Part B Insider (Multispecialty) Coding Alert

Published on Sat Jun 19, 2010 PDF

You could benefit from incentive bonuses by next year.

Your practice could be edging ever closer to a potential $44,000 EHR bonus, thanks to new clarification from CMS.

Eligible professionals who want to demonstrate "meaningful use" of an electronic health record (EHR) -- and therefore exhibit eligibility to qualify for potential $44,000 perphysician EHR incentives from Medicare that will be issued to those who qualify over a five-year period -- have been eager to find out what type of standards they'll have to meet to qualify as a meaningful user. That time is finally here, with the release of final rules for both electronic health record standards for certification and the Medicare EHR incentive program.

On July 13, CMS issued a final rule that defines the minimum requirements you'll have to meet through EHR use to qualify for the bonus incentive payments. "For years, health policy leaders on both sides of the aisle have urged adoption of electronic health records throughout our health care system to improve quality of care and ultimately lower costs," said HHS Secretary Kathleen Sebelius in a July 13 statement. "Today, with the leadershipof the President and the Congress, we are making that goal a reality."

Unlike the proposed rule, which would have required physicians to meet 25 requirements in their use of EHRs, the final rule will ensure that physicians meet a "core group of required objectives plus an additional menu of procedures from which providers may choose," the CMS fact sheet on the final rule states.

"This is a turning point for electronic health records in America, and for improved quality and effectiveness in health care," said David Blumenthal, MD, HHS's national coordinator for Health Information Technology, in a July 13 statement.

Check out What's Included in the Final Rule

According to the final rule, which is available for viewing in the Federal Register (www.ofr.gov/OFRUpload/OFRData/2010-17207_PI.pdf), the core set of meaningful use objectives includes 15 bullet points that you'll have to meet, including the following (among others):

• Record demographics
• Maintain an up-to-date problem list
• Record smoking status for patients 13 and older
• Implement drug-drug and drug-allergy interaction checks
• Record and chart changes in vital signs

CMS lists the requirements you'll have to meet for each core objective in the final rule, and each has a different threshold during "Stage 1"of the program (which applies to any eligible professional attempting to collect the incentive bonus payments in 2011 or 2012). For instance, when meeting the "record smoking status" objective, you'll have to do this for more than 50 percent of all unique patients 13 years old or older seen by the eligible professional.

Select From A Separate 'Menu'

After meeting the core requirements, eligible professionals will also have to meet several elements from the "menu set" listing, which the Federal Register also published. It includes the following options, among others:

• Implement drug formulary checks
• Send reminders to patients for preventive and follow-up care (based on patient preference)
• Submit electronic immunization data to immunization registries or immunization information systems

You'll have to meet all but five of the menu set requirements during Stage 1 of the program, according to the final rule.

To read CMS's fact sheet on the final rule, visit www.cms.gov/apps/media/fact_sheets.asp.