Tuesday, May 31, 2011

HIPAA Accounting of Disclosures of Health Info Proposed Rule Released

The Department of Health and Human Services (HHS) Office for Civil Rights published and requests public comment a notice of proposed rulemaking to modify the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule’s standard for accounting of disclosures of protected health information. The purpose of the proposed modifications is, in part, to implement the statutory requirement under the Health Information Technology for Economic and Clinical Health Act (“the HITECH Act’’ or ‘‘the Act’’) to require covered entities and business associates to account for disclosures of protected health information to carry out treatment, payment, and health care operations if such disclosures are through an electronic health record.

Pursuant to both the HITECH Act and its more general authority under HIPAA, HHS proposes to expand the accounting provision to provide individuals with the right to receive an access report indicating who has accessed electronic protected health information in a designated record set.

Under its more general authority under HIPAA, HHS also proposes changes to the existing accounting requirements to improve their workability and effectiveness.

The proposed rule may be viewed here. HHS invites the public to submit comments on the proposed rule. Submit comments on or before August 1, 2011.

Source: HHS Notice of Proposed Rulemaking

CMS Requests Input onProposed Rule for eRx Incentive Program

The Centers for Medicare & Medicaid Services (CMS) announced proposed changes to the Medicare Electronic Prescribing (eRx) Incentive Program.

CMS’ proposed rule on electronic prescribing is available for public review and comment by clicking here. The proposed rule will be published in the Federal Register on June 1, 2011. The comment period will close on July 25, 2011. For more information about the Electronic Prescribing Incentive Program, please click here.

Section 132 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) amended the Social Security Act to require the Secretary to establish a new reporting program that offers a combination of financial incentives and payment adjustments to eligible professionals to encourage electronic prescribing. Section 1848(m)(3)(B) of the Social Security Act (the Act), as added and amended by MIPPA, sets forth the requirements for being a successful electronic prescriber.

Although the Electronic Prescribing Incentive Program has similarities in structure and processes to the Physician Quality Reporting System (formerly the Physician Quality Reporting Initiative or PQRI), the Electronic Prescribing Incentive Program is a standalone program with distinct reporting requirements and associated incentive payments and payment adjustments.

Under the eRx Incentive Program, eligible professionals who are successful electronic prescribers can receive a 1-percent incentive payment for program years 2011 and 2012, and 0.5 percent for 2013. In addition to incentive payments, MIPPA requires a Medicare Physician Fee Schedule (PFS) payment adjustment, beginning in 2012, for eligible professionals who are not successful electronic prescribers. For the 2012 electronic prescribing payment adjustment, the fee schedule amount for covered professional services furnished by such professionals during the year shall be 1.0 percent less than the PFS amount that would otherwise apply. The PFS reductions for eligible professionals who are not successful electronic prescribers in the future are as follows: 1.5 percent for 2013 and 2.0 percent for 2014.

CMS’ proposed rule may be viewed here.

Source: CMS News Release

CMS Announces First Medicare EHR Incentive Payments

The Centers for Medicare and Medicaid Services (CMS) announced that the Medicare EHR Incentive Program issued the first round of payments totaling $75 million to providers who signed up in the first two weeks of the program.

On April 18 CMS opened a secure website through which eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) can demonstrate meaningful use of certified EHR technology to CMS by “attesting” to their compliance with program requirements for a continuous 90-day reporting period for their first year of participating in the Medicare EHR Incentive Program. In their second year and subsequent years of participation in the program, providers must demonstrate meaningful use based on a full year reporting period. CMS expects that providers will attest throughout 2011 and that the total amount of Medicare EHR incentive payments will continue to grow.

Medicare providers demonstrate meaningful use through CMS' web-based Medicare and Medicaid EHR Incentive Program Registration and Attestation System. In that system, providers fill in numerators and denominators for the meaningful use objectives and clinical quality measures established by CMS, indicate if they qualify for exclusions to specific objectives, and legally attest that they have successfully demonstrated meaningful use. Once providers have completed a successful online submission through the Attestation System, they may qualify for a Medicare EHR incentive payment.

From January 3 through April 29, 2011, $83.3 million has been disbursed by state Medicaid EHR incentive programs in seven states to eligible professionals and eligible hospitals that met federal and state program requirements.

Under both the Medicare and Medicaid EHR Incentive Programs, a total of S158.3 million has been awarded in 2011 to eligible professionals and eligible hospitals that have adopted, implemented, upgraded, or successfully demonstrated meaningful use of certified EHR technology under the Medicare and Medicaid EHR Incentive Programs. Over 42,600 eligible professionals and eligible hospitals registered for the Medicare and Medicaid programs through April 30, and CMS anticipates that many more will register in the months ahead. The EHR Incentive Programs were established by the American Recovery and Reinvestment Act of 2009 (Recovery Act).

Under the Medicaid EHR Incentive Program, eligible providers can receive incentive payments in their first year of participation by successfully registering through CMS’ web-based registration system and then demonstrating to their state that they are eligible and have adopted, implemented, or upgraded certified EHR technology. Medicaid EPs and eligible hospitals do not need to demonstrate that they have met meaningful use criteria in the first year. However, they will have to demonstrate meaningful use in subsequent years of participation in the program.

Eleven states began participating in the Medicaid EHR Incentive Program in January: Alaska, Iowa, Kentucky, Louisiana, Michigan, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, and Texas. At the beginning of April, Alabama and Missouri launched their incentive programs. Indiana and Ohio began participating in May. Most of the remaining states will launch their Medicaid EHR Incentive Programs throughout 2011. Check here to see states' scheduled launch dates for their Medicaid EHR Incentive Programs: http://www.cms.gov/apps/files/medicaid-HIT-sites/ With respect to attestation, participants in the Medicaid EHR Incentive Program will use their State's Attestation System through a process similar to that for attestation under the Medicare EHR Incentive Program .

Under the Medicare EHR Incentive Program, eligible professionals can receive as much as $44,000 over a consecutive five-year period. Under the Medicaid EHR Incentive Program, eligible professionals can receive as much as $63,750 over six years. Under both the Medicare and Medicaid EHR Incentive Programs, millions of dollars will be available to help eligible providers implement and meaningfully use certified EHR technology.

For more information on the Medicare and Medicaid EHR Incentive Programs, visit: http://www.cms.gov/ehrincentiveprograms/.

Source: CMS Press Release

CMS Announces Flexibility, Incentives for Provider to Adopt EHR

The Centers for Medicare & Medicaid Services (CMS) announced two steps that will help modernize America’s health care delivery system by encouraging doctors, hospitals, and other health care providers to adopt and meaningfully use health information technology. Under the American Recovery and Reinvestment Act, providers are receiving incentive payments through both the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs for the meaningful use of certified EHR technology. The proposed rule for the Electronic Prescribing Incentive Program released would give more flexibility to providers who are adopting electronic prescribing systems.

“We can bring America’s health care system into the 21st century by adopting electronic health records and using electronic prescribing systems,” said CMS Administrator Donald M. Berwick, MD. “Today’s announcements are steps on the right path – toward the health IT system America needs, which will save lives, save money, and save time.”

These two programs give providers new options and incentives to use health IT to improve care for their patients, which can improve patient health and lower costs.

- On May 19, 2011, the Medicare EHR Incentive Program issued the first round of payments totaling $75 million to providers who signed up in the first two weeks of the program.

- Medicaid EHR Incentive Programs are being implemented on a State by State basis. Since January 2011, fifteen States have initiated their Medicaid EHR Incentive Programs and to date, over $83 million in incentive payments has been made to qualified Medicaid providers.

“Through the EHR incentive programs, we are helping eligible providers invest in their technology infrastructure,” said Farzad Mostashari, MD, ScM., National Coordinator for Health Information Technology. “But this isn’t just about technology. The goal is better and safer health care, and that means it’s about patients — about their health care and protection of their information.”

- The Electronic Prescribing Incentive Program announced proposals for new flexibilities to help providers phase in the use of electronic prescription technology. This program provides financial incentives, including payment adjustments beginning January 1, 2012, for eligible providers to encourage electronic prescribing. The proposals announced today would provide exemptions from the payment adjustment for providers who plan to participate in the program but who face certain barriers to using electronic prescribing systems or meeting program requirements that may be beyond their control.

“Today’s rule demonstrates that CMS is willing to work cooperatively with the medical professional community to encourage, participation in electronic prescribing,” said Patrick Conway, MD, MSc, CMS Chief Medical Officer and Director of the CMS Office of Clinical Standards and Quality. “These proposed changes will continue to encourage adoption of electronic prescribing while acknowledging circumstances that may keep health professionals from realizing the full potential of these systems right away.”

These efforts are part of a broader effort by the Obama Administration to improve care and lower costs, including through new initiatives established by the Health Information Technology Economic and Clinical Health Act (HITECH), part of the American Recovery and Reinvestment Act of 2009. Other HITECH initiatives have helped train workers to support the adoption and meaningful use of EHRs, and provide advice and technical assistance to providers as they switch to EHRs. For more information about progress under the HITECH act to date, click here.

For detailed fact sheets on both the e-prescribing proposed rule and the EHR incentive payments, click here.

Medicare EHR Incentive Program payments will continue to be made on the monthly basis. For a list of providers who have received Medicare EHR Incentive Program payments, click here. This information will be updated on a regular basis.

CMS’ proposed rule on electronic prescribing is available for public review and comment by clicking here. The proposed rule will be published in the Federal Register on June 1, 2011. The comment period will close on July 25, 2011. For more information about the Electronic Prescribing Incentive Program, please click here.

Source: CMS Press Release

Thursday, May 26, 2011

HHS Requests Input on Retrospective Review of Regulations

The U.S. Department of Health and Human Services (HHS) released its Preliminary Plan for Retrospective Review of Existing Rules. The Plan is a part of President Obama's initiative announced earlier this year for a review of existing significant regulations to eliminate rules that are unnecessary, out of date, redundant, and are in conflict with other rules.

HHS is actively seeking public input to suggest which regulations could be eliminated or streamlined. To review the plan and make comments, please click here.

Wednesday, May 25, 2011

CMS Guidance on WCSMA Thresholds Issued

The Centers for Medicare and Medicaid Services (CMS) Office of Financial Management released a new document that reiterates previous guidance pertaining to
CMS’ Workers’ Compensation Medicare Set-aside Agreement (WCMSA) proposal review thresholds.

The document may be viewed here: http://www.cms.gov/WorkersCompAgencyServices/Downloads/May112011Memorandum.pdf

CMS' Workers Compensation Agency Services website may be viewed here: http://www.cms.gov/WorkersCompAgencyServices/01_overview.asp#TopOfPage

Friday, May 20, 2011

TJC Releases 2012 National Patient Safety CAUTI Goals in Hospitals

The Joint Commission (TJC) has approved one new National Patient Safety Goal for 2012 that focuses on catheter-associated urinary tract infection (CAUTI) for the hospital and critical access hospital accreditation programs. There are no new NPSGs for the other accreditation programs.

Source: The Joint Commission May 18, 2011 Newsletter

Thursday, May 19, 2011

TJC Issues New Standards FAQ for Unlicensed Persons Acting As Scribes

The Joint Commission (TJC) issued a new Standards FAQ pertaining to unlicensed persons acting as scribes for physicians and other licensed practitioners.

The FAQ defines what a "scribe" is and outlines how organizations may use scribes.

The FAQ may be viewed here: http://www.jointcommission.org/standards_information/jcfaqdetails.aspx?StandardsFAQId=345

Source: The Joint Commission

Wednesday, May 18, 2011

Implementation WG Seeks Comments on EHR Certification Program

The Health Information Technology Standards Committee (HITSC) Implementation Workgroup is currently seeking comments on the electronic health record (EHR) Temporary Certification Program, Stage 1 Meaningful Use. Comments are due by Friday, June 17, 2011.

Eligible professionals (EPs) and eligible hospitals (EHs) who seek to qualify for incentive payments under the Medicare and Medicaid EHR Incentive Programs are required by statute to use Certified EHR Technology. Once certified, Complete EHRs and EHR Modules can be used by EPs and EHs to meet the statutory requirement for Certified EHR Technology.

The Workgroup is now collecting feedback on the progress of the EHR product certification program, which has been certifying EHR technology on Stage 1 Meaningful Use criteria for almost a year. Following analysis of the comments received through the approximately 30-day public comment period, the Workgroup intends to make recommendations to the HITSC regarding the EHR Certification Program for Stage 2 Meaningful Use. The Workgroup’s goal is to obtain feedback on the process for communicating the testing and certification criteria, as well as for testing and certifying the EHR technology.

Please submit your comments by no later than 5 p.m. EDT on June 17, 2011.

Information about submitting comments may be found here: http://healthit.hhs.gov/blog/faca/index.php/2011/05/12/implementation-wg-seeks-comments-on-ehr-certification-program-by-june-17-2011/


Tuesday, May 17, 2011

HHS offers support, flexibility for states affected by tornados

In the wake of recent significant loss of life and property suffered by several states due to last week’s horrific tornados and other storms, Health and Human Services (HHS) Secretary Kathleen Sebelius offered those states several options to speed Medicaid eligibility for those who may desperately need health services but have no means to pay for it.

In a letter to Alabama, Kentucky, Mississippi, and Tennessee, Secretary Sebelius outlines ways states can immediately expand access to health care by providing temporary increases in Medicaid income eligibility limits and removing resource tests. States can also allow residents who may have lost documents in the storm to certify their income and residency, and can delay the process of redetermining whether an individual remains eligible for Medicaid. The Secretary urged states to consult with CMS central and regional offices to determine how best to meet their needs within available legal authority. The Secretary provided a commitment that the department would expedite whatever federal approvals that states may need for state plan amendments or waivers, and that such authorities could be retroactive as early as the beginning of the disaster period. Already, HHS is working closely with Alabama on a waiver to help residents, in that hard-hit state, access the health care they need.

HHS has a strong history of using the Medicaid program to help states during times of crisis and through the recovery process. Iowa received a fast-track waiver to suspend eligibility redeterminations and relax documentation requirements after 2008 floods across five counties created need for emergency medical services. After the September 11, attacks, CMS quickly granted New York authority to create Disaster Relief Medicaid after the state’s Medicaid computer systems were heavily damaged. The temporary program allowed the state to expand eligibility and expedite application processing.

Secretary Sebelius' letter can be viewed at www.hhs.gov/news/press/2011pres/05/letter0506.html.

Source: http://www.hhs.gov/news/press/2011pres/05/20110506a.html

Monday, May 16, 2011

AHRQ Releases New Report: Enabling Medication Management Through Health IT

A new Agency for Healthcare Research & Quality- (AHRQ)funded report, Enabling Medication Management through Health Information Technology, examines the evidence and research gaps regarding the impact of health information technology on all phases of the medication management process. Areas examined include prescribing and ordering, order communication, dispensing, administration and monitoring as well as education and reconciliation. Select for the report. The report shows improved care processes but mixed feelings about the effectiveness of HIT.

Click here to view the Executive Summary and Report.

HHS Launches Partnership for Patients

HHS Secretary Kathleen Sebelius and CMS Administrator Donald Berwick, MD, recently announced a new public-private partnership designed to bring together leaders of hospitals, employers, health plans, physicians, nurses, patient advocates, and the State and Federal governments to make hospital care safer, more reliable, and less costly. Called the Partnership for Patients, the campaign has two goals: keep hospital patients from getting injured or sicker, and help reduce the number of readmissions.

One measure is to reduce preventable hospital-acquired conditions by 40% by the end of 2013. The second measure is to reduce hospital re-admissions by 20% by the end of 2013.

HHS hopes that the combined efforts of this partnership could save 60,000 American lives and reduce millions of preventable injuries and complications in patient care over the next three years. HHS also estimates that successful implementation could save as much as $35 billion to the health care system, including up to $10 billion in Medicare savings.

Click here to view a list of resources, including AHRQ patient safety tools and products, being used as part of the campaign.

Click here for more information about Partnership for Patients.

Wednesday, May 11, 2011

Concerns Raised About GOP's Plan to Cut Medicaid

An article in the New York Times discusses how Republican's plans to cut Medicaid could have a heavy impact on the nation's aged population.

Read Critics Fear G.O.P.'s Proposed Medicaid Changes Cut Coverage for the Aged by clicking here: http://www.nytimes.com/2011/05/11/health/policy/11medicaid.html?_r=1&emc=eta1

Thursday, May 5, 2011

Study Highlights Barriers to Effective e-Rx Use

The non-partisan policy research organization Center for Studying Health System Change released a new study indicating that physician practices are having difficulty accessing external e-prescribing data to assist them in making better prescribing decisions.

The study revealed that tools to view and import data into e-prescribing systems were cumbersome to use and the data that was received was frequently determined to be unhelpful.

View The Center for Studying Health System Change's press release on the study here: http://hschange.org/CONTENT/1203/?topic=topic03.

View the research brief on the study and the full report here: http://hschange.org/CONTENT/1202/