Commercial Payors Implementing EHR Meaningful Use Criteria in P4P Programs

August 7, 2010October 31, 2011 Kathie McDonald-McClure Health care reform, Health Information Technology, HITECH Law, Hospital EHR Stimulus, Meaningful Use, Physician EMR Stimulus commercial payer support for EHRs, Electronic Health Records, eligible professional incentives for electronic medical records, Health Information Technology, HITECH Act, hospital incentives for EHRs, linkedin, meaningful use of certified EHR

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.

Continue reading →

Electronic Health Record Incentives for Multi-Campus Hospitals Act of 2010

August 4, 2010October 31, 2011 Kathie McDonald-McClure Electronic Health Records, Health Information Technology, HITECH Law, Hospital EHR Stimulus, Meaningful Use EHR Incentives Multi-Campus Hospitals Act of 2010, Electronic Health Records, Health Information Technology, HITECH Act, hospital incentives for EHRs, linkedin, Meaningful Use

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.

Continue reading →

CMS Holds Training Teleconference on EHR Final Rules

July 23, 2010August 4, 2010 Kathie McDonald-McClure EHR Certification Standards, Electronic Health Records, Eligible Professional Incentives, Health Information Technology, HITECH Law, Hospital EHR Stimulus, Meaningful Use, Physician EMR Stimulus EHR Certification Standards, Electronic Health Records, eligible professional incentives for electronic medical records, Health Information Technology, hospital incentives for EHRs, linkedin, meaningful use of certified EHR, ONC

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).

Continue reading →

HHS Releases Final Rule on “Meaningful Use” of Electronic Health Records

July 14, 2010January 10, 2011 Kathie McDonald-McClure EHR Certification Standards, Electronic Health Records, Health care reform, Health Information Technology, HITECH Law, Hospital EHR Stimulus, Meaningful Use, Physician EMR Stimulus, Privacy & Security 75 Fed Reg 44314 July 28 2010, 75 Fed Reg 44590 July 28 2010, EHR Certification Standards, Electronic Health Records, eligible professional incentives for electronic medical records, Health Information Technology, HITECH Act, hospital incentives for EHRs, linkedin, meaningful use of certified EHR, privacy and security of health information exchange

Update: On December 29, 2010, HHS published in the Federal Register a “Correcting Amendment” to its Final Rule on Meaningful Use, which can be viewed here.

HHS Secretary Kathleen Sebelius wasted no time in putting the brand new CMS Director to work on July 13, 2010, in announcing the release of two rules under the Health Information Technology for Clinical and Economic Health Act (HITECH), including the Final Rule on Meaningful Use and the Final Rule on Initial Set of EHR Standards and Certification Criteria. Donald M. Berwick, MD, MPP, FRCP, was sworn in as Director of the Centers for Medicare and Medicaid Services on Monday afternoon, July 12, 2010, and by the next morning was primed to discuss the important role of health information technology (HIT) in America. In addition to Dr. Berwick’s participation at the press briefing, other participants included David Blumenthal, MD, the Chief Coordinator for the HHS Office of National Coordinator of HIT (ONC), Regina Benjamin, MD, U.S. Surgeon General, and Regina Holiday, an individual who shared a personal experience involving access to health information and how such access impacts the care of patients.

Quick Reference: The CMS Fact Sheet on both Final Rules is available here.

Continue reading →

Can hospitals benefit from HITECH Act stimulus funds for their non-hospital based, employed physicians?

February 18, 2010July 8, 2010 Kathie McDonald-McClure Eligible Professional Incentives, Health Information Technology, HITECH Law, Hospital EHR Stimulus, Physician EMR Stimulus eligible professional incentives for electronic medical records, HITECH Act, hospital incentives for EHRs

IMPORTANT NOTICE: This article was originally written in June 2009, before HHS released the Proposed Rule on “meaningful use” on December 30, 2009 and before President Obama signed the Continuing Extension Act of 2010. Under the Proposed Rule, the determining factor of whether a physician is “hospital-based” under the Medicare incentive program was to be his or her “site of service” on the claim, specifically, “21” for hospital inpatient, “22” for hospital outpatient, and “23” for emergency department. If 90% or more of a physician’s claims had these places of service codes, then CMS would have deemed such physician to be “hospital-based” and ineligible for the incentive. However, on April 15, 2010, President Obama signed the Extension Act, which amended the HITECH Act language by replacing the words “outpatient setting” with the words “emergency room setting.” Accordingly, CMS will not be able to deem a physician practicing in a hospital outpatient setting, such as an urgent care clinic, ineligible for the incentive soley on this basis. If an employed or contracted physician practicing in an outpatient setting is eligible (EP), the hospital should take steps to ensure the incentive awarded to such EP due to the meaningful use of a certified EHR in that hospital’s outpatient setting is appropriately assigned to the employing or contracting hospital.

Article Summary: This article explores the potential for hospitals to obtain the HITECH Act incentives made available to “eligible professionals.” Hospital-based physicians who meet the “hospital-based” definition are not eligible for the eligible professional incentives. The definition of “hospital-based” contains several terms, including “hospital setting,” that are not clearly defined and, importantly, the HITECH Act leaves some discretion in the Secretary of Health & Human Services (HHS) to further define it. If the objective is to prevent hospitals from being paid twice for the same electronic medical record (EMR), then the exclusion of “hospital-based” physicians makes sense. However, if hospital-owned physician clinics or practices must implement specially designed health information technology (HIT) that will enable such physicians to make a “meaningful use” of the EMR, then the hospital owner might be advised to consider this in formulating its business and financial strategy for a totally integrated HIT system-wide.