HHS Final Rules Address EHR Incentives, Certification Criteria

AAFP Scrutinizing Documents' Details

October 13, 2015 01:20 pm News Staff

On Oct. 6, CMS and the Office of the National Coordinator (ONC) for Health Information Technology issued a set of final rules meant to guide the country's march toward a health care system that is reinforced with interoperable health information technology.

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The final rule for 2015 Edition Health IT Certification Criteria(s3.amazonaws.com) and the final rule for the Medicare and Medicaid electronic health record (EHR) incentive programs(s3.amazonaws.com) are available for public inspection and due for publication in the Federal Register on Oct. 16.

The EHR incentive program rule includes a 60-day public comment period that will give the AAFP and other interested parties an opportunity to provide CMS with feedback and clarity as to how the rule will help -- or hinder -- physicians who are busy taking care of their patients.

According to an HHS press release,(www.hhs.gov) CMS intends to use information gleaned from those stakeholder comments to help frame policy during the rulemaking process that will implement the Medicare Access and CHIP, or Children's Health Insurance Program, Reauthorization Act of 2015 -- and the accompanying Merit-based Payment System due for release in the spring of 2016.

Story Highlights
  • HHS recently released final rules meant to speed the implementation, interoperability and flexibility of electronic health records in the U.S. health care system.
  • The rules include changes to the Medicare and Medicaid electronic health record incentive programs and to the 2015 Edition Health IT Certification Criteria.
  • AAFP experts are scrutinizing the rules before providing their recommendations on how best to move forward with the incentive programs and to ensure that HHS has delivered rules that simplify requirements as promised.

Family physicians are advised to stay tuned in to this issue. AAFP experts are combing through more than 1,300 pages of final rules and fully intend in coming days to give family physicians -- and HHS officials -- guidance about how to best proceed.

Academy leaders also want to verify that the rules deliver what's been promised.

For instance, CMS called out its own work in streamlining the EHR programs and noted in its fact sheet(www.cms.gov) that the new rules reduced the number of meaningful use "objectives" from 18 to 10.

However, Academy experts told AAFP News that although CMS' simplification efforts are much appreciated, the AAFP will look closely at the full extent of those efforts and specifically will check whether CMS has also reduced the number of "measures" to which physicians must attest as part of the meaningful use program.

EHR Incentive Program Changes

In the release, CMS Chief Medical Officer Patrick Conway, M.D., said the agency expected "active engagement of stakeholders" so as to get "broad input on how to improve these programs over time."

Speaking of the overall reach of the just-released rules, Conway, who also serves as CMS deputy administrator for innovation and quality, said, "We eliminated unnecessary requirements, simplified and increased flexibility for those that remain, and focused on interoperability, information exchange and patient engagement. By 2018, these rules move us beyond the stage approach of 'meaningful use' and focus on broader delivery system reform."

Keep Tabs on MU With AAFP Online Resource

In an interview with AAFP News, Steven Waldren, M.D., director of the AAFP's Alliance for eHealth Innovation, urged family physicians to tap into an important resource -- created just for them -- to help keep up with changes in the Medicare and Medicaid electronic health record (EHR) incentive programs.

Waldren noted that the Academy's meaningful use Web page will be updated as new information becomes available.

And it's all just a few quick clicks away for family physicians.

For instance, according to CMS, the rules governing the EHR incentive programs will, among other things,

  • instill simplicity and flexibility into the programs by allowing physicians to choose and report on measures that are most meaningful to their practices,
  • give physicians and state Medicaid agencies until Jan. 1, 2018, to comply with new requirements,
  • allow more time for software developers to create products that make sense to physicians and are appropriate for new models of care coming down the pike, and
  • support the exchange of health information between physicians and other health care professionals and patients.

Importantly, the final rule adopts flexible reporting periods that align with other programs and include moving from a fiscal year to calendar year reporting schedule for all participants beginning in 2015.

That flexibility includes instituting a 90-day reporting period -- of the physician's choosing -- in 2015 for all participants, for new participants in 2016 and 2017 and for anyone moving to stage three of meaningful use in 2017.

2015 Edition Health IT Certification

According to a another fact sheet(www.healthit.gov) released by the ONC, the 2015 edition final rule

  • improves interoperability with the inclusion of a common clinical data set;
  • facilitates how physicians and other users access and exchange information;
  • establishes a framework for health IT across the care continuum;
  • addresses health disparities by providing for the capture of additional information related to race and ethnicity, sexual orientation, gender identity, and social, psychological and behavioral data;
  • ensures all health IT products presented for certification contain appropriate privacy and security capabilities; and
  • improves patient safety.

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