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| News & Events |
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| ARRA and HITECH Act Update |
| What it Means to You and Why You Should Act Now |
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| Updated July 13, 2010 |
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First Insight guarantees to deliver certified EMR/EHR software that is
compliant with federal government defined standards for meaningful use. |
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| Breaking News: |
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| July 28, 2010: HHS published final rules on ‘meaningful use’ and ‘EHR standards’ |
On July 13, 2010, federal officials announced the release of the final rule (published July 28, 2010) that defines how health care providers and hospitals can demonstrate EHR ‘meaningful use’ to qualify for federal incentive payments that are part of the 2009 American Recovery and Reinvestment Act (ARRA). Officials also released the final rule that describes the required standards and certification criteria for EHR technology.
The final rules offer providers more flexibility than the proposed regulations that were released in January 2010. |
- Health care providers will need to comply with a set of 15 core objectives during the first year (Stage 1) of adoption, down from 23 measures in the proposed regulations.
- Hospitals are required to comply with 14 core objectives, down from 25 measures.
- The final rule also reduces the number of electronic prescriptions a doctor must submit from 75 percent to 40 percent.
- Providers will need to enact a single measure to meet the clinical decision support requirements, down from five measures.
- CMS reduced the number of quality measures that providers must report and CMS is deferring some of the measures to Stage 2.
- In addition to the core objectives, doctors and hospitals will choose five more objectives from a ‘menu’ of 10. The remaining objectives will be deferred to Stage 2 (2013-2014). One of the new objectives in the ‘menu’ calls for health care providers to offer patients condition-specific educational resources.
- One core objective requires hospitals and doctors to use computerized physician order entry systems to capture at least 30 percent of medication orders.
- Comparison Chart: Meaningful Use ‘Proposed Rule' vs ‘Final Rule’ Comparison Chart.
- Final Rule Presentation: Overview of the CMS Final Rule on the EHR Incentive Programs—what’s changed, what generated the most comments and final policies.
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| June 24, 2010: HHS releases final rule for temporary EHR certification program |
On June 24, 2010, the Office of the National Coordinator for Health Information (ONC) published its final rule for the temporary EHR certification program.
The final rule requires that CCHIT must apply to become an ONC Authorized Testing and Certifying body
(ONC-ATCB) along with other interested organizations, beginning July 1. The final rule does not grandfather existing CCHIT-certified EHRs as being Certified EHR Technology.
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- While some EHR companies are announcing they are ARRA-certified through CCHIT, no EHR software is currently certified and compliant with government certified standards.
- For up-to-date EHR Incentive news, visit the CMS website at www.cms.gov/EHRIncentivePrograms.
- On July 1, 2010, ONC will begin accepting applications from not-for-profit organizations seeking to test and certify electronic health records under the ARRA/HITECH Act.
- ONC says it will certify bodies on both full EMRs and various components and modules, such as e-prescribing and specialty-specific systems.
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| CMS Unveils New Website |
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| EHR Incentive Program
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The Centers for Medicare & Medicaid Services (CMS) launched the official website for the Medicare & Medicaid EHR Incentive Programs. This website provides the most up-to-date, detailed information about the EHR incentive programs.
Visit www.cms.gov/EHRIncentivePrograms
to learn about who is eligible for the programs, how to register, meaningful use, upcoming EHR training and events, and much more! |
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What is the HITECH Act? |
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On February 17, 2009, President Barack Obama signed into law the American Recovery and Reinvestment Act (ARRA) of 2009. The $19.2 billion HITECH ACT, more commonly referred to as the Health Information Technology for Economic and Clinical Health Care Act, allocates $17.2 billion in Medicare and Medicaid incentives to eligible providers who adopt certified electronic health/medical records. |
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How much are the incentive payments? |
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Medicare Incentives: Beginning in 2011 physicians who are “meaningful users” of “certified EMR/EHR technology” will be eligible to receive up to $44,000 paid out over a five-year period in the form of incentive payments through Medicare reimbursements. Medicare incentives are based on “meaningful use” and are not tied to the actual cost of acquiring or maintaining an EHR.
According to the Centers for Medicare and Medicaid Services (CMS), the incentive payment is equal to 75 percent of Medicare allowable charges for covered services furnished by the eligible provider in a year, subject to a maximum payment in years 1-5.
An additional 10% incentive bonus payment is available to physicians operating in a designated Health Professional Shortage Area (HPSA); for more information visit www.hpsafind.hrsa.gov.
The maximum payment for the first year is $18,000 (2011 and 2012) and bonus payments decline each subsequent year within the five-year period. Incentives will be paid out on a per provider basis. Bonus payments will phase out in 2016. See the table below for details. |
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MEDICARE INCENTIVES BY YEAR SCHEDULE
| First Calendar Year for Incentive Payments |
| Calendar Year |
2011 |
2012 |
2013 |
2014 |
2015 |
2016 |
Total bonus payment |
| 2011 |
$18,000 |
$12,000 |
$8,000 |
$4,000 |
$2,000 |
$0 |
$44,000 |
| 2012 |
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$18,000 |
$12,000 |
$8,000 |
$4,000 |
$2,000 |
$44,000 |
| 2013 |
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$15,000 |
$12,000 |
$8,000 |
$4,000 |
$39,000 |
| 2014 |
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$12,000 |
$8,000 |
$4,000 |
$24,000 |
| 2015 |
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$0 |
$0 |
$0 |
| Source: Centers for Medicare and Medicaid Services. Because federal statutes, regulations and rulings change frequently, information in this table is subject to change. |
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Medicaid Incentives: Non-hospital based physicians whose Medicaid patient caseload is at least 30% may be eligible for up to $63,500 in Medicaid incentive payments over a five-year period. Physicians must demonstrate “meaningful use” of a certified EMR/EHR product.
Note: Eligible providers must decide to receive either Medicare or Medicaid incentives, not both. However, hospitals will be eligible for both incentive payments. |
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What are the proposed reporting periods? |
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The reporting period for 2011 requires you to submit for 90 consecutive days. Starting in 2012, the reporting period for each year is the entire calendar year. |
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Why should you purchase and implement EMR/EHR now? |
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Although federal EHR incentive payments will not start until 2011, eligible providers who wait to implement EHR will face a high risk of failing to achieve meaningful use in time to start collecting maximum federal incentive payments. Allow plenty of time for implementation, training and documenting meaningful use. As an early adopter of EHR, it will be much easier for you to capitalize on incentive dollars-70% of the funding comes in the first two years. In addition, starting January 1, 2015, if you are not a meaningful EHR user, you will see a reduction in Medicare payments. |
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Are there penalties for not using EMR/EHR? |
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Starting January 1, 2015, physicians who are not “meaningful” EHR users will see a 1% reduction in Medicare payments. The reduction increases to 2% in 2016 and 3% in each subsequent year. If the United States Department of Health and Human Services (HHS) Secretary finds that by the end of 2017 the proportion of physicians who are meaningful EHR users is less than 75%, HHS may continue to ratchet down payments by 1% a year (not more than 5 percent overall). Hardship exceptions may be issued on a case-by-case basis, such as exceptions for physicians who practice in rural areas without adequate Internet access. |
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How will maximEyes comply with certification standards? |
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First Insight guarantees to deliver certified EMR/EHR software that is compliant with federal government defined standards for meaningful use. Once HHS releases final EHR certification bodies, First Insight will submit maximEyes to be tested and certified in accordance with the ONC certification program. First Insight’s government relations team and maximEyes user consultants have taken a proactive approach by reviewing the recently released EHR standards--making sure we are prepared well in advance.
On March 2, 2010, HHS released a proposed “two-phased approach” for establishing a certification program to test and certify EHR technology (see http://healthit.hhs.gov). Under the temporary certification process, the ONC National Coordinator would authorize organizations to test and certify EHR technology. The permanent certification program would transition much of the responsibility to organizations in the private sector. While some EHR companies are announcing they are ARRA certified through CCHIT, this is not a guarantee that their system will comply—final criteria and standards have not been finalized by the federal government. |
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What is a meaningful user? |
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Eligible providers must meet the following elements to qualify for incentive payments:
• Use certified EHR software, which must include the ability to send compliant electronic prescriptions to pharmacies.
• Electronically exchange (interoperability) patient health information with labs, hospitals, providers, payers and other EHR.
• Submit compliant clinical quality measures, such as PQRI. |
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How will an eligible provider prove meaningful use? |
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Eligible providers will provide attestation through a secure mechanism, such as through claims-based reporting or an online portal. This attestation process identifies the certified EHR technology providers are using, as well as the results of the eligible providers performance on all of the measures associated with the meaningful use objectives.
On July 28, 2010, federal officials released the final rule (published July 28, 2010) that define how health care providers and hospitals can demonstrate EHR ‘meaningful use’ to qualify for federal incentive payments that are part of the 2009 American Recovery and Reinvestment Act (ARRA). The final rule offer providers more flexibility than the proposed regulations that were released in January 2010. Check out the Meaningful Use ‘Proposed Rule' vs ‘Final Rule’ Comparison Chart that CMS released on July 13, 2010.
Health care providers will need to comply with a set of 15 core objectives during the first year (Stage 1) of adoption, down from 23 measures in the proposed regulations. Hospitals are required to comply with 14 core objectives, down from 25 measures. The final rule also reduces the number of electronic prescriptions a doctor must submit from 75 percent to 40 percent.
Providers will need to enact a single measure to meet the clinical decision support requirements, down from five measures. CMS reduced the number of quality measures that providers must report and CMS is deferring some of the measures to Stage 2.
In addition to the core objectives, doctors and hospitals will choose five more objectives from a ‘menu’ of 10. The remaining objectives will be deferred to Stage 2 (2013-2014). One of the new objectives in the ‘menu’ calls for health care providers to offer patients condition-specific educational resources. One core objective requires hospitals and doctors to use computerized physician order entry systems to capture at least 30 percent of medication orders.
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What incentives are available now for PQRI data verification? |
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Eligible providers who successfully report PQRI quality information in 2010 may earn a bonus payment of 2 percent of their total allowed charges for Medicare Part B covered professional services. Allowable charges are that portion of the submitted charges that is approved for Medicare payment (including the deductible and coinsurance).
Eligible providers must report a minimum of three quality measures at least 80% of the time on claims submitted during the PQRI 2010 reporting period. There are two reporting options in 2010: January 1 through December 31, 2010, or July 1 through December 31, 2010. For more information on how to implement and report PQRI 2010, download the CMS 2010 PQRI Implementation Guide.
Did you know that maximEyes will prompt you when a patient qualifies for PQRI then will automatically add the codes to the Superbill? MaximEyes also checks to see if the patient has Medicare, verifies the patient’s age at the time of exam, reviews diagnoses and procedure codes, and reviews specific items detailed under the PQRI measures. |
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What incentives are available now for ePrescribing? |
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In 2010, physicians who successfully ePrescribe may receive a bonus payment of 2 percent of their overall Medicare Part-B professional services. Amounts will vary depending on the annual allowable Medicare Part-B billings. In 2011-2012, the reward for ePrescribing will be 1 percent, while the penalty for not ePrescribing begins in 2012.
CMS has made changes in 2010 by only requiring eligible providers to enter one G-code to show a visit resulted in an electronic prescription. Simply add G-code G8553 to your Superbill to show the visit resulted in you sending an e-prescription using a qualified electronic prescribing system. Next, bill the G-code for at least 25 unique ambulatory visits during the calendar year. It’s important that you do not enter 2009 G-codes or this will result in the loss of eligibility for the incentives.
Did you know that First Insight was the first company focused exclusively on the ophthalmic market to publicly launch a true “end-to-end” ePrescribing solution through our integration with DrFirst's® award winning GoldRxTM certified RcopiaTM ePrescribing technology. Learn more about maximEyes’ built-in e-prescribing link. |
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How can you get started and reap the benefits? |
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Contact First Insight at sales@first-insight.com and send us your comments or questions. Or complete an online form to schedule a personalized demo and we’ll be happy to help you develop a plan of action, evaluate a return on your investment, and create a smooth-running paperless office using maximEyes software. |
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Resources, Articles and Quick Links |
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Final Meaningful Use Rule: Defines how health care providers and hospitals can demonstrate meaningful use |
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Final EHR Technology Standards and Certification Rule: Describes the required standards and certification |
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HIMSS: News about Meaningful Use, Certification Criteria, Criteria and Standards, FAQs, and Health and Human Services Certification Process |
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HHS Health Information Technology: Information on meaningful use, privacy and security, standards and certification, and certification programs. |
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HITECH Answers: An Independent Analysis of the Healthcare Stimulus Package and HITECH Act |
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EHRWatch.com: News, commentary and developments in EHR |
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IHealthBeat.com: News and reports on technology’s impact on health care |
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FierceEMR.com: News and insights about EHR adoption, implementation, incentives, security and more |
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Note: First Insight has made every effort to provide you with the most recent information. Because federal statutes, regulations and rulings change frequently, information is this article is subject to change. This is provided to you for informational purposes only. We recommend that you seek professional advice from your attorney, accountant or other professional advisor. |
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