CMS rule reduces Meaningful Use burdens; CMA advocates for more change On June 15, the California Medical Association (CMA) submitted comments to the Centers for Medicare and Medicaid Services (CMS) on proposed rules modifying Stage 1 and Stage 2 Meaningful Use criteria of the federal electronic health records (EHR) incentive programs. Under the federal EHR incentive programs, qualifying Medicare and Medi-Cal providers are eligible to receive incentive payments for adopting and demonstrating “Meaningful Use” of certified health information technology. The proposed rule aligns Stage 1 and Stage 2 Meaningful Use objectives and measures for 2015 through 2017 with proposed Stage 3 requirements by removing redundant, duplicative and topped-out measures and by reducing the reporting burden. It also proposes additional modifications to the EHR reporting period and timeline that will help physician practices. “CMA, located in the hub of tech industry, encourages the widespread adoption of EHRs and the use of innovative technologies that facilitate and improve the provision of quality health care,” CMA President Luther F. Cobb, M.D., wrote in the letter to CMS. “California physicians, however, have found participating in the EHR incentive programs and achieving Meaningful Use to be difficult and frustrating due to EHR systems that are unable to keep up with the constantly changing requirements, complex criteria, high costs for EHR implementation and upgrades, inconsistencies in how EHRs report data, and lack of interoperability.” In its letter, CMA supported the detailed comments submitted by the American Medical Association (AMA) and offered further comments that are of particular interest to California physicians. CMA commended CMS on the proposed modification to allow for a 90-day reporting period for all incentive program participants in 2015, while urging CMS to extend the proposal beyond 2015 and allow for a reporting period that is less than a full calendar year for all participants in 2016 and 2017. Additionally, CMA supported CMS’s proposal to streamline the program requirements to provide a more flexible framework to reduce the burden on physicians. CMA also recommended changes to Meaningful Use measures requiring physicians to provide online access to health information for more than 50 percent of unique patients seen by the provider. CMA had been advocating to CMS to reduce the patient portal requirements that are beyond a physician’s control. The new regulation only requires one patient to access the online portal during the reporting period for a physician to receive credit. CMA’s letter also stressed that physicians who face adjustments for not achieving Meaningful Use may be forced out of the Medicare program, and urged CMS to adopt less burdensome requirements and facilitate participation in the EHR incentive programs by adopting realistic modifications to Meaningful Use. The letter urged CMS to eliminate the “all-or-nothing” approach to meeting Meaningful Use, which penalizes physicians who are able to meet a majority of Meaningful Use requirements with the same payment adjustment penalties as those who do not participate in the EHR incentive program at all. CMA’s letter recommended a Meaningful Use program where incentives and penalties are proportional to the measures successfully completed. For more information on AMA’s comments regarding the Modifications to Meaningful Use Stage 1 and Stage 2 in 2015 through 2017, click here. Read CMA's letter here. For more information and resources, including CMA On-Call documents #4302 “Meaningful Use of Electronic Health Records” and #4305 “EHR Meaningful Use Stage 2,” as well as additional information on the EHR Federal Incentive Program and Meaningful Use, visit CMA’s HIT website at www.cmanet.org/hit. These documents, as well as the rest of CMA’s online health law library, are available free to members in CMA’s online resource library. Nonmembers can purchase documents for $2 per page. Contact: Lishaun Francis, (916) 551-2554 or lfrancis@cmanet.org. June 26, 2015 Managed Care, Medi-Cal, Medicare CMS, EHR, Electronic Health Record, HIT, Meaningful Use 0 0 Comment Read More »
CMA submits comments on Meaningful Use Stage 3 to CMS On May 29, the California Medical Association (CMA) submitted comments to the Centers for Medicare and Medicaid Services (CMS) and the National Coordinator for Health Information Technology on the Meaningful Use Stage 3 notice of proposed rulemaking. Under the federal electronic health records (EHR) incentive programs, qualifying Medicare and Medi-Cal providers are eligible to receive incentive payments for adopting and demonstrating “meaningful use” of certified health information technology (HIT). The proposed rule, published in the Federal Register on March 30, specifies the final stage of meaningful use criteria that eligible professionals, hospitals and critical access hospitals must meet in order to qualify for the Medicare and Medicaid EHR incentive payments and avoid payment adjustments under Medicare. In its letter, CMA supported the detailed comments submitted by the American Medical Association (AMA) and offered further comments that are of particular concern to California physicians. Specifically, CMA urged CMS to hold off on finalizing Stage 3 Meaningful Use criteria until CMS implements stronger interoperability directives on EHR vendors, including certifying only those EHRs with the ability to satisfy all meaningful use requirements and prohibiting vendors from charging additional fees and costs for necessary upgrades and interfaces to achieve meaningful use. In addition, CMA argued that proposed measures relating to coordination of care through electronic patient interactions set an exceedingly high bar for physicians in light of the technological limitations and administrative burdens facing many physician practices. Finally, CMA objected to the proposed elimination of the 90-day reporting period for providers demonstrating meaningful use for the first time and recommended a reporting period that is less than a full calendar year for all participants in the EHR incentive programs. For more information on AMA’s comments on the Meaningful Use Stage 3 proposed regulations, click here. For more information and resources, including CMA On-Call documents #4302 “Meaningful Use of EHRs: Stage 1,” and #4305, “Meaningful Use of EHRs: Stage 2,” as well as general information on the EHR Federal Incentive Program and Meaningful Use, visit CMA’s HIT website at www.cmanet.org/hit. These documents, as well as the rest of CMA’s online health law library, is available free to members in CMA’s online resource library. Nonmembers can purchase documents for $2 per page. Read CMA’s comments here. Contact: Lishaun Francis, (916) 551-2554 or lfrancis@cmanet.org. June 5, 2015 General Electronic Health Record, Health Information Technology, HIT, EHR, Meaningful Use 0 0 Comment Read More »
CalHIPSO seeks physicians to sign up for free practice transformation assistance The California Health Information Partnership and Services Organization (CalHIPSO) is applying for a grant from the Center for Medicare and Medicaid Services (CMS) to give California physicians access to free health practice improvement tools and services that would normally be cost prohibitive. The California Medical Association was a founding member of CalHIPSO, which was established in 2009 as a federally designated Regional Extension Center to provide education, outreach and technical assistance to help physicians select and implement electronic health records. To win this grant, CalHIPSO must show commitment and interest from providers (non-binding). To that end, CalHIPSO is seeking physicians and physician groups willing to submit an online form stating that they would benefit from assistance preparing for the new care delivery and payment models and quality initiatives, which, with limited resources, would be a challenge to accomplish independently. Physicians can alternatively send an email stating their interest, including their name, specialty, and NPI. Responses are requested by January 26, 2015. The grant being applied for is part of the federal Transforming Clinical Practice Initiative, designed to help support 150,000 clinician practices over the next four years in sharing, adapting and further developing their comprehensive quality improvement strategies. Physicians who participate in this program will gain critical assistance to engage in new delivery models, such as medical homes or ACOs. To find out more about the CMS initiative, click here. To find out more about the CalHIPSO grant application, visit the CalHIPSO website. January 22, 2015 Medi-Cal, Medicare Health Information Technology, CalHIPSO, HIT 0 0 Comment Read More »
Anthem and Blue Shield to partner in the creation of California's largest health information exchange Two of California's largest health insurers – Anthem Blue Cross and Blue Shield of California are investing a total of $80 million to develop a not-for-profit health information exchange database called Cal INDEX, which is expected to go live in November. It is expected to house the medical records of 9 million patients, about a quarter of California’s population. The initial $80 million stake will get the exchange through the first three years, the insurers said. After that, they expect funding will come from participating health plans and providers who will be charged a subscription fee. Thirty large medical groups are expected to help build the database. It will house such information as patient diagnoses, lab tests, physician and hospital visits and procedures. In a press release, the plans said they hope the exchange will improve quality of care by providing physicians with a unified and integrated source of patient information; and that the portability of patients' information will be seamless between health plans and across various health care professionals and hospitals. Although consumers will not initially be able to access their own data, Anthem and Blue Shield say that functionality will be added at a later date. While the plans say the exchange will comply with all federal and state privacy laws for medical records, consumer groups have raised concerns about patient privacy. According to the plans, patients will be notified that their information will be placed in the information exchange database and they will be given the opportunity to opt out. August 25, 2014 General Blue Shield, Health Information technology, HIT, Anthem Blue Cross 0 0 Comment Read More »
Deadline to submit meaningful use hardship exception is July 1 Beginning January 1, 2015, Medicare physicians who have not successfully attested to meaningful use of a certified electronic health record (EHR) system may incur payment penalties, as mandated by the Health Information Technology for Economic and Clinical Health (HITECH) Act. These payment adjustments will be 1-2 percent of total Medicare charges in 2015, to 2 percent in 2016 and 3-5 percent in 2017 and beyond. The 2015 penalties are based on 2013 reporting data. Physicians who failed to successfully demonstrate meaningful use in 2013 can apply for a hardship exception to avoid the upcoming Medicare payment adjustment for 2015. Hardship exception applications must include supporting documentation that proves that demonstrating meaningful use would be a significant hardship for the physician. The deadline to submit a hardship exception application for 2015 is midnight Eastern time on July 1, 2014. The Centers for Medicare Services (CMS) will review applications to determine whether or not you will be granted a hardship exception. If approved, the exception is valid for one year. Eligible professionals can apply for hardship exceptions in the following categories: Infrastructure: Eligible professionals must demonstrate that they are in an area without sufficient internet access or face insurmountable barriers to obtaining infrastructure (e.g., lack of broadband). New Eligible Professionals: Newly practicing eligible professionals who would not have had time to become meaningful users can apply for a 2-year limited exception to payment adjustments. Unforeseen Circumstances: Examples may include a natural disaster or other unforeseeable barrier. Patient Interaction: Lack of face-to-face or telemedicine interaction with patient Lack of follow-up need with patients CMS has posted hardship exception applications on the EHR website at www.cms.gov/ehrincentiveprograms. CMS has also published a hardship exception tip sheet for physicians. For more information on the federal EHR incentive program and meaningful use, see CMA On-Call documents #4301 "Electronic Health Records: Federal Incentive Program," #4302 "Meaningful Use of EHRs: Stage 1," and #4305 "Meaningful Use of EHRs: Stage 2." June 25, 2014 Medicare EHR, Electronic Health Record, HIT, Medicare, Certified EHRs 0 0 Comment Read More »
HHS releases security risk assessment tool to help providers with HIPAA compliance The U.S. Department of Health and Human Services (HHS) has released a new tool to help guide health care providers in small to medium sized practices conduct information security risk assessments of their organizations. The tool, available at www.HealthIT.gov, is the result of a collaborative effort by the HHS Office of the National Coordinator for Health Information Technology (ONC) and Office for Civil Rights (OCR). It is designed to help practices conduct and document a risk assessment in a thorough, organized fashion at their own pace by allowing them to assess the information security risks in their organizations under the Health Insurance Portability and Accountability Act (HIPAA) Security Rule. The tool also produces a report that can be provided to auditors. HIPAA requires organizations that handle protected health information to regularly review the administrative, physical and technical safeguards they have in place to protect the security of the information. By conducting these risk assessments, health care providers can uncover potential weaknesses in their security policies, processes and systems. Risk assessments also help providers address vulnerabilities, potentially preventing health data breaches or other adverse security events. A vigorous risk assessment process supports improved security of patient health data. Conducting a security risk assessment is a key requirement of the HIPAA Security Rule and a core requirement for providers seeking payment through the Medicare and Medicaid EHR Incentive Program, commonly known as the Meaningful Use Program. The tool is available for both Windows operating systems and iPad. Download the Windows version here. The iPad version is available from the iTunes App Store (search “HHS SRA tool”). For more information, see CMA On-Call document #4102, "HIPAA Security Rule." On-Call documents are available free to members in CMA's online health law library at www.cmanet.org/cma-on-call. Nonmembers can purchase documents for $2/page. April 9, 2014 General HIPAA, HIT, Medical Records, Health Information Technology 0 0 Comment Read More »
HHS develops toolkit to help physicians prepare for online communication with patients The California Health and Human Services Agency (HHS) has developed a toolkit to help medical practices prepare for online patient communications through an electronic health record (EHR) portal, personal health record, mobile app, secure messaging or other electronic means. Data indicates that patients who use health information technologies may be more efficient users of health care resources, better managers of their health behaviors and feel more satisfied with the health care system. The free toolkit, "Preparing for Online Communication with Your Patients," provides checklists and worksheets to help offices collect and organize information needed to create an effective plan for online patient communications. It also provides materials that can be given directly to patients including, a letter that can be customized to explain the medical practice’s electronic communication services; a brochure about electronic communication with physicians; and a video explaining the benefits of communicating online with their health care providers. Click here to download the toolkit. March 27, 2014 General Electronic Health Record, Health Information Technology, HIT, EHR, Mobile Health 0 0 Comment Read More »
