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July/August 2010
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HHS Announces Final Rules on ‘Meaningful Use’ of Electronic Health Records
New Website Aims To Help Physicians Put the New Rules into Practice

The Department of Health and Human Services (HHS) on July 13 announced a final rule under which eligible physicians and hospitals can qualify for Medicare and Medicaid incentive payments when they adopt certified electronic health records (EHR) technology and use it to achieve specified health and safety goals, officially known as “meaningful use.”

Eligible physicians can receive as much as $44,000 under Medicare or $63,750 under Medicaid under the new rules. (Even if you meet the eligibility requirements for both the Medicare and Medicaid incentive programs, you may participate in only one program—no “double dipping” is allowed.)

IDSA and the HIV Medicine Association (HIVMA) had been concerned about the eligibility requirements that were originally proposed (see IDSA News, March 2010), but HHS expanded eligibility in response to provider concerns.  The final rule clarifies that hospital-based physicians who provide less than 90 percent of their services in an inpatient hospital setting or emergency room are eligible.

Physicians must report on six total quality measures and 20 meaningful use objectives. The quality measures include three core measures (hypertension, tobacco screening and cessation, and adult weight screening—alternates can be substituted if these don’t apply) and three additional quality measures. The meaningful use objectives include 15 core objectives (such as implementing drug-drug and drug-allergy checks or maintaining an up-to-date list of diagnoses) and five additional objectives (such as implementing drug-formulary checks or incorporating clinical lab-test results into the EHR).

IDSA and HIVMA had also been concerned that ID and HIV physicians would not be included in the quality measure specialty groups.  For now, the Centers for Medicare and Medicaid Services (CMS) put off finalizing those groups. In addition, the reporting requirements for many of the objectives, including one dealing with computerized physician order entry (CPOE), have been relaxed from what was described in the proposed rule.

During the first year in which a physician receives an incentive payment, he or she must report on the measures and objectives for 90 continuous days.  For every year after the first payment year, the EHR reporting period is the entire year.  

Although the new incentive program starts in 2011, physicians do not have to gear up for participation next year.  In fact, experts say it is far better to take the time necessary to research, select, and integrate an EHR into your practice to ensure that implementation is successful.  With this in mind, 60 regional extension centers will be set-up around the country to provide guidance and feedback to practices, particularly those in rural or underserved areas, on how to achieve meaningful use of EHRs.

To help IDSA members compare EHRs and learn about meaningful use, IDSA is partnering with the American College of Physicians and other medical specialty societies on a new, free interactive website, AmericanEHR Partners (www.AmericanEHR.com). The goal is to provide credible information, tools, and expertise to support the optimal use of health information technology, and to improve the delivery of health care.

For more information on the website, visit www.AmericanEHR.com.

Comprehensive resources on the new EHR incentive programs are available at www.cms.gov/EHRIncentivePrograms and a CMS tipsheet on the program is available at www.cms.gov/MLNProducts/downloads/CMS_eHR_Tip_Sheet.pdf. For more information about all of Medicare’s incentive payment programs, see this CMS tipsheet or go to the related IDSA News article on the 2011 Physician Fee Schedule Proposed Rule.

CMS will also hold a series of calls this week to address the specifics of the EHR incentive programs: A call on Tuesday, Aug. 10, for individual providers; one on Wednesday, Aug. 11, for hospitals; and a question-and-answer call for both groups on Thursday, Aug. 12. Registration instructions are available on the CMS website.

IDSA will provide additional information as it becomes available in the Health Information Technology section of the IDSA website (log in required).
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