Health IT Law Blog : Health IT Law Blog : Post & Schell: Law Firm : HIT & Electronic Health Records

Centers for Medicare and Medicaid Services (CMS) released the final requirements for Stage 2 of Meaningful Use, which health care providers must meet in order to qualify for incentives during this stage of the program, and criteria that electronic health records must meet to achieve certification.

Via CMS press release:

The requirements announced today:

Make clear that stage two of the program will begin as early as 2014. No providers will be required to follow the Stage 2 requirements outlined today before 2014.
Outline the certification criteria for the certification of EHR technology, so eligible professionals and hospitals may be assured that the systems they use will work, help them meaningfully use health information technology, and qualify for incentive payments.
Modify the certification program to cut red tape and make the certification process more efficient.
Allow current “2011 Edition Certified EHR Technology” to be used until 2014.

The CMS final rule also provides a flexible reporting period for 2014 to give providers sufficient time to adopt or upgrade to the latest EHR technology certified for 2014.

You can find a fact sheet on CMS’s final rule on Stage 2 here and a detailed fact sheet on ONC's standards and certification criteria here.

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On February 24, 2012, Center for Medicare and Medicaid Services (CMS) and the Office of National Coordinator for Health IT (ONC) issued proposed rules regarding Stage 2 of Meaningful Use. The proposed rules include the criteria for demonstrating Stage 2 Meaningful Use, and address the penalties for failure to achieve Meaningful Use by 2015. HHS noted the progress made in the last few years, but also recognized the challenges facing the industry, and pushed back the attestation for Stage 2 to 2014. Via HHS Press Release:

In a November 2011 'We Can’t Wait' announcement, the Department outlined plans to provide an additional year for providers who attested to meaningful use in 2011. Under today’s proposed rule, stage 1 has been extended an additional year, allowing providers to attest to stage 2 in 2014, instead of in 2013. The proposed rule announced by ONC identifies standards and criteria for the certification of EHR technology, so eligible professionals and hospitals can be sure that the systems they adopt are capable of performing the required functions to demonstrate either stage of meaningful use that would be in effect starting in 2014.

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HHS announced today that the government intends to make it easier for healthcare providers to adopt electronic health records (EHRs).  As part of this initiative, HHS decided to extend the deadline for meeting Stage 2 of Meaningful Use until 2014. Via HHS press release:

Under the current requirements, eligible doctors and hospitals that begin participating in the Medicare EHR (electronic health record) Incentive Programs this year would have to meet new standards for the program in 2013. If they did not participate in the program until 2012, they could wait to meet these new standards until 2014 and still be eligible for the same incentive payment. To encourage faster adoption, the Secretary announced that HHS intends to allow doctors and hospitals to adopt health IT this year, without meeting the new standards until 2014.

HHS also trumpeted the results of a CDC survey which found that more than half of U.S. physicians plan to take advantage of the EHR incentive program, and that the rate of EHR adoption doubled between 2008 and 2011, from 17% to 34% among physicians.

Of course, HHS did not comment on how low those numbers are. The fact remains that about two-thirds of U.S. physicians have not adopted electronic health records, and continue to use, in Secretary's words, the same technology as Hippocrates. The Obama administration is relying heavily on Regional Extension Centers and training efforts in order to aid healthcare enterprises in adopting EHRs.

We will update this post with links to any relevant regulations if and/or when HHS publishes them in the Federal Register.

"We Can't Wait: Obama Administration takes new steps to encourage doctors and hospitals to use health information technology to lower costs, improve quality, create jobs," HHS press release (November 30, 2011).

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The HIT Policy Committee, which advises the Office of the National Coordinator for Health IT in the Department of Health and Human Services, voted 12-5 to approve a significant delay in requiring providers to meet Stage 2 Meaningful Use until 2014.  If finalized by CMS, such delay would be a welcome relief to those providers who qualified for Stage 1 Meaningful Use in 2011 (and therefore would have only a few months to commence Stage 2 Meaningful Use under the current rule).

Via Government Health IT:

The delay is among the stage 2 recommendations that the Health IT Policy Committee approved at its meeting June 8 by an overwhelming vote of 12 to 5.

The original 2013 timeframe does not give vendors enough time to design, develop, and test new functionality and providers to deploy it and report measures for one year, said Dr. Paul Tang, vice chair of the Health IT Policy Committee and chair of its meaningful use work group.

“The only group that would be affected is the early entrants who qualify for stage 1 in 2011 who get put into a bit of predicament in an unintended way,” he said. Tang is also chief medical information officer at the Palo Alto Medical Foundation.

As a result, stage 1 demonstration and attestation would continue through 2013; stage 2 would start in 2014 and stage 3 in 2015. With the revised timing, providers will still receive the same payments as originally planned. Instead of 2013, however, early entrants will have to wait to attest and receive payments for stage 2 in 2014.

You can find and download the Meaningful Use workgroup's recommendations by clicking here.

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On October 1, 2010, CCHIT announced certifications of 19 "complete" EHR products, including, for example, Epic products for both hospitals and eligible professionals, and Allscripts and GE Centricity products for eligible professionals.  

CCHIT also certified 14 "module" EHR products, from vendors which applied for certification of their products as complete EHRs "but testing could not be completed on a small number of criteria (such as electronic prescribing) because planned updates to the test procedures by NIST were not available at the time of testing." Such "EHR Module" certified products may seek certification as a complete EHRs in the near future.  Via Healthcare IT News:

The Certification Commission for Health Information Technology announced Oct. 1 that it has tested and certified 33 Electronic Health Record products under the ONC-ATCB program.

CCHIT is one of three Approved Testing and Certification Bodies, designated by the Office of the National Coordinator (ONC). The other two are the Drummond Group and InfoGard Laboratories, Inc.

The ATCBs certify that the EHRs are capable of meeting the 2011/2012 criteria supporting Stage 1 meaningful use. Certification is required to qualify eligible providers and hospitals for funding under the American Recovery and Reinvestment Act (ARRA).

The CCHIT certifications include 19 Complete EHRs, which meet all of the 2011/2012 criteria for either eligible provider or hospital technology, and 14 EHR Modules, which meet one or more – but not all – of the criteria.

"CCHIT announces 33 certifications," Healthcare IT News (October 1, 2010).

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