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:
- Having been certified through the Centers for
Medicare and Medicaid’s EHR Incentive Programs
- Working at a meaningful use certified hospital
- Participating as an Authorized Users of the MA
HIway, a new secure system for the transmission of electronic patient specific
information among providers
- 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.
