meaningful use of certified EHR

Final Rule on ACOs encourages EHR adoption but eliminates “meaningful use” requirement

Margaret Young Levi EHR Certification Standards, Electronic Health Records, Health care reform, Health Information Technology, HITECH Law, Meaningful Use , , , , , , , ,

The Centers for Medicare and Medicaid Services (CMS) announced today, October 20, 2011, that the use of certified electronic health records (EHRs) will be the highest-weighted quality measure for an Accountable Care Organization (ACO) under the new Medicare Shared Savings Program.

ACOs are designed to encourage primary care doctors, specialists, hospitals, and other health care providers to coordinate their care. The CMS Final Rule on ACOs bases the amount of shared savings that an ACO may receive for its performance on four domains of quality: 1) quality standards on patient experience; 2) care coordination and patient safety; 3) preventive health; and 4) at-risk populations.  To earn shared savings the first performance year, providers must report across all four domains of quality, which include a total of 33 quality measures.  Providers will begin to share in savings based on how well they perform on 23 of the 33 quality measures in the second performance year and on 32 of the 33 measures in the third performance year. 

Measure 20 of the 33 quality measures requires ACOs to report the percentage of primary care providers (PCPs) who successfully qualify for an EHR Incentive Program payment.  CMS expanded the scope of PCPs who can be counted in this measure by eliminating the requirement that the PCP be a “meaningful EHR user” as defined in 42 C.F.R. § 495.4 of the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009.  CMS stated that it “decided to . . . expand [measure 20] to include any PCP who successfully qualifies for an EHR Incentive Program incentive rather than only including those deemed meaningful users.”

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Farzad Mostashari, MD, speaks at 2011 Kentucky eHealth Summit

Kathie McDonald-McClure EHR Certification Standards, Electronic Health Records, Eligible Professional Incentives, Health Information Technology, HITECH Law, Hospital EHR Stimulus, Meaningful Use, State HIT Grants & Loans , , , , ,

On September 6 and 7, 2011, the Kentucky Governor’s Office of Electronic Health Information hosted the 4th annual Kentucky eHealth Summit at the METS Center, 3861 Olympic Boulevard, Erlanger, KY 41018 in northern Kentucky.  

Farzad Mostashari, MD, ScM, the National Coordinator for Health Information Technology for the United States Department of Health & Human Services, addressed attendees of the Summit. Dr. Mostashari discussed the Office of National Coordinator’s initiatives and the future of health information technology, including the launch of a Consumer Health IT Program on September 12, 2011.  More information about the Kentucky eHealth Summit can be found here.

Kentucky was the first state in the United States to award Medicaid incentive money to a hospital and quickly followed in awards to other healthcare providers who completed an attestation of their plan to adopt, implement, or upgrade an Electronic Health Record (EHR) system.  For more information about the Kentucky Medicaid EHR Incentive program, and to read the FAQs and access additional helpful links, click here .

Office of Civil Rights Steps Up HIPAA Audits

Margaret Young Levi Electronic Health Records, Federal Law Resources, Health Information Technology, HITECH Law, Privacy & Security , , , , , ,

SUMMARY:  In June 2011, the  United States Department of Health & Human Services (HHS) Office of Civil Rights (OCR)contracted for new periodic audits of covered entities and business associates to ensure compliance with the Privacy and Security Standards found in the Health Insurance Portability and Accountability Act of 1996 (HIPAA) as amended by the Health Information Technology for Economic and Clinical Health Act (HITECH Act).  Announcement of these new audits followed closely on the heels of a May 2011 report from the HHS Office of Inspector General (OIG) criticizing oversight and enforcement of the HIPAA Security Rule requirements and recommending that the OCR conduct random audits. 

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Health IT Policy Committee Recommends Delay for Stage 2 Meaningful Use

Kathie McDonald-McClure Electronic Health Records, Eligible Professional Incentives, Health Information Technology, HITECH Law, Hospital EHR Stimulus, Meaningful Use, Physician EMR Stimulus , , , , , , ,

UPDATE: On July 6, 2011, Farzad Mostashari, M.D., ONC Chief, backed the ONC Policy Committee’s recommendation to delay implementing Stage 2 meaningful use criteria.

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On June 16, 2011, Paul Tang, M.D. , as Vice Chair of the Health IT Policy Committee for the  Office of National Coordinator (ONC), wrote a letter to Farzad Mostashari, M.D., the ONC National Coordinator, requesting a delay in implementing Stage 2 of the meaningful use criteria that eligible healthcare providers must meet in order to obtain the monetary incentives for adoption of electronic health records (EHRs).  The monetary incentives were established pursuant to the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH Act), which was part of the American Recovery and Reinvestment Act of 2009 (ARRA).  Dr. Tang states in the letter:

The HITPC has heard from both the vendor community and the provider community that the current schedule for compliance with stage 2 meaningful use objectives in 2013 poses a nearly insurmountable timing challenge for those who attest to meaningful use in 2011. With the anticipated release of the final rule for stage 2 in June, 2012, it would require EHR vendors to design, develop, and release new functionality, and for eligible hospitals to upgrade, implement and begin using the new functionality by the beginning of the reporting year in October of 2012. After careful consideration of the trade-offs between the urgency with which new functionality is needed and the ability to safely deliver and to effectively use the new functionality, the HITPC recommends that—only for those who begin to attest to MU in 2011—an extra year be provided to phase in the stage 2 expectations (ie., Stage 2 for those who attest in 2011 would begin in 2014).

The Committee asserts that the delay would only affect providers who implement Stage 1 in 2011.  This assumes that providers who wait until 2012 to implement Stage 1 would not have been ready to implement Stage 2 until 2014 anyway.  The letter also sets forth the proposals for stengthening Stage 1 criteria in Stage 2.  The Committee voted 12 to 5 in favor of the recommendations in the letter.  To read the entire 14-page letter, click here.

CMS Proposed Rule on Accountable Care Organizations is linked to Meaningful Use Measures

Kathie McDonald-McClure EHR Certification Standards, Electronic Health Records, Health care reform, Health Information Technology, HITECH Law, Meaningful Use , , , , ,

What do the Physician Quality Reporting Incentives Program (PQRI) and Hospital Inpatient Value Based Purchasing (VBP) Program have in common with the recently released proposed regulation for establishing an Accountable Care Organization (ACO)? Answer: The meaningful use measures established by the Centers for Medicare and Medicare Services (CMS) for qualifying for incentives under the Health Information  Technology for Economic and Clinical Health Act of 2009 (HITECH).  Of course! 

On April 7, 2011, CMS published the Proposed Rule on Medicare Shared Savings Program: Accountable Care Organizations in the Federal Register. The Proposed Rule sets forth the requirements that an ACO must meet in order to qualify for the cost savings that will be available to qualifying providers.  Among the requirements, CMS incorporates the EHR meaningful use incentives, stating:

[T]he ACO should have a process in place (or clear path to develop such a process) to electronically exchange summary of care information when patients transition to another provider or setting of care, both within and outside the ACO, consistent with meaningful use requirements under the EHR Incentive program.

Now Medicare providers have another reason to get on board sooner rather than later with the implementation of a certified electronic health record (EHR). 

Stay tuned to the HITECH Law Blog for a post that will have a more in-depth review of how the ACO requirements may impact providers in regard to the implementation and use of certified EHRs, including a review of the overlapping measures for PQRI, Hospital VBP Programs, HITECH EHR incentives and ACOs.  In the meantime, to read more about the HITECH meaningful use measures utilized in the CMS Hospital VPB Program, see the article, “Certified EHRs Expected to Transmit Data for Medicare’s New Hospital Inpatient Value-Based Purchasing Program,” posted to the HITECH Law Blog on February 8, 2011.