hear the encore recording. CMS will post an audio recording link to the teleconference on its EHR Incentive Programs website sometime in August 2010. The slides accompanying the audio are available on that same website, here (scroll to Downloads and click on the links for the July 22, 2010 Training materials).
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