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eduTrax News Service - January 8, 2010.
New Proposed Rule Governs EHR Incentive Programs, Defines 'Meaningful Use'
The Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) issued two new regulations listing the "meaningful use" criteria healthcare providers must meet in order to quality for federal funding of their information technology (IT) projects under the American Recovery and Reinvestment Act of 2009 (ARRA), on December 30, 2009, just under the statute's deadline. ....
A proposed rule published by CMS outlines proposed provisions to govern EHR incentive programs, including a definition of the central concept of “meaningful use” of EHR technology. Also, an interim final regulation (IFR) issued by ONC sets the initial standards, implementation specifications, and certification criteria for EHR technology. Both regulations now invite public comment.
The IFR issued by ONC describes the standards that must be met by certified EHR technology to exchange healthcare information among providers and between providers and patients. This initial set of standards begins to define a common language to ensure accurate and secure health information exchange across different EHR systems. The IFR describes standard formats for clinical summaries and prescriptions; standard terms to describe clinical problems, procedures, laboratory tests, medications and allergies; plus standards for the secure exchange of this information using the Internet.
The IFR also calls for the industry to standardize the way in which EHR information is exchanged between organizations. It sets forth criteria required for an EHR technology to be certified, and therefore approved for purchase and use by providers. The standards support meaningful use and data exchange among providers who must use certified EHR technology to qualify for the Medicare and Medicaid incentives, in the near future.
Under the ARRA, HHS was required to adopt an initial set of standards for EHR technology by Dec. 31, 2009. The IFR will now go into effect 30 days after publication, with an opportunity for public comment and refinement over the next 60 days. The final rule will then be issued later in 2010.
The ARRA established programs to provide incentive payments to eligible professionals and eligible hospitals participating in Medicare and Medicaid that adopt and make “meaningful use” of certified EHR technology. Incentive payments may begin as soon as October 2010 to eligible hospitals. Incentive payments to other eligible providers may begin in January 2011.
The proposed rule defines a "meaningful EHR user" as an eligible professional or eligible hospital that, during the specified reporting period, demonstrates meaningful use of certified EHR technology in a form and manner consistent with certain objectives and measures presented in the regulation. These objectives and measures would include use of certified EHR technology in a manner that improves quality, safety, and efficiency of healthcare delivery, reduces healthcare disparities, engages patients and families, improves care coordination, improves population and public health, and ensures adequate privacy and security protections for personal health information.
The proposed rule also defines meaningful use for the Medicare EHR incentive programs, proposing one definition that would apply to eligible professionals participating in the Medicare fee-for-service and the Medicare Advantage EHR incentive programs, as well as a proposed definition that would apply to eligible hospitals and critical access hospitals. These definitions would also serve as the minimum standard for eligible professionals and eligible hospitals participating in the Medicaid EHR incentive program.
The rule further proposes that states could request CMS approval to implement additional meaningful use measures, as appropriate, but could not request approval of fewer or less rigorous meaningful use measures than required by the rule.
Finally, the rule proposes a phased approach to implement the proposed requirements for demonstrating meaningful use: initially, reasonable criteria would be established for meaningful use based on currently available technological capabilities and providers’ practice experience. CMS will establish more extensive, stricter criteria for demonstrating meaningful use over time, as developments in technology and providers’ capabilities occur.
CMS allows for a 60-day comment period on the proposed rule.
The CMS proposed rule and fact sheets, plus ONC’s interim final rule may be found in our Documents section, HERE. |
