CMS Provides Details and Answers Questions on Meaningful Use

On July 22, the Centers for Medicare and Medicaid Services staff provided an hour and a half teleconference to clarify some of the questions surrounding the recently released final rulemaking (IFR) regarding Meaningful Use.  You can retrieve a .pdf of the slides here

Focus of the call:

• What changed since the NPRM?
• What generated the most comments?
• Final policies

What's in the IFR?

• Definition of Meaningful Use (MU)
• Clinical Quality Measures (CQM)
• Definition of Eligible Professional (EP) and Eligible Hospital/Critical Access Hospital (CAH)
• Definition of Hospital-based EP
• Medicare Fee-For-Service (FFS) EHR Incentive Program
• Medicare Advantage (MA) EHR Incentive Program
• Medicaid EHR Incentive Program

Summary of Changes

Stage 1 (2011 and 2012)

• To meet certain objectives/measures, 80% of patients must have records in the certified EHR technology
• EPs have to report on 20 of 25 MU objectives
• Reporting Period: 90 days for first year; one year subsequently
• Providers can start measurements, using certified products, January 1, 2011, provide attestation in April, 2011 for first-year payments starting in May, 2011

Eligible Provider: 15 Core Objectives

1. Computerized physician order entry (CPOE)
2. E-Prescribing (eRx)
3. Report ambulatory clinical quality measures to CMS/States
4. Implement one clinical decision support rule
5. Provide patients with an electronic copy of their health information, upon request
6. Provide clinical summaries for patients for each office visit
7. Drug-drug and drug-allergy interaction checks
8. Record demographics
9. Maintain an up-to-date problem list of current and active diagnoses
10. Maintain active medication list
11. Maintain active medication allergy list
12. Record and chart changes in vital signs
13. Record smoking status for patients 13 years or older
14. Capability to exchange key clinical information among providers of care and patient-authorized entities electronically
15. Protect electronic health information

Eligible Providers Can Defer 5 From Following Menu Set

• Drug-formulary checks
• Incorporate clinical lab test results as structured data
• Generate lists of patients by specific conditions
• Send reminders to patients per patient preference for preventive/follow up care
• Provide patients with timely electronic access to their health information
• Use certified EHR technology to identify patient-specific education resources and provide to patient, if appropriate
• Medication reconciliation
• Summary of care record for each transition of care/referrals
• Capability to submit electronic data to immunization registries/systems*
• Capability to provide electronic syndromic surveillance data to public health agencies*

* One of these, public health objectives must be chosen

Exclusions

If a measure is not applicable to a practice, it can be excluded from the count, i.e., dentists who do not give immunizations or chiropractors who do not ePrescribe.

Clinical Quality Measures

Providers must report on 6 total measures: 3 required core measures (substituting alternate core measures where necessary due to exclusion) and 3 additional measures. The core measures are:

• Hypertension: Blood Pressure Measurement
• Preventive Care and Screening Measure Pair:
  • Tobacco Use Assessment,
  • Tobacco Cessation Intervention
• Adult Weight Screening and Follow-up

Registration

Providers using certified EHR products to achieve Meaningful Use must register via the EHR Incentive Program website (does not yet exist) and provide:

1. Name of the EP, eligible hospital, or qualifying CAH
2. National Provider Identifier (NPI)
3. Business address and business phone
4. Taxpayer Identification Number (TIN) to which the provider would like their incentive payment made
5. CMS Certification Number (CCN) for eligible hospitals
6. Medicare or Medicaid program selection (may only switch once after receiving an incentive payment before2015) for EPs
7. State selection for Medicaid providers
8. Medicare providers and Medicaid eligible hospitals must be enrolled in Provider Enrollment, Chain and Ownership System (PECOS)

Concurrent Participation in Multiple Incentive Programs

Medicare-track Eligible Providers can participate in PQRI and Medicare Electronic HealthRecord Demonstration but not the eRx during the same program year. Medicaid-track EPs can participate in the eRX simultaneously.

Regional Extension Center (MeHI) Announces Dates for Kickoff Sessions

The REC is dedicated to helping providers implement electronic health records and achieve meaningful use.

MeHI has announced 7 dates for Regional Extension Center Summits during the summer and fall.