Federal and State Government News Update


Edition Seventy-One (6/15/11)

ONC Names ANSI Permanent Accreditor
Modern Healthcare, subscription required, 6/10/11
ONC named the American National Standards Institute as its designated accreditor of organizations certifying EHR systems. The selection of ANSI as the ONC-AA represents one of the first steps in the implementation of the permanent certification program, which is scheduled to begin in 2012.

Health Care Will Take Up Nearly 20 Percent of the U.S. Economy by 2019

Computerworld, 6/8/11
Health care spending will represent nearly one-fifth of the U.S. gross domestic product by 2019, and much of the money can be attributed to new regulations requiring better information technology and mobile health apps, according to a report.

ACP Questions Meaningful Use Recommendation for ACOs

InformationWeek, 6/8/11
The American College of Physicians (ACP) has raised concerns regarding the recommendation at least 50 percent of participating primary care participants within an ACO be Meaningful Users of HIT by the second year of the contract. This requirement, along with several others which have been outlined in the proposed rules for ACOs, has been cited by the ACP as measures which limits the participation of many physicians and could hurt the development of ACOs moving forward. 

Docs Tell Congress EHR Adoption Presents Serious Challenge

InformationWeek, 6/8/11
Doctors representing small physician practices gave Congressional representatives on the House Small Business Committee's Healthcare and Technology subcommittee an earful as they spoke of the significant barriers to the adoption of health I.T. and the potential consequences this could have on the health care sector. These barriers include regulations, financial penalties, an unpredictable marketplace, and concerns over interoperability between different I.T. systems, and the most prominent barrier of all—costs. 

Delay Stage 2 Meaningful Use for Those Who Attest in 2011?

Health Data Management, 6/8/11
The Meaningful Use workgroup of the Health I.T. Policy Committee is recommending that Stage 2 be delayed by one year to 2014 for providers who attest to Stage 1 Meaningful Use in 2011. The rationale is Stage 1 pioneers who attest in 2011 should not be penalized by tight timeframes next summer for getting ready for Stage 2, which starts in fiscal 2013 on October 1, 2012.

New Meaningful Use Guidance from CMS

Health Data Management, 6/7/11
The CMS released four new frequently asked questions about the EHR Meaningful Use incentive program. The questions cover providing patients with an electronic copy of health information and counting patients not seen by the eligible provider. CMS answers to the questions demonstrate the complexity of meeting Meaningful Use criteria.

What are the Meaningful Use Barriers for Medicaid Providers?
Health Data Management, 6/3/11 
The Agency for Health Care Research and Quality and research organization RTI International conducts a two-year, $425,000 study on barriers Medicaid providers encounter in achieving Meaningful Use. AHRQ uses data from the study to develop recommendations for the next Stages of the Meaningful Use program.

Medicare to Open its Claims Data

Health Data Management, 6/3/11
The CMS issued a proposed rule which would allow certain qualified organizations to access Medicare data to compile quality and safety reports about physician practices, hospitals, and other health care providers. Under the rule—which was mandated by the federal health reform law—CMS would provide standardized extracts of claims data for Medicare Parts A, B, and D for a fee to certain entities who are able to accurately and safely process data according to standard performance evaluation measures.

ONC Seeks Input on EHR Certification

Healthcare IT News, 6/2/11 
ONC is seeking comments on approaches which enables providers and other health care entities to obtain and manage digital certificates that are cross-certified with the Federal Bridge. The Federal Bridge is an architecture, designed by the government, to address health care I.T. authentication, privacy, and data protection between various parties.

Bipartisan House Group to Seek EHR Payment Change

Modern Healthcare, subscription required, 6/1/11
The use of Medicare provider numbers—rather than physical campuses—as the basis for doling out federal incentive payments for the use EHRs is expected to soon face a legislative challenge. A bipartisan group led by Rep. Michael Burgess (R-TX) plans to introduce legislation sought by some hospitals which would require the CMS to issue those Medicare and Medicaid provider incentives to each campus in a multi-campus hospital system.

CDC to
Build Public Health Surveillance Via EHR Data
Government Health IT, 6/1/11
The CDC intends to identify standards and develop requirements for syndromic surveillance using clinical data from HIEs. Establishing Meaningful Use is important for public health agencies because it creates an opportunity to identify messaging standards and the technical architecture which supports population health to be incorporated in the functionality for EHRs so providers can easily share the information.

Q&A: Another Side of ACOs
Government Health IT, 5/31/11
Proposed regulations for becoming an ACO have drawn harsh criticism from nearly every direction. Several health care associations have individually and publicly described the regulations as essentially too difficult to be realistically workable—and seven U.S. Senators have said the ACO program is doomed to failure. Is the ACO model simply supposed to be intimidatingly stringent in the early phases?

CMS to Align e-Rx Incentive with EHR Program

Government Health IT, 5/31/11
The CMS plans to modify its e-prescribing incentives schedule to better align with its EHR incentive program so physicians can both avoid e-prescribing penalties and also participate in CMS’ EHR Incentive Program. E-prescribing is a requirement for Meaningful Use of EHRs to qualify for incentives. 

ONC Adds Disciplinary Measures to EHR Accreditor Rules
Modern Healthcare, subscription required, 5/31/11
ONC has published a proposed rule creating a disciplinary and removal process for a key organization in the federal HIT incentive payment program.

Maryland Extension Center Signs up 1,000 Docs for EHR Adoption
Government Health IT, 6/7/11
Maryland’s regional health I.T. extension center has reached its initial goal of signing up 1,000 primary care providers to help them deploy and become Meaningful Users of EHRs, making the state one of the nation’s stand-outs in enrolling physicians. The Chesapeake Regional Information System for our Patients is the Maryland extension center, which offers local technical assistance and project management to small providers digitizing their records.

N.Y. Slow to Set Up Health Exchange
Politico, 6/1/11
Several of the seven states awarded HHS' Early Innovator grants have yet to move forward on key aspects of implementing their state insurance exchanges and have not yet passed legislation to set up new on-line insurance marketplaces. Despite the setbacks, HHS officials have said the Early Innovator program is moving forward. Other grantees—Kansas, Maryland, Oregon, Wisconsin, and a consortium of states led by Massachusetts—have succeeded in developing models.

VA, DOD Test Joint EHR Interface in Hawaii

Government Health IT, 5/31/11
The Veterans Affairs and Defense departments have started testing in their Hawaii facilities an application which provides physicians from both departments a common view of patient information. The graphical interface provides a single point of entry and a first step to what will become a joint EHR.

Should Mobile Health Apps be Regulated by FDA?
InformationWeek, 6/7/11
The FDA is in the process of developing draft guidance on "greater regulatory clarity" for health-related mobile applications. The agency is responding to the increasing use, popularity, and sophistication of mobile apps.

Telemedicine Could Answer Health Care Challenges
CMIO, 6/6/11
As global health care reform continues to change approaches to providing quality care, research has shown implementing telemedicine models in the hospital setting can achieve desirable results. Telemedicine is an enabler for combating the rising cost of health care, providing high-quality care, meeting care demands, overcoming provider shortages, and achieving patient satisfaction.

ONC's Fridsma Joins HL7 Board
Health Data Management, 5/31/11
Standards development organization Health Level Seven International has appointed to its board of directors Doug Fridsma, M.D., director of the office of interoperability and standards in the ONC.