New CMS Resource Available: Payment Adjustment & Hardship Exceptions Tipsheets for Eligible Hospitals and Eligible Professionals

CMS has developed new tipsheets to help providers learn more about congressionally mandated payment adjustments that will be applied to Medicare eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) that do not demonstrate meaningful use of certified electronic health record (EHR) technology under the EHR Incentive Programs. Click here to download the tipsheet for EPs and here for the tipsheet for eligible hospitals and CAHs.

Key takeaways from the tipsheets include:

Medicare EPs

• Payment Adjustment Amount: 1% per year, cumulative for every year that an EP is not a meaningful user. The maximum cumulative payment adjustment is 5%.
• Timing:Payment adjustments begin on January 1, 2015.

Medicare Subsection (d) Eligible Hospitals

• Payment Adjustment Amount:Applicable to the percentage increase to the Inpatient Prospective Payment System (IPPS) rate. Hospitals that do not demonstrate meaningful use will receive a lower payment than the IPPS standard amount. The payment adjustment is cumulative for each year that a Medicare Subsection (d) eligible hospital does not demonstrate meaningful use.
• Timing: Payment adjustments begin on October 1, 2014.

Critical Access Hospitals

• Payment Adjustment Amount: This payment adjustment for CAHs applies to their Medicare reimbursement for inpatient services during the cost reporting period in which they did not demonstrate meaningful use. If a CAH has not demonstrated meaningful use, its reimbursement would be reduced from 101% of its reasonable costs to 100.66%.
• Timing: Payment adjustments will begin with the fiscal year 2015 cost reporting period.

Hardship Exceptions
Hardship exceptions will be granted to EPs, eligible hospitals and CAHs only under specific circumstances. Providers must demonstrate to CMS that those circumstances pose a significant barrier to achieving meaningful use. Information on how to apply for a hardship exception will be posted on the CMS EHR Incentive Programs website in the future.

If you have any questions on any of the material in this posting, please contact David Ginsberg, Senior Advisor to THE Consortium.

Join CMS for a Webinar Providing a Detailed Look at Stage 2 of the EHR Incentive Programs on August 30

We apologize for the late notice, but CMS sent this at 8:50am MDT and it was posted as soon as possible.

The Centers for Medicare & Medicaid Services (CMS) and Physicians Practice are holding a free and open webinar on Stage 2 of the Medicare & Medicaid Electronic Health Record (EHR) Incentive Programs on August 30 from 11:00 – 12:00 pm MDT.

Description:
Understanding the latest set of regulations for the EHR Incentive Programs will help providers successfully participate, receive incentive payments, and refine and integrate EHRs into their practices. CMS expert Robert Anthony, will review the Stage 2 rule and how the new requirements differ from the Stage 1 requirements. There will also be a Q&A session.

Presenter:
Robert Anthony, a Health Specialist in the Office of E-Health Standards and Services at CMS, will present on details about Stage 2 requirements. He contributes to policy development and implementation of the Medicare and Medicaid EHR Incentive Programs.

Registration:
To register for this webinar, visit this Physicians Practice website and click on the registration link.

Visit the New Stage 2 Web Page on the EHR Incentive Programs Website

On August 23, 2012, the Centers for Medicare & Medicaid Services (CMS) published the final rule for Stage 2 of the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. The rule provides new criteria that eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) must meet in order to successfully participate in the EHR Incentive Programs.

CMS recently updated the EHR Incentive Programs website with a new Stage 2 section, which provides helpful information on the Stage 2 final rule and how it affects the EHR Incentive Programs. The Stage 2 page includes an overview of the final rule and links to Stage 2 resources:

• Stage 2 Overview Tipsheet – Provides an overview of the rule, including important dates, basic requirements, new audiences, and additional Stage 2 resources
• Stage 1 vs. Stage 2 Comparison Tables – Compares basic requirements of Stage 1 versus Stage 2 for both EPs and eligible hospitals
• Stage 1 Changes Tipsheet – Outlines major changes to Stage 1 included in the rule
• Payment Adjustments & Hardship Exceptions Tipsheets – Details the schedule and percentages of the payment adjustments, as well as information about hardship exemptions for both EPs and eligible hospitals
• 2014 Clinical Quality Measures Tipsheet – An overview of the 2014 CQM requirements that will apply to all providers, regardless of their stage of meaningful use

CMS will continue to provide resources for providers on Stage 2 rule and the EHR Incentive Programs. Visit the Stage 2 page to view upcoming webinars and sessions discussing Stage 2 and the different changes occurring.

CMS Releases Stage 2 Meaningful Use Final Rule/ONC Releases Certification Rule

For those of us waiting with baited breath for the final rule, CMS and ONC obliged with a release of two documents today-one provides the final rule for Stage 2 Meaningful Use and the other provides the requirements and specifications for certification and related standards.

CRHC will be intensely studying these rules and provide a comprehensive review at our next Consortium Webinar on Thursday, September 20th. We will also have a session on Stage 2 at our Annual Meeting October 25-26th.

For those of you brave enough to read over 1100 pages of the two rules, there links can be found at:

· CMS - http://www.ofr.gov/OFRUpload/OFRData/2012-21050_PI.pdf 

· ONC - http://www.ofr.gov/OFRUpload/OFRData/2012-20982_PI.pdf 

A fact sheet on CMS's final rule is available at http://www.cms.gov/apps/media/fact_sheets.asp. 

A fact sheet on ONC's standards and certification criteria final rule is availableathttp://www.healthit.gov/policy-researchers-implementers/meaningful-use-stage-2-0

Meaningful Use Attestation Functionality to Open in Colorado R&A in September

Currently, the Colorado Registration & Attestation (R&A) system has only been open for eligible professionals (EPs) and eligible hospitals (EHs) to attest to adoption, implementation and upgrade of a certified EHR system (AIU).

Beginning in September, the Colorado R&A will begin accepting attestations for Meaningful Use. Please keep in mind that if an EP or EH previously attested to AIU in 2012, Meaningful Use will not become available in their account until 2013 due to restrictions on duel attestations within a program year.

Certified Health IT Product List Screen Shot Now Required

The Colorado Department of Healthcare Financing & Policy is now requiring a screen shot from the Certified Health IT Product List (CHPL) website be uploaded in the Colorado Registration & Attestation (R&A) System at Step 3 when completeing the Medicaid AIU process. The screen shot must display the CMS Certification Number of the corresponding version of certified EHR software purchased.

Currently, the CPHL website screen shot is listed as "Optional" under the required documents at Step 3 of attestation. The Department has requested that this screen shot be changed from "Optional" to "Required", but due to resource constraints on development,  this change will not be made until December. Although the CHPL website screen shot will continue to be listed as "Optional", please upload this document during Step 3 of your attestation to avoid delays in your attestation’s approval.

September 10-14 is National Health Information Technology (HIT) Week

Through knowledge-sharing webinars and grantee spotlights, HRSA helps safety net providers overcome barriers, including maximizing return-on-investment, ensuring patient privacy, and detailing opportunities for workforce training.

HRSA’s real-world examples demonstrate how electronic health records create pathways for effective treatment, preventive care, and support the consumer demand for personalized medicine. Learn about guidelines for the, “Meaningful Use,” of HIT, ICD- 10, mhealth, and workforce training opportunities. Explore HRSA’s Health Information Technology resources.

HRSA Webinar: Telehealth Resources for Safety Net Providers

Friday, August 17, 12:00 PM MDT

Telehealth technology can be a valuable addition to a wide variety of care settings -- from critical access hospitals and rural health clinics to ambulatory and primary care settings. Presented by HRSA’s Office for the Advancement of Telehealth (OAT), this webinar will provide an overview of the HRSA activities and programs available to improve health care delivery, education and health information services to meet the needs of the underserved.

Presenters, from both policy and safety net environments, will provide an overview of FCC and HRSA programs available to support the use of telehealth. Presenters include:

Monica Cowan, Senior Public Health Analyst

HRSA Office of Rural Health Policy, Office for the Advancement of Telehealth. Rockville, MD

Gordon Alloway, Project Director

Heartland Telehealth Resource Center. Kansas City, KS 

Paloma Costa, Program Manager of Outreach

Rural Health Care, Universal Service Administrative Company. Washington, DC

Stephanie Laws, RN BSN, Manager

Telehealth and Innovative Technologies Department, Union Hospital. Clinton, IN

Click here to register: http://webcast.streamlogics.com/audience/index.asp?eventid=96474855.

Questions may be submitted prior to webinar and emailed to healthit@hrsa.gov.

Previous HRSA Health and Quality Webinars are available at: http://www.hrsa.gov/healthit.

Rural Hospital & Clinics Reach 'Meaningful Use' With Help from Colorado Regional Extension Center

Even though Rio Grande is located in a remote area of the state, this has not been a barrier to the adoption of health IT in their organization. In fact, by working closely with the Colorado Rural Health Center, a Colorado Regional Extension Center (CO-REC) partner, Rio Grande’s clinics were among the first to successfully attest for Stage 1 of Meaningful Use for the Medicare Electronic Health Records Incentive Program. Additionally, Rio Grande Hospital was the third hospital in the in the state to achieve this goal.

To read the entire article, click here.

Information on the Medicare EHR Incentive Program 2012 Reporting Pilot for Eligible Hospitals and CAHs Now Available

CMS announced that details about the Medicare Electronic Health Record (EHR) Incentive Program 2012 Reporting Pilot for Eligible Hospitals and Critical Access Hospitals (CAHs) have been published and are available on the QualityNet website. 

The Medicare EHR Incentive Program 2012 Reporting Pilot provides Eligible Hospitals and CAHs with an opportunity to meet the Stage 1 clinical quality measure (CQM) requirements of the Medicare EHR Incentive Program through electronic submission of CQM data.

Eligible Hospitals and CAHs must submit a full year of CQM data in order to meet the CQM requirements for the Medicare EHR Incentive Program 2012 Reporting Pilot. The reporting period to submit this data opens on October 1, 2012, and closes on November 30, 2012. A test database became available on July 1, 2012 to accept test files for the Stage 1 CQMs. The database is also available through the QualityNet website.

Pilot participants who successfully meet all other meaningful use requirements will receive EHR incentive payments following the verification of the CQM data. 

If you have questions or are interested in participating please call the QualityNet helpline at (866) 288-8912 TTY: (877) 715-6222.  To learn more about the pilot, please visit the QualityNet website.

CMS Meaningful Use Audits Begin

A contractor working for the CMS has begun the promised audits of Medicare providers and dual-eligible Medicare and Medicaid hospitals that have received federal electronic health-record system incentive payments, the agency confirmed.

To read the entire article, click here.

Yampa Valley Medical Center was the first Colorado rural PPS hospital to successfully attest to Meaningful use!

This week they received incentive payment from Medicare as a reward for their hard efforts.

While the Colorado Rural Health Center provided guidance and education throughout the process, this truly was a team effort that was expertly managed and delivered by their exceptional staff.

CRHC congratulates Yampa Valley Medical Center on this tremendous achievement!

October 3rd is the Last Day for EPs to Begin their 90-Day Reporting Period for 2012

Wednesday, October 3rd, is the last day for eligible professionals (EPs) to begin their 90-day reporting period for calendar year (CY) 2012 for the Medicare EHR Incentive Program. For EPs, this means that they must begin their consecutive 90-day reporting period by October 3rd in order to attest to meeting meaningful use and be eligible to receive an incentive payment for CY 2012.

For EPs who have already completed their reporting period, CMS has a number of tools available to help prepare for attestation. EPs can use the CMS Eligible Professional Attestation Worksheet to record their meaningful use measures to have as a reference when attesting for the Medicare EHR Incentive Program in CMS' web-based Registration and Attestation System. The Meaningful Use Attestation Calculator and Attestation User Guide for Eligible Professionals can also help EPs to successfully attest to meeting meaningful use.

CMS encourages EPs not to miss the opportunity to participate in the Medicare EHR Incentive Program this year. Begin your reporting period by October 3rd to get on the path to payment for CY 2012.

GAO Report Confirms Urban/Rural HIT Disparity

The Government Accounting Office issued a report July 25th that confirms the meaningful use disparity between PPS/CAH, urban/rural, and large/small hospitals that rural advocates (including this one) predicted when the HITECH Act became law officially exists!

To read the entire article, click here.

Tips for Small Provider Practices to Plan for the ICD-10 Transition

Although the final rule on the proposed ICD-10 deadline change has yet to be published, it is important to continue planning for the transition to ICD-10. The switch to the new code set will affect every aspect of how your organization provides care, but with adequate planning and preparation, you can ensure a smooth transition for your practice.

You should consider the following checklist to help keep your efforts on track with your transition:

• Educate staff and leadership about ICD-10
• Appoint an ICD-10 coordination manager and delegate a steering committee  to manage the transition 
• Train staff on changes in documentation requirements from health plans and how this will affect work flow 
• Perform an impact assessment
• Examine existing uses of ICD-9 codes in order determine aspects of work flow and business practices that ICD-10 will potentially change. Be sure to evaluate planned and ongoing projects as well
• Create a list of staff members who need ICD-10 resources and training, such as billing and coding staff, clinicians, management, and IT staff
• Plan a realistic and comprehensive budget
• Estimate a budget that includes costs such as software, hardware, staff training, and any initial change in patient volume
• Coordinate with external partners
• Contact system vendors, clearinghouses, and billing services to assess their readiness and evaluate current contracts
• Ask your vendors how they will support you in the transition to ICD-10 and request  a timeline and cost estimate
• Analyze existing health plan trading partner agreements
• Get ready for testing
• Request a testing plan to schedule from your vendor
• Conduct internal testing within your clinical practice as well external testing with payers and other external business partners after you have completed the planning stages 

Keep Up to Date on ICD-10.
Please visit the ICD-10 website for the latest news and resources to help you prepare!