On May 22, 2013, Kathleen Sebelius, Secretary of the United States Health & Human Services Department, announced that over 50 percent of doctors and over 80 percent of hospitals are making a “meaningful use” of electronic health records (EHRs) and have received incentives for such use. By comparison, in 2008, just nine percent had adopted EHRs. Secretary Sebelius credits the “dramatic increase” in adoption of EHRs to the Health Information Technology for Economic and Clinical Health Act (HITECH Act) that was passed as part of the American Recovery and Reinvestment Act of 2009 (ARRA). The HITECH Act awards incentives to eligible professionals (physicians) and hospitals who make a “meaningful use” of EHR technology that has been certified by the HHS Office of National Coordinator of Health Information Technology (ONC). The HHS press release with further information is available here.
meaningful use of certified EHR
ONC revokes two EHR product certifications — review your vendor contract warranties!
On April 25, 2013, the Officer of National Coordinator for Health Information Technology (ONC) announced that it had revoked certification for two electronic health record (EHR) products that the ONC had previously certified for use as part of the incentive program implemented pursuant to the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH Act). The products for which ONC revoked certification are EHRMagic-Ambulatory and EHRMagic-Inpatient. The ONC’s press release with additional information is available here.
Whether the providers who purchased these products in reliance on the previous ONC certification will be able to recoup their investment in these products may depend on the terms of any vendor agreement signed between the parties. For providers who are purchasing ONC-certified products, this development highlights the importance of examining the provider’s EHR vendor agreement to ensure that it contains adequate warranty and indemnification provisions that will protect the provider in case the vendor’s product is de-certified by the ONC. Importantly, without “certified EHR technology”, the provider will not qualify for the HITECH Act’s meaningful use incentive payments.
Patient Engagement is Key in Stage 2 Meaningful Use
Stage 2 of Meaningful Use under the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH Act) requires providers who want the HITECH Act’s EHR incentive payments to ensure that at least some patients are engaged and are actually using their electronic health records (EHRs). The Final Rule for the Stage 2 criteria call for eligible professionals (EPs), eligible hospitals and critical access hospitals (CAHs) to provide a means for patients to access their health care information online. EPs must also provide a means for patients to send secure messages electronically, however, patients have to actually use these services in order for providers to meet these new measures for making a Meaningful Use of certified EHRs.
Get Ready for Audits on EHR Incentive Payments
The promised audits have begun for providers receiving electronic health records (EHR) incentives available under the Health Information Technology for Economic and Clinical Health (HITECH) Act.
In order to receive Medicare EHR incentive payments, providers must attest to CMS that they meet Meaningful Use (MU) criteria using certified EHR technology. Any provider attesting to receive an EHR incentive payment for either the Medicare EHR Incentive Program or the Medicaid EHR Incentive Program potentially may be subject to an audit. If an audit finds a provider is not eligible for an EHR incentive payment because it does not meet MU criteria, then the incentive payment will be recouped. Here’s what providers need to know to prepare for an audit:
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.
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