ONC HIT Policy Committee discusses clarifications to meaningful use
Clarifications to Stage 1 meaningful use as well as the content and structure of Stage 2 and Stage 3 criteria were discussed at the October 20th meeting of the ONC HIT Policy Committee. Tony Trenkle, head of the CMS Office on e-Health Standards and Services, confirmed that both a notice to correct inconsistencies in the meaningful use final rule, and a document providing  guidance to providers on how to meet the CMS incentive program’s required quality measures, were in the federal clearance process. The Committee also discussed whether Stage 2 criteria should be incremental or require larger steps by providers than those required in Stage 1. Several members raised concerns and opinions about the subsequent stage, including Paul Tang, CMIO, Palo Alto Medical Foundation, and others. It is expected that draft requirements for Stage 2 and Stage 3 will  be available for comment by mid-November. The Notice of Proposed Rule Making for subsequent stages is expected about a year from the publication of the first draft. Read Mary Mosquera’s October 20 article in Government Health IT for more on this issue.

ONC Clarifies Public Health Provisions for Meaningful Use

  • In an Interim Final Rule in the Federal Register published on October 13, 2010, HHS announced revisions to the implementation specifications for the Public Health Surveillance Submission standard, in order to provide additional clarity and address certain technical errors identified in the original.  This rule states that the implementation specifications, HL7 2.3.1, &  HL7 2.5.1: Public Health Information Network HL7 Version 2.5 Message Structure Specification for National Condition Reporting Final Version 1.0 and the Errata and Clarifications National Notification Message Structural Specification were adopted in error in that they were intended for a different purpose and do not provide guidance in how to design EHR technology to implement the adopted standard for Public Health Submission (syndromic surveillance). The ONC is presently revising the Interim Final Rule of July 13, 2010 (45 CFR §170.205(d) (1) and (d) (2)) to remove these specifications.
  • What this means is that EHR vendors will have to make HL7 2.5.1 available as the standard for Public Health exchange, rather than HL 7 2.3.1 or HL 7 2.5 Message Structure 1.0. This simplifies the technical basis for public health information exchange. Read the Federal Register for more info.

CMS Incentive Payments may be subject to  taxation
The American Academy of Family Physicians (AAFP), after consultation with both the ONC and tax experts, has concluded that CMS incentive payments will be viewed as taxable income by the IRS. Mark Estroff, C.P.A., a principal at the Atlanta, GA. health care consultancy and accounting firm Gates Moore and Co., is of the opinion that the meaningful use incentives would be taxable income, but that healthcare organizations and individual providers could take advantage of tax credits for technology investments, staff training etc. For more on this see AAFP’s piece by Sherry Porter.

House and Senate Bills Would Streamline HIT Payments for Community Health Centers
The National Association of Community Health Centers has been working with key House and Senate Members to develop a legislative “fix” to a major administrative problem that is making it very cumbersome for health centers to qualify for ARRA Medicaid incentive payments.

  • In the House: Rep. Frank Kratovil (D-MD) introduced H.R. 6348 which will allow health centers to better coordinate and deliver care in every state.
  • In the Senate: Senators Debbie Stabenow (D-MI) and Olympia Snowe (R-ME) have written and begun circulating a “Dear Colleague Letter” asking Senators to join them in supporting the Medicaid HIT fix for health centers this year. Senators can do this by cosigning the letter.

Without these proposed changes each health center will have to revise their contracts with eligible providers to ensure they can receive part of the nearly $1 billion in federal support for the adoption of EMRs.

As noted in NACH’s recent update, “Without these proposed changes each health center will have to revise their contracts with eligible providers to ensure they can receive part of the nearly $1 billion in federal support for the adoption of EMRs. Without this important fix health centers could lose out on millions of dollars!” Read the NACHC ADVOCACY UPDATE and ask your Representatives for their support so that Health Centers receive this important support as Congress intended.