Board of Medicine Starts Process of Clarifying Meaningful Use Requirement for Massachusetts Physicians

Background Information

Full Text of Proposed EHR Regulations (.pdf, 5 pages)

The Massachusetts Board of Registration in Medicine has started the process of developing regulations to comply with a problematic section of a 2012 state law, while also trying to prevent an unintended potential outcome of that section - widespread disruption of the delivery of health care by licensed physicians.

That provision of the law, opposed by the MMS, requires that physicians must demonstrate proficiency with electronic health records equivalent to the skills necessary to achieve meaningful use, for all licenses issued or renewed after January 1, 2015.

The MMS has sought legislative repeal or clarification of this requirement many times.  In February the House passed language to amend the requirement but it was rejected by the Senate. The MMS argued that even though Massachusetts is a state with significant adoption of EHRs, only 15,000 of the 40,000 physicians with Massachusetts licenses are meaningful use certified.

Therefore, the Board’s interpretation of the language is critical to avoiding a catastrophic disruption of the licensing process and the vital services that licensed physicians provide.

The Board has carefully reviewed the language of the statute and considered the legislative intent in a logical and comprehensive manner with the intent of responsibly implementing the mandate the legislature has created.  The Board will now start the complex process of promulgating new regulations. The process takes a minimum of three months and involves a public hearing. We will alert physicians on how to support the Board’s efforts.

Details

Under the proposed regulatory amendments, there are three ways an applicant could meet the requirement: achieving the requirement, having waiver status, or having an exemption.

In past discussions, the Board noted that sole practitioners and small group practitioners may be unduly burdened by an EHR mandate, because it would require the installation of expensive systems that physicians would not have the staff or the finances to maintain. Therefore, under the Board’s approach you would still be eligible for licensure if you don’t own an electronic health information system, use such a system on a daily basis, or have meaningful use certification.  

Fully Achieving the requirement

You would meet the new requirement in any one of the following ways:

  1. Having been certified through the Centers for Medicare and Medicaid’s EHR Incentive Programs
  2. Working at a meaningful use certified hospital 
  3. Participating as an Authorized Users of the MA HIway, a new secure system for the transmission of electronic patient specific information among providers
  4. Physicians unable to qualify under any of the above options by January 1, 2015 could  meet this requirement through taking three credits of an EHR-related continuing professional development course that would explain in detail the key principles of Meaningful Use.

Exemptions

The following license categories would be exempt from these requirements:

  • Limited License: Exempt
  • Volunteer License: Exempt
  • Administrative License: Exempt
  • Temporary License: Exempt
  • Academic Faculty License: Exempt
  • Substitute License: Exempt
  • Inactive License: Exempt
  • Not Engaged in Practice of Medicine: Exempt
  • Emergency Restricted License: Exempt
  • Emergency Restricted Limited License: Exempt

The Board has determined that it will require meeting the requirements once, not at every renewal. It is not clear how the board will approach the waiver issue, but it is thought that limited time waivers may be allowed to reach achievement status for those unable to complete requirements fully at the time of licensure.

The MMS believes this is a standard that may be met by all licensees in the Commonwealth and we support the Board in its approach. Stay tuned for further developments.

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