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E-Prescribing Deadline Approaching

Posted by AMS at 14 MAY 10:53 am

e-prescribingClinicians slow to adapt to digital medicine have until June 30 to electronically transmit 10 prescriptions to the pharmacy for Medicare patients, and thereby avoid a 2% cut in their Medicare reimbursement next year.

The 2% penalty is the punitive side of a federal program designed to motivate physicians and other clinicians to replace their prescription pads with iPads, smart phones, and the like. In 2010, the Centers for Medicare & Medicaid Services (CMS) began paying bonuses to clinicians who e-prescribe for their Medicare patients. The bonus that year was 2% of a clinician’s Medicare reimbursement. In 2013, the final year for these incentive payments, the bonus is 0.5%.

Last year, Medicare began penalizing clinicians who had not previously qualified as “successful electronic prescribers,” in CMS parlance, or electronically transmitted at least 10 scripts for Medicare patients in the first half of the 2011. That number of e-prescriptions, reported to CMS through G codes on Medicare claims, is not enough to earn a bonus, but it staves off the penalty, which was 1% in 2012. The penalty disappears after 2014.

Clinicians will be exempt from the 2% penalty in 2014 if they:

  • — qualified for an e-prescribing bonus during 2012;
  • — did not have at least 100 Medicare claims in the first 6 months of 2013 with 1 of the 50-plus billing codes that must be associated with an e-prescription for it to count toward the bonus;
  • — did not generate 10% or more of their Medicare allowable charges in the first 6 months of 2013 with the required billing codes;
  • — were not a physician, podiatrist, nurse practitioner, or physician assistant as of June 30;
  • — achieved “meaningful use” under the Medicare or Medicaid incentive programs for electronic health record (EHR) systems in either 2012 or the first 6 months of 2013, and reported that to CMS by June 30, 2013;
  • — registered to participate in one of the EHR incentive programs by June 30 and adopted certified EHR technology; or
  • — Lacked prescribing privileges and indicated that with code G8644 at least once on a Medicare claim before June 30.

Clinicians also can apply for one of several hardship exemptions, which include practicing in a rural area without sufficient high-speed Internet access and being barred by local, state, or federal law from e-prescribing. The deadline for a hardship exemption application, accomplished with a G code on a Medicare claim, is June 30.

More information about avoiding the Medicare e-prescribing penalty is available on the CMS Web site.

Source: www.medspace.com; Robert Lowes; May 7, 2013.



Categories: EHR Health Care News, Electronic Medical Records, News Blog, News Updates

Bill Would Prohibit HHS From Mandating ICD-10 Transition

Posted by AMS at 7 MAY 1:15 pm

HHSRep. Ted Poe (R-Texas) has introduced a bill (HR 1701) that would prohibit HHS from mandating that health care providers switch to ICD-10 code sets, ICD-10 Watch reports (Natale, ICD-10 Watch, 4/25).

About ICD-10

U.S. health care organizations are working to transition from ICD-9 to ICD-10 code sets to accommodate codes for new diseases and procedures. The switch from ICD-9 to ICD-10 code sets means that health care providers and insurers will have to change out about 14,000 codes for about 69,000 codes.

In August 2012, HHS released a final rule that officially delayed the ICD-10 compliance date until
Oct. 1, 2014.

In December 2012, the American Medical Association — along with 42 state medical organizations and 40 medical specialty groups – sent a letter urging CMS to halt the implementation of ICD-10 code sets and instead find an “appropriate replacement” for ICD-9 code sets.

Previous Comments From Poe

During a speech on the House floor earlier this month, Poe called the ICD-10 mandate “red tape” and “bureaucracy.” According to Poe, complying with the new ICD-10 coding system will cost about $80,000 for individual doctors and about $250,000 for physician practices with five to 10 doctors.

He also noted that the level of detail required for ICD-10 coding would pose challenges for health care providers (iHealthBeat, 4/11).

Legislation Details

Poe’s bill states that it would “prohibit the Secretary of Health and Human Services [from] replacing ICD-9 with ICD-10 in implementing the HIPAA code set standards” (ICD-10 Watch, 4/25).

The legislation has been introduced to the House Energy and Commerce and Ways and Means committees (Linder, Becker’s Hospital Review, 4/29).

Both committees need to approve HR 1701 before it can advance to the full House (ICD-10 Watch, 4/25).

Source: www.ihealthbeat.org; April 30, 2013



Categories: EHR Health Care News, Electronic Medical Records, News Blog, News Updates

ONC Offers Rural Providers Some Health Information Exchange Guidance

Posted by AMS at 30 APR 9:58 am

health information exchangeMade available through the ONC’s National Rural Health Resource Center, the toolkit provides a set of “practical” HIE resources designed to help rural health stakeholders, including State Offices of Rural Health and Flex Programs, rural hospitals and clinics, critical access hospitals (CAHs), rural health networks, and other invested parties, develop and manage HIEs.

The toolkit includes the following components:

Health Information Exchange – First Considerations. This document covers the first steps in forming or joining an HIE. The guide also includes a readiness self-assessment tool designed around governance, sustainability, technology, legal and policy, provider adoption, evaluation and consumer engagement domains.

HIE DIRECT Guide. Included in this guide are a description of technologies used, a glossary of terms and recommendations on implementing DIRECT, which is a set of standards, protocols and services that enable simple, secure electronic transport of health information (push messaging) between healthcare participants (e.g. providers, labs). The goal of DIRECT is to facilitate “direct” communication with a focus towards more advanced levels of interoperability than simple paper can provide.

ROI Calculator.  This spreadsheet calculates potential savings and costs of implementing an electronic health record (EHR) and a health information exchange (HIE). Sources are listed along with each calculation.

Privacy and Security Overview and Resource List.  This compilation of resources includes the privacy and security requirements for organizations participating in an HIE as well as a list of HIPAA-related resources.

HIE Policy Matrix. This document provides “policy models” adapted from The Connecting for Health Common Framework. The policy suggestions specifically emanate from Section P2: Model Privacy Policies and Procedures for Health Information Exchange, which contains much of the necessary policy and procedure language needed for an HIE.

Source: www.himsswire.com; March 5, 2013.



Categories: EHR Health Care News, Electronic Medical Records, News Blog, News Updates

Lawmakers Call For ‘Reboot’ of Meaningful Use Program

Posted by AMS at 23 APR 10:58 am

meaningful useSix Republican Senators have formally requested that U.S. Department of Health & Human Services Secretary Kathleen Sebelius provide a written plan to address how the agency is implementing the Health Information Technology for Economic and Clinical Health (HITECH) Act.

In an April 16 letter–signed by Senators Lamar Alexander (R-Tenn.), Richard Burr (R-N.C.), Tom Coburn (R-Okla.), Mike Enzi (R-Wyo.), Pat Roberts (R-Kan.) and John Thune (R-S.D.)–they state that Congress has an obligation to conduct oversight of government programs. To that end, they released a 28-page white paper entitled “REBOOT: Re-Examining the Strategies Needed to Successfully Adopt Health IT” that outlines their concerns with current health IT policy, including the costs, interoperability, the potential for waste and abuse, patient privacy and sustainability.

“[W]e have significant concerns with the implementation of the HITECH Act to date, including the lack of data to support the Administration’s assertions that this taxpayer investment is being appropriately spent and actually achieving the goal of interoperable health IT,” the senators said in the letter.

The senators asked Sebelius to respond to the concerns cited in the white paper with a written plan, and to provide additional information, such as a list of all contracts awarded under the HITECH Act and the agency’s evaluation of state programs, a task required by HITECH. Expressing a desire for “robust dialogue,” the senators gave a deadline of June 16.

This is not the first time that Congress has expressed concerns about health IT. Last October, four House republicans urged Sebelius to change the course of the Meaningful Use program, and asked that its incentive payments be frozen until the agency promulgated universal interoperable standards. Last June, Rep. Renee Ellmers (R-N.C.) asked HHS to improve the safety of EHR systems, piggybacking on the Institute of Medicine’s 2011 report outlining similar concerns.

To learn more:
- read the letter (.pdf)
- here’s the senators’ white paper (.pdf)

Source: www.fierceemr.com; Marla Durben Hirsch; April 16, 2013.



Categories: EHR Health Care News, Electronic Medical Records, News Blog, News Updates

CMS and OIG Propose Extension of Electronic Health Record Donation Protections

Posted by AMS at 16 APR 11:07 am

CMSThe Centers for Medicare & Medicaid Services (CMS) and the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) have each proposed new rules to extend existing protections that allow hospitals to donate electronic health record (EHR) technology to physicians who refer patients to their facilities. By way of background, in 2006, CMS established an exception to the Stark self-referral law to allow hospitals to donate EHR technology to physicians under certain circumstances. Likewise, in 2006, the OIG established a safe-harbor to protect such EHR donations from enforcement under the federal anti-kickback statute. While both protections are set to expire on December 31, 2013, the proposed rules would extend the provisions until the end of 2016 as a means to facilitate the adoption of EHR technology.

In addition to extending the EHR donation protections, the proposed rules would (1) remove the requirement from the original rule that donated EHR technology contain electronic prescribing capability, and (2) update the provision under which EHR technology is deemed interoperable, which would expand the types of EHR systems that qualify for the protections.

CMS’s proposed rule is available here. The OIG’s proposed rule is available here. Comments regarding both proposed rules should be submitted in writing, or electronically at www.regulations.gov, by June 10, 2013.

Source: www.lexology.com; Jennifer Pike, Brad M. Rostolsky; April 12, 2013.



Categories: EHR Health Care News, Electronic Medical Records, News Blog, News Updates
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