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New Interactive Hardship Exception Tool for Eligible Professionals

Eligible professionals can now use CMS’ new interactive tool to help determine if they will avoid upcoming 2015 and 2016 Medicare EHR Incentive Program payment adjustments by demonstrating meaningful use, or if they should apply for a hardship exception.

If an eligible professional determines that they need to apply for a hardship exception, the application must be submitted by July 1, 2014CMS will review applications to determine whether or not a hardship exception will be granted. If approved, the exception is valid for one year.

Applying for Hardship Exception
When submitting hardship exception applications, entries must include supporting documentation that proves demonstrating meaningful use presented significant hardship.

CMS has posted hardship exception applications on the EHR website for:

Please read and follow the submission instructions on the application. Note that all required supporting documentation must be included at the time of submission. Completing your application online and submitting it electronically toEHRhardship@provider-resources.com, with all required supporting documentation, will reduce the application processing time. Please do not submit hand-written applications.

Hardship Exception Tipsheets
You can also avoid payment adjustments by successfully demonstrating meaningful use prior to the payment adjustment. Tipsheets are available on the CMS website that outline when eligible professionals must demonstrate meaningful use in order to avoid the payment adjustments.

June 18, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Eligible Professionals: Deadline to Submit Hardship Exception Applications Approaching

Here’s the latest email from CMS on the hardship exception deadline:

Are you a Medicare provider who was unable to successfully demonstrate meaningful use for 2013? CMS is accepting applications for hardship exceptions to avoid the upcoming Medicare payment adjustment for the 2015 reporting year.

Payment adjustments for the Medicare EHR Incentive Program will begin on January 1, 2015 for eligible professionals.

However, you can avoid the adjustment by completing a hardship exception application and providing supporting documentation that proves demonstrating meaningful use would be a significant hardship for you. CMS will review applications to determine whether or not you are granted a hardship exception.

CMS has posted hardship exception applications on the EHR website for:

Applications for the 2015 payment adjustments are due July 1, 2014 for eligible professionals.  If approved, the exception is valid for one year.

New Hardship Exception Tipsheets
You can also avoid payment adjustments by successfully demonstrating meaningful use prior to the payment adjustment. Tipsheets are available on the CMS website that outline when eligible professionals must demonstrate meaningful use in order to avoid the payment adjustments.

May 28, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Meaningful Use Stage 2 Delayed Until 2015 (Unless You Don’t Want to Wait)

Big news coming out of HHS today, CMS issued a proposed rule that changes the EHR certification requirements, firms up the meaningful use stage 3 delay that was announced previously, and most importantly delays the meaningful use stage 2 requirement until 2015. I guess one could argue that it’s not a delay since you can still attest to MU stage 2 in 2014 if you’d like (some already have), but for practical purposes this is a delay in the enforcement of meaningful use stage 2 for many organizations.

It looks like CMS and ONC was listening to the backlash against meaningful use stage 2 and the potential fallout. This isn’t quite blowing up meaningful use, but it’s a step in that direction. Here’s the chart that ONC put out that shows the new timelines:
New Meaningful Use and EHR Certification Timelines - Meaningful Use Stage 2 Delay

It’s worth noting that this is just a proposed rule, but there were usually very few drastic changes between proposed rules and final rules in the past. Sure, there could be a few tweaks, but I bet this goes into place essentially as it stands.

This will be a relief to hundreds of EHR vendors that are behind on becoming 2014 Certified. I expect most will continue with their 2014 Certified plans, but many of their users will likely opt to stick with the simpler meaningful use stage 1 objectives and measures. What’s not clear to me is if the attestation process will stay the same (ie. self attestation in MU stage 1) or not. I’ve asked HHS and will update the post (see update at the bottom of the post) once I hear from them.

What do you think of these changes? What impact will this have on you and your organization?

Here’s another email that CMS sent out:

CMS and ONC Release NPRM Allowing CEHRT Flexibility and Extending Stage 2

Today, CMS and ONC released a notice of proposed rulemaking (NPRM) that would allow providers participating in the EHR Incentive Programs to use the 2011 Edition of certified electronic health record technology (CEHRT) for calendar and fiscal year 2014.

The NPRM will grant flexibility to providers who are experiencing difficulties fully implementing 2014 Edition CEHRT to attest this year. The proposed rule would allow providers to use EHRs that have been certified under the 2011 Edition, a combination of the 2011 and 2014 Editions, or the 2014 Edition.

Beginning in 2015, all eligible providers would be required to report using 2014 Edition CEHRT.

2014 Participation Options
Under this proposal, valid only for the 2014 reporting year, providers would be able to use 2011 Edition CEHRT for either Stage 1 or Stage 2, would have the option to attest to the 2013 definition of meaningful use core and menu objectives, and use the 2013 definition CQMs.

Providers currently working on Stage 1 in 2014 would be able to demonstrate:

  • Stage 1 (2013 Definition) using 2011 Edition CEHRT, or using a combination of 2011 and 2014 Edition CEHRT; or
  • Stage 1 (2014+ Definition) using 2014 Edition CEHRT.

Providers currently working on Stage 2 in 2014 would be able to demonstrate:

  • Stage 1 (2013 Definition) using 2011 Edition CEHRT, or using a combination of 2011 and 2014 Edition CEHRT;
  • Stage 1 (2014+ Definition) using 2014 Edition CEHRT; or
  • Stage 2 (2014+ Definition) using 2014 Edition CEHRT.

UPDATE: Here’s the response I got from CMS about the reporting periods:

Reporting periods are not changing.

For 2014 Only
Because all providers must upgrade or adopt newly certified EHRs in 2014, all providers regardless of their stage of meaningful use are only required to demonstrate meaningful use for a three-month (or 90-day) EHR reporting period in 2014:

Medicare eligible professionals beyond their first year of meaningful use must select a three-month reporting period fixed to the quarter of the calendar year for eligible professionals. Providers must attest to these reporting periods no later than February 28, 2015 at 12 am ET.

Medicare eligible professionals in their first year of meaningful use may select any 90 day reporting period.

Medicaid eligible professionals can select any 90-day reporting period that falls within the 2014 calendar year.

May 20, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Last Day for Medicare Eligible Professionals to Register for 2013 EHR Incentive

Today is the last day to register for the 2013 EHR incentive money. If you haven’t done so already, you’ll want to go and do that now. Unlike ICD-10, I don’t see this being delayed.

Here’s an email from CMS with details of the deadline:

If you are an eligible professional, today is the last day you can register and attest to demonstrating meaningful use for the 2013 Medicare EHR Incentive Program. You must successfully attest by 11:59 p.m. Eastern Daylight Time, to receive an incentive payment for your 2013 participation.

CMS extended the deadline for eligible professionals to attest to meaningful use for the Medicare EHR Incentive Program to allow more time for providers to submit their meaningful use data and receive an incentive payment for the 2013 program year.

Medicaid Eligible Professionals
Eligible professionals participating in the Medicaid EHR Incentive Program need to refer to their state deadlines for attestation information.

Payment Adjustments
Payment adjustments for eligible professionals will be applied beginning January 1, 2015, to Medicare participants that have not successfully demonstrated meaningful use. For more information, visit the payment adjustment tipsheet for eligible professionals.

You must attest to demonstrating meaningful use every year to receive an incentive and avoid a payment adjustment.

If you are only eligible to participate in the Medicaid EHR Incentive Program, you are not subject to payment adjustments.

Resources

Plan Ahead
Review important dates for the EHR Incentive Programs and all CMS eHealth programs using this Interactive Timeline.

March 31, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Medicare Eligible Hospitals: Take Action by April 1 to Avoid 2015 Payment Adjustment

Payment adjustments for eligible hospitals that have not successfully participated in the Medicare EHR Incentive Program will begin on October 1, 2014. Hospitals can avoid the payment adjustment by taking action by April 1.

Hospitals that have never participated in the Medicare EHR Incentive Program can:

  • Submit a hardship exception application for experiencing circumstances that posted a significant barrier to achieving meaningful use
  • Begin 90 days of meaningful use for the 2014 reporting year by April 1 and attest by July 1

Hospitals that participated in 2011 or 2012, but did not successfully participate in 2013 due to circumstances that created barriers can also submit a hardship exception.

About Hardship Exceptions
The hardship exception application for Medicare eligible hospitals is available on the EHR Incentive Programs website and outlines the specific types of circumstances that CMS considers to be barriers to achieving meaningful use. Supporting documentation must also be provided. CMS will review applications to determine whether or not a hardship exception should be granted.

As a reminder, the application must be submitted electronically or postmarked no later than 11:59pm ET on April 1, 2014 to be considered. If approved, the exception is valid for one year.

March 10, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

2015 Edition EHR Certification Criteria NPRM Out as a #HIMSS14 Present

HHS just sent out the announcement about the 2015 Edition EHR Certification Criteria (“2015 Edition”) NPRM (Notice of Proposed Rule Making). I guess the new ONC coordinator didn’t learn from the last time an NPRM was released during HIMSS. It ruined a lot of people’s time at HIMSS as they scoured the rule. Although, I don’t think the 2015 Edition will be quite as big of a deal as the original MU NPRM. You can sure many people will enjoy the 2015 Edition NPRM as some light reading on their airplane ride to HIMSS. I’m sure HHS wanted it published before HIMSS so they could talk about it during their sessions at HIMSS as well.

Here’s the announcement and for those that don’t want to filter through the fluff of the full final rule, here’s a great 2015 Edition Fact Sheet.

The HHS Office of the National Coordinator for Health Information Technology (ONC) today issued proposals for the next edition (the “2015 Edition”) of electronic health record (EHR) technology certification criteria.

This proposed rule marks the first time ONC has proposed an edition of certification criteria separate from the Centers for Medicare & Medicaid Services’ “meaningful use” regulations. The proposals represent ONC’s new regulatory approach that includes more incremental and frequent rulemaking. This approach allows ONC to update certification criteria more often to reference improved standards, continually improve regulatory clarity, and solicit comments on potential proposals as a way to signal ONC’s interest in a particular topic area.

“The proposed 2015 Edition EHR certification criteria reflect ONC’s commitment to incrementally improving interoperability and efficiently responding to stakeholder feedback,” said Karen DeSalvo, M.D., M.P.H., national coordinator for health IT. “We will continue to focus on setting policy and adopting standards that make it possible for health care providers to safely and securely exchange electronic health information and for patients to become an integral part of their care team.”

Compliance with the 2015 Edition would be voluntary — EHR developers that have certified EHR technology to the 2014 Edition would not need to recertify to the 2015 Edition for customers to participate in the Medicare and Medicaid EHR Incentive Programs. Similarly, health care providers eligible to participate in the Medicare and Medicaid EHR Incentive Programs would not need to “upgrade” to EHR technology certified to 2015 Edition to have EHR technology that meets the Certified EHR Technology definition. “This provides the opportunity for developers and health care providers to move to the 2015 Edition on their own terms and at their own pace,” said Dr. DeSalvo.

The proposed rule will be published in the Federal Register on February 26, 2014. ONC will accept comments on the proposed rule through April 28, 2014. The final rule is expected to be issued in summer 2014.

For more information, visit Standards and Certification Regulations page on HealthIT.gov.

February 21, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

New EHR Attestation Deadline for Eligible Professionals: March 31, 2014

I just got the following update to meaningful use deadlines from CMS:

CMS is extending the deadline for eligible professionals to attest to meaningful use for the Medicare EHR Incentive Program 2013 reporting year from 11:59 pm ET on February 28, 2014 to 11:59 pm ET March 31, 2014.

In addition, CMS is offering assistance to eligible hospitals who may have experienced difficulty attesting to submit their attestation retroactively and avoid the 2015 payment adjustment.

This extension will allow more time for providers to submit their meaningful use data and receive an incentive payment for the 2013 program year, as well as avoid the 2015 payment adjustment.

This extension does not impact the deadlines for the Medicaid EHR Incentive Program or any other CMS program, including the electronic submission for the Physician Quality Reporting System EHR Incentive Program Pilot.

February 7, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Timeline and Details of Medicare EHR Penalties

Eligible professionals (EPs) participating in the Medicare EHR Incentive Program may be subject to payment adjustments beginning on January 1, 2015. CMS will determine the payment adjustment based on meaningful use data submitted prior to the 2015 calendar year. EPs must demonstrate meaningful use prior to 2015 to avoid payment adjustments.

Determine how your EHR Incentive Program participation start year will affect the 2015 payment adjustments:

If you began in 2011 or 2012…
If you first demonstrated meaningful use in 2011 or 2012, you must demonstrate meaningful use for a full year in 2013 to avoid the payment adjustment in 2015.

If you began in 2013…
If you first demonstrate meaningful use in 2013, you must demonstrate meaningful use for a 90-day reporting period in 2013 to avoid the payment adjustment in 2015.

If you plan to begin in 2014…
If you first demonstrate meaningful use in 2014, you must demonstrate meaningful use for a 90-day reporting period in 2014 to avoid the payment adjustment in 2015. This reporting period must occur in the first 9 months of calendar year 2014, and EPs must attest to meaningful use no later than October 1, 2014, to avoid the payment adjustment.

Avoiding Payment Adjustments in the Future
You must continue to demonstrate meaningful use every year to avoid payment adjustments in subsequent years.

If you are eligible to participate in both the Medicare and Medicaid EHR Incentive Programs, you MUST demonstrate meaningful use to avoid the payment adjustments. You may demonstrate meaningful use under either Medicare or Medicaid.

If you are only eligible to participate in the Medicaid EHR Incentive Program, you are not subject to these payment adjustments.

February 3, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

McKesson and Meditech Named as First “Test EHRs” by CMS and ONC

CMS and ONC just announced the first two “Test EHRs” are McKesson and Meditech. Here’s the details of their announcement:

As part of our and CMS’ ongoing effort to improve interoperability among certified Electronic Health Records Technology (CEHRT), we are pleased to announce McKesson and Meditech are the first two “Test EHRs,” selected from among certified EHRs. We strongly encourage others in the EHR technology developer community to participate in the program to become a CMS designated test EHR.

Under Stage 2 of Meaningful Use transition of care objective measure #3 [PDF - 218 KB]eligible professionals (EPs) and eligible hospitals/critical access hospitals (CAHs) must either:

- Conduct one or more successful electronic exchanges of a summary of care document, with a recipient who has EHR technology designed by a different EHR technology developer than the sender’s.

Or

- Conduct one or more successful tests with the CMS designated test EHR during the EHR reporting period

ONC and NIST conducted a pilot that ran from September through November of last year to finalize the test procedures. The pilot participants were AthenaHealthMcKesson andMeditech.

To find out more about becoming a CMS designated test EHR, read the “EHR Technology Developers” section of the FAQs on becoming a CMS designated test EHR and the “Developer Participant Information for Cross Vendor Exchange” document.

I find it interesting that AthenaHealth was a pilot participant, but isn’t one of the official “Test EHRs.” I wondered what happened there. Looks like a lot of EHR vendors will be able to at least connect to McKesson and Meditech.

January 16, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

One Physician Ready for the EMR Revolution – #EHRBacklash

In my post about the Coming Physician EHR Revolt (some are calling it the #EHRBacklash), I got the following comment from Rick Spencer, MD.

Let alone the extreme inefficiency of EMR, the generated documents are a waste of time to read. I’ve not found one EMR generated document from an ER or speciaty office that is worth any more than throwing in the trash can. An ER will send you 8 pages on your patient, and you’re lucky if you find one paragragh where a human being actually took the time to enter something useful. God forbid that doctors and nurses should actually see their patients and give good clinical descriptions of their observations and examinations. You can’t fit a round peg in a square hole, and that’s exactly what EMR is all about. What really gripes me is who is all of this for?–insurance companies?– they seem to run every thing else. And, really, what interest does the government have in mandating how helath care providers see their patients?– don’t tell me that it’s for better patient care because I’m sure they could care less. Finally, the medical school professors that taught me 25 years ago would roll over in their graves if they knew how the medical profession just rolled over and let government and insurance companies tell them how to conduct a doctor-patient relationship. I’m eager to be part of any revolution that would put health care providers back in the driver’s seat where they belong. Thanks for this opportunity to get this off my chest!!!!

Is this an isolated case or an example of a larger trend. I personally think it’s part of a larger trend. I’m not sure most doctors are ready for a revolution, but they would certainly welcome a revolution in the way EMR’s document care. I’ve heard hundreds of doctors complain about the spew of data that many EMR vendors push out to satisfy billing.

Along with this pressure, I talked to someone today who said that many doctors are looking at the meaningful use stage 2 requirements and thinking that it may not be worth the effort. The requirements are higher and the EHR incentive is lower. Don’t be surprised if many doctors revolt against MU stage 2 as well.

September 27, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.