The U.S. Department of Health and Human Services (HHS) is ramping up efforts to get doctors, hospitals and other care providers to computerize patient records.
But HHS officials say they have decided against including two key electronic health record (EHR) use objectives from their first batch of EHR incentive program standards. One objective eliminated would have called for providers to submit claims to both public and private health plans electronically, and the other would have required providers to verify both public and private health plan eligibility electronically.
NUTS AND BOLTS
The Centers for Medicare and Medicaid Service, an arm of HHS, has sent an 864-page draft of thefinal rule for the “Medicare and Medicaid Programs; Electronic Health Record Incentive Program” to the Office of the Federal Register for publication.
Managers at the office expect to publish the final rule, which is based on an interim final rule released in January, in the Federal Register July 28.
HHS itself has sent the Federal Register office a 228-page final rule relating to “Health Information Technology: Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology” and a 234-page notice of proposed rulemaking for “Modifications to the HIPAA Privacy, Security, and Enforcement Rules under the Health Information Technology for Economic and Clinical Health Act.”
The Federal Register is set to publish the proposed rule Wednesday and the final rule July 28. The final rule is based on an interim final rule that came out in December 2009.
The CMS final rule implements the Health Information Technology for Economic and Clinical Health (HITECH) Act provisions of the American Recovery and Reinvestment Act of 2009. The HITECH Act provisions are supposed to give physicians, hospitals and other eligible Medicaid and Medicare health care providers financial incentives to adopt EHR systems.
The CMS final rule and the HHS final rule, developed by the HHS Office of the National Coordinator for Health Information Technology, will help create a set of standards for implementing “Stage 1″ of the shift to EHR standards. Regulators are supposed to use the criteria to determine whether providers are making enough “meaningful use” of EHR systems to qualify for incentive payments.
The proposed rule will help HHS implement the new EHR incentive system by updating existing health information privacy standards, health data security standards, and related compliance rules.
The CMS final rule is scheduled to take effect 60 days after the Federal Register publication date, and the HHS final rule is scheduled to take effect 30 days after the Federal Register publication date.
Doctors can qualify for tens of thousands of dollars in EHR incentives, and hospitals can qualify for millions of dollars in EHR incentives.
AHIP BACKS EHR EFFORTS
Karen Ignagni, president of America’s Health Insurance Plans, Washington, has put out a statement welcoming the release of the HHS and CMS EHR regulations.
“Broad adoption and meaningful use of health information technology by providers is essential to creating an efficient, high-performing 21st-century health care system,” Ignagni says. “Health plans and providers share the responsibility of making the investments needed to enhance efficiency and improve health outcomes.”
Many plans already are rewarding providers for shifting to EHR systems and using other electronic systems to improve the quality and efficiency of care, Ignagni says.
THE HITECH ACT AND PPACA
The HITECH Act is not officially part of the Affordable Care Act – the legislative package that includes the Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act – but the same entities that developed the ACA package developed the HITECH package, and, in practice, federal agencies are having to coordinate HITECH Act implementation with ACA implementation, as if the HITECH Act were another part of the ACA package.
CMS officials will wait until ACA programs are implemented before develop Stage 2 EHR adoption standards, and the ACA administrative simplification provisions aimed at health plans and health plan clearinghouses will probably help shape the EHR standards, officials say.