On July 28, 2010, CMS’ final rule was published in the Federal Register regarding incentive payments to eligible professionals and hospitals participating in Medicare and Medicaid programs that adopt and successfully demonstrate meaningful use of certified electronic health record (“EHR”) technology. The rule makes final a proposed rule issued in January 2010. The final rule differs from January’s proposed rule in allowing professionals and hospitals more flexibility in choosing which objectives they can utilize to demonstrate meaningful use.
Under the HITECH Act of 2009, the Medicare and Medicaid EHR incentive programs provide a financial reward for the meaningful use of qualified, certified EHRs to achieve health and efficiency goals. “Meaningful use” means meeting a series of objectives that utilize the potential of EHRs and relate to the improvement of quality, efficiency and patient safety in the healthcare system through the use of certified EHR technology. To qualify for incentive payments, meaningful use requirements must be met as follows:
• Medicare EHR incentive program – Eligible professionals and hospitals must successfully demonstrate meaningful use of certified electronic health record technology every year they participate in the program.
• Medicaid EHR incentive program – Eligible professionals and hospitals may qualify for incentive payments for the adoption, implementation, upgrade or the demonstration of meaningful use in their first year of participation. They must successfully demonstrate meaningful use for the remaining years they participate in the program.
Meaningful use includes both a “core” set of objectives and an additional “menu” set of objectives that are specific for eligible professionals and hospitals. There are a total of 25 meaningful use objectives for eligible professionals; 20 of the objectives must be completed to qualify for an incentive payment. Of those 20 objectives, 15 are required core objectives and the remaining 5 objectives may be chosen from the list of 10 menu set objectives. There are a total of 24 meaningful use objectives for hospitals and 19 of the objectives must be completed to qualify for incentives. Of those 19 objectives, 14 are required core objectives, and the remaining 5 objectives may be chosen from the list of 10 menu set objectives. A detailed overview of meaningful use objectives is available at the New England Journal of Medicine.
The criteria for meaningful use will be implemented in three stages over the course of the next five years. Stage 1 (2011 – 2012) sets the baseline for electronic data capture and information sharing. Stage 2 (2013 – 2014) and State 3 (beginning 2015) will continue to expand on this baseline and be developed through future rule making.
Also on July 28, 2010, the Federal Register published the Office of the National Coordinator for Health Information Technology’s companion final rule identifying the criteria for certification of EHR technology so eligible professionals and hospitals may be assured that their EHR systems are capable of performing the required functions.
