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HHS releases EHR Stage 2 final rule

Posted on August 23, 2012 | No Comments

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Key Developments
Implementation Briefs

The U.S. Department of Health and Human Services (HHS) released a final rule defining requirements for Stage 2 of the Electronic Health Record Incentive Program. The program creates incentives for providers who meet benchmarks in the adoption of EHR, also known as meaningful use.

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The U.S. Department of Health and Human Services (HHS) issued a 563-page omnibus rule yesterday afternoon. The rule updates the Health Insurance Portability and Accountability Act (HIPAA) privacy and security regulations, as required under the American Recovery and Reinvestment Act of 2009. Notably, the rule expands direct liability for breaches to contractors, subcontractors and other associates of healthcare providers, plans and insurers. In addition, the rule outlines noncompliance penalties, which vary depending on level of negligence and are capped at $1.5 million. The rule also expands patient rights, such as improving electronic medical record access and enabling patients to limit disclosure of out-of-pocket payments for treatments. HIPAA-covered entities and business associates must by in compliance with the new regulations by September 23 of this year. The final rule will be published in the January 25 Federal Register.
The Centers for Medicare & Medicaid Services recently posted an 11-page list of corrections to its Stage 2 proposed rule on meaningful use. The CMS notice amends technical and typographical errors in the proposed rule entitled "'Medicare and Medicaid Programs; Electronic Health Record Incentive Program—Stage 2." The proposed rule was made public in February and a final rule is expected to be issued this summer. Many of corrections are semantic, although some involved actual errors (the proposed rule incorrectly identified the National Committee for Quality Assurance as the National Council on Quality Assurance, for example).
On February 23, The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule for Stage 2 requirements for the Medicare and Medicaid electronic health record (EHR) incentive programs. The proposed rule outlines the second stage of “meaningful use” criteria for eligible providers and hospitals. If implemented, the rule would increase requirements for the EHRs, as well as increase the requirements for information exchange. Additionally, the proposal introduces changes to the program timeline, details payment adjustments for providers and hospitals, and adds objectives for specialists in the EHR incentive programs. The final rule for Stage 1 of the EHR incentive program was published in the July 28, 2010.
The Department of Health and Human Services announced final rules for achieving “meaningful use”of electronic health records so that eligible physicians and hospitals may qualify for as much as $27 billion in federal funding.
Previous implementation briefs have addressed the electronic health record (EHR) incentive programs enacted by the HITECH Act, part of ARRA. These programs financially incentivize adoption of EHR technology that meets standards of interoperability and accessibility, among other criteria, and incentivize providers to use the technology to engage with patients and improve patient care. Among other goals, the EHR incentive program is intended to improve patient...
A previous Implementation Brief discussed the electronic health record (EHR) incentive program enacted by the HITECH Act, which is part of ARRA[1]. Stage 1 of that program began in 2011 and the Centers for Medicare and Medicaid Services (CMS) reports that through July 2012, more than $6 billion in Medicare and Medicaid incentive payments had been made to 132,511 physicians and hospitals that demonstrated meaningful use of EHRs[2]. On August 23, 2012, CMS published a final rule on the Stage 2 Meaningful Use criteria that eligible professionals (EPs), eligible hospitals and critical access hospitals (CAHs) must meet to qualify as meaningful users of electronic health records (EHRs) and receive incentive payments under the Medicare and Medicaid programs[3]. This final rule builds upon the Stage 2 proposed rule, released on March 7, 2012. The Stage 2 final rule also revises certain Stage 1 criteria, which were finalized in the July 28, 2010 final rule[5]. Stage 1 of the incentive program was designed to encourage providers to move key clinical data into an electronic format, and focused on establishing the functionalities of a certified EHR system[6]. With the final rule, CMS continues its incremental approach to continuing this transitional process and strikes a balance between stakeholders calling for Stage 2 to require demonstrated improvements in care as a result of EHR use and those seeking more flexibility in the rules, with incentives simply to acquire EHR technology.
The health reform law makes no major revisions to provisions of the American Recovery and Reinvestment Act (ARRA) of 2009 to move the nation toward a national health information policy and create incentives for the adoption and meaningful use of health information technology (HIT). However, because the adoption and use of HIT is foundational to the implementation of many aspects of health reform, this entry summarizes the key provisions of the 2009 law.
A new report released by the University of Massachusetts Medical School (UMMS) and the National Academy of Social Insurance (NASI) examines the establishment of the information technology (IT) infrastructure to promote access to and enrollment in health plans through Exchanges and expanded Medicaid programs under the Affordable Care Act (ACA). The report reviews lessons from “Early Innovator” and other advanced states as they prepare for these ACA provisions. The report, entitled "Establishing the Technology Infrastructure for Health Insurance Exchanges Under the Affordable Care Act," reviews issues that policymakers should consider as they develop state-based technology infrastructures.