Meaningful Use and Massachusetts Medical Licenses

State Update

There is a great deal of concern among physicians regarding a provision of the state’s 2012 health reform law linking federal meaningful use to physician licensure in Massachusetts. The brief section requires physicians to be proficient in the use of health information technology as a condition of obtaining or renewing a medical license, after January 1, 2015.

The issue dates back to 2008 when an EMR proficiency requirement for 2015 was included in another piece of legislation. The Board of Registration in Medicine passed regulations interpreting the law to apply to licenses issued or renewed after January 1, 2015. In seeking language repealing this requirement or eliminating references to federal standards, the MMS worked with the Mass e-Health Institute, a quasi-public state agency that receives federal funding to assist in adoption of EHRs and meaningful use. The MMS met with MeHI several times and helped develop statistics and approaches to adapting to the new statutory requirement.

Of the approximately 40,000 physicians with Massachusetts licenses, about 15,000 have attained meaningful use certification. The vast majority of the remaining 25,000 are not eligible for a variety of reasons. For example, there are nearly 5,000 residents and interns with limited licenses. First-year residents and interns have no history on which to claim meaningful use. Other categories lack firm numbers but would include researchers, volunteer physicians, academics, and those not treating a certain threshold of Medicaid or Medicare patients.

The MMS does not favor a process to “certify” physicians as meeting the meaningful use requirements. The MMS feels that an individual certification process beyond a CME course is not warranted. Physicians do not need an additional state-mandated process and presumed cost relating to EMRs, particularly as Massachusetts is a leading state in the adoption of EMRs and in achieving meaningful use.

The Board has started the process to hold a public hearing on proposed regulations to comply with the legislative requirement. In a recent public session, the Board voted to take a view of the statute that would allow compliance in a number of ways, including meaningful use certification, working in a MU-certified hospital, using the MA HIWay information exchange, or taking a three-hour training program.

Additional exemptions would be made for those not actively seeing patients, volunteers, and limited licensees. The Board intends certification to be a one-time event and not subject to every renewal.

The MMS is still seeking legislative repeal of the 2012 requirement and supported alternative language that will allow physicians to meet the requirements for proficiency in EMRs in a manner consistent with the proposed regulations. We have won support in the House but not the Senate.

Look to Vital Signs This Week and our Legislative Update e-newsletter for news on the status of the legislation and the dates of the Board hearings on regulations. We hope that physicians will actively support the Board of Registration’s proposed regulations in public testimony.

—William J. Ryder, ESQ.
MMS Legislative Counsel

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