Home > CMS

CMS Chief Answers Some Tough Questions

February 22, 2011 By 2 Comments

On American Medical News, a report on a meeting of the AMA National Advocacy Conference found CMS Administrator Donald Berwick, MD, answering some tough questions, including the effect that some reimbursement cuts have had on certain specialties and challenges to EMR adoption.

Also on the agenda was David Blumenthal, MD, the outgoing national health information technology chief (ONCHIT), who states that “physicians who fail to invest in EMRs will see their practices decline in value relative to colleagues who do invest” and that “they also will face more difficulty recruiting young physicians and attracting patients who will expect such technology.”

Are Your Papers in Order?

January 3, 2011 By 3 Comments

That feels like it should be said with a German accent. But seriously, the date for registration for Medicare’s EHR incentive payment program begins on January 3, 2011. According to a report on MassDevice.com, the CMS and the ONCHIT (Office of the National Coordinator for Health Information Technology) have announced key milestones for implementation of the incentive program’s first year:

  • Jan. 3, 2011 — Registration for the Medicare EHR incentive program begins.
  • Jan. 3, 2011 —States that are ready may launch their incentive programs for Medicaid providers.
  • January 2011 — Some state agencies begin issuing Medicaid EHR incentive payments.
  • April 2011 — Attestation for the Medicare EHR incentive program begins.
  • May 2011 — Issuing of Medicare EHR incentive payments expected to begin.
  • July 3, 2011 — Last day for eligible hospitals to begin their 90-day reporting period to demonstrate meaningful use for the Medicare EHR incentive program for federal FY 2011.
  • Sept. 30, 2011 — Federal FY 2011 payment year ends at midnight for eligible hospitals and critical access hospitals (CAHs).
  • Oct. 3, 2011 — Last day for eligible professionals to begin their 90-day reporting period for calendar year 2011 to demonstrate meaningful use for the Medicare EHR incentive program.
  • Nov. 30, 2011 — Last day for eligible hospitals and CAHs to register and attest to receive an incentive payment for federal fiscal year 2011.
  • Dec. 31, 2011 — Calendar 2011 payment year ends for eligible professionals

Jot these dates down, or bookmark that page. In addition, we will be keeping you up-to-date with these milestones in the coming months.

Please post any comments on this topic below.

CMS Meaningful Use Rules, Part 3

July 29, 2010 By 3 Comments

In part 1, we discussed just what is meant by a meaningful user and in part 2 we touched briefly on some of the changes made in the meaningful use rules from the proposed rules to the final rules. Whereas initially there was an 80% threshold that had to be met for pretty much every objective, after much discussion and consideration, CMS agreed that for some of these measures that was too high a bar to jump.

Here is a nice summary of the final rules thresholds for each of the meaningful use objectives and measures. Thanks to Robin Raiford, RN, from the HIMSS Legislation and Regulation Review Task Force, for providing us with this great resource.

It’s too detailed to see clearly on the website so….

RIGHT-CLICK HERE to download the PDF file

CMS Meaningful Use Rules, Part 2

July 22, 2010 By 2 Comments

In part 1, we introduced the different stages of meaningful use criteria as defined by CMS in their final rules, released July 13, 2010. Many practices and hospitals breathed a collective sigh of relief on the one hand, as several criteria had thresholds that were less onerous than were originally proposed. It seems that CMS has been listening.

Thresholds for CPOE and e-Prescribing

For example, as we mentioned earlier, the threshold for meeting criteria for CPOE (computerized physician order entry) is now set at 30%. This means that only 30% of unique patients (not total patient visits) need to have at least one order entered into the electronic medical record system to meet those goals.

Another example is electronically transmitted prescriptions or e-Prescribing. Originally set at 75% of “permissible prescriptions”, this has been dropped to “at least 40%”. This was due in part to objections that (1) some pharmacies are not quite ready to accept e-Prescribing and (2) some patients insist on getting a paper prescription.

Structured Data vs Unstructured Data

Along the subject of prescriptions, an active medication list must be maintained on patients (with the default threshold of at least 80% of unique patients) in the form of “structured data”. Structured data refers to data that can be identified by the EMR system. In other words, [Read more...]

CMS Releases EHR Adoption Rules, Part 1

July 14, 2010 By 2 Comments

On Tuesday July 13, CMS released the final rule for adopting a certified electronic health record (EHR) system.

After listing about 60 acronyms and abbreviations (and it’s impossible to remember them when reading the subsequent text), what follows is approximately 800 pages of proposals, related comments, and final rulings.

All this is to spell out the meaning of meaningful use (which we first touched on in October ), how to be considered an EP (eligible professional) and when said EP can expect to first receive any kind of incentive payment – for the early adopters, the first “payment year” is calendar year (CY) 2011.

When you actually receive the payment could be the end of the following calendar year). Hospitals will typically be incentivized on a fiscal year (FY) basis.

We’ll attempt to digest this compelling tome, one 100-page piece at a time (or so). Keep in mind, though, that this is only what CMS considers “Stage 1″ of the meaningful use criteria. Stage 2 criteria are expected by the end of 2011 and Stage 3 criteria by the end of 2013. The idea is to have an “initial graduated approach to arriving at the ultimate goal”: total enlightenment of EMR, I suppose.

As we previously mentioned, a meaningful user is one who:

[Read more...]

CMS to Publish "Meaningful Use" Final Rule by July 14

July 2, 2010 By 1 Comment

According to a report on FierceEMR.com, the CMS has announced that by July 14 it will release its final ruling on the EMR “meaningful use” standards which will finally spell out just how healthcare providers can become eligible for the HITECH (Healthcare Information for Electronic and Clinical Health) Act financial incentive payments.

In addition, it will presumably unveil its plan for aligning its Physician Quality Reporting Initiative (PQRI) with the EMR financial incentives program.

“We propose to include many ARRA core clinical quality measures in the PQRI program, to demonstrate meaningful use of EHR and quality of care furnished to individuals,” CMS states in an advanced copy of the proposed reg, CMIO magazine reports. “We propose the selection of these measures to meet the requirements of planning the integration of PQRI and EHR reporting.”

CMS Releases Proposed Meaningful Use Criteria

December 30, 2009 By Leave a Comment

The Centers for Medicare and Medicaid Services (CMS) announced today a proposed outline for Meaningful Use criteria, in accordance with EMR implementation provisions under the Health Information Technology for Clinical and Economic Health (HITECH) Act, part of the American Recovery and Reinvestment Act (ARRA) of 2009. These specify some of the guidelines by which physicians can receive incentives of up to $44,000 per provider, over 5 years, beginning as early as 2011.

Stage 1 criteria (the first of 3 total) would cover 25 meaningful use objectives (and 23 for hospitals). These are listed under modules known as Health Outcomes Policy Priorities such as Improving quality and patient safety (use of drug-allergy interaction checks, use of ePrescribing, maintaining active medication list, etc.), Engaging patients and their families in their health care (e.g., provide patients with a copy of their health information), Improving care coordination (e.g., exchanging key clinical information among authorized entities), Improving population and public health (e.g., capability to submit data to immunization registries), and Ensuring adequate privacy and security for personal health information (through the use of appropriate EMR technology).

The implementation of Stage 1 meaningful use standards would begin in 2011. Stage 2 (which would essentially expand upon certain aspects of Stage 1) and Stage 3 (which would deal with achieving improvements in conditions of a national high-priority nature and population health outcomes) would follow later.

While this certainly doesn’t clear things up completely for the individual physician, every piece of information that trickles down from Washington is eventually analyzed and translated for all parties which have a vested interest in the process. Hopefully, resources such as this can help doctors stay informed and as up-to-date as possible.

If you have any comments or questions, please post them here. If we don’t know the answer we’ll certainly try to find someone who does.