CMS Final Rules to Qualify for Health IT Incentive More Flexible

The Centers for Medicare & Medicaid Services gave health care providers some flexibility in choosing which objectives they can implement to qualify for health information technology incentive payments.

In its final rule issued last week on electronic health records (EHR) meaningful use and certification, CMS said hospitals must comply with 14 core objectives to be deemed meaningful users of electronic health records to qualify for Medicare and Medicaid incentives payments in 2011.  Providers must meet five additional objectives, which can be selected from a list of 10 objectives. CMS also said critical access hospitals can qualify for Medicaid payments.

Some objectives of EHRs, such as recording patient demographic information, maintaining medication lists, up-to-date problem lists and providing patients with electronic copies of their health information are expected to benefit medical debt buyers and debt collectors as well. Industry experts say EHRs would help providers determine which patient is responsible for a specific debt.  Likewise, patients would have more information about their medical history, allowing them to question duplicate services or recognize debt them may owe.

CMS had proposed that providers meet at least 23 standards and use a certified EHR system to qualify for the incentive payments.  But 53 health organizations, including the American Hospital Association, said the criteria was too stringent, noting that failure to meet even one objective would disqualify providers from receiving any incentive payment (“CMS Proposed Rule to Receive Health IT Incentives Too Inflexible, Say 53 Health Organizations,” May 21).

Senate Finance Committee Chairman Max Baucus (D-Mont) and Senate Health, Education, Labor and Pensions Committee Chairman Tom Harkins (D-Iowa) led a group of senators requesting that CMS give providers more flexibility and allow rural hospitals and doctors to qualify for the $17 billion in  stimulus funding set aside in American Recovery and Reinvestment Act of 2009.

While AHA welcomed the options given providers in CMS’ final rules, it said incentive payments still may be out of reach for some hospitals.

"Unfortunately, CMS continues to place some barriers in the way of achieving widespread IT adoption by our nation’s hospitals and physicians," AHA President and CEO Rich Umbdenstock said.

In particular, Umbdenstock said that individual hospitals in multi-campus settings continue to be excluded from the incentive payments, and that the final rule requires hospitals to immediately use Computerized Provider Order Entry, "which can be complicated, costly to implement, and takes time to do right," he said.

But Harkins said he is encouraged that CMS will allow physicians and hospitals to quality for incentives as they make incremental investments in adoption and use of this technology.

“The news is nothing short of a breakthrough in strengthening health information technology in this country,” Harkins said.

Baucus added, “While I’ll continue to work to ensure rural hospitals are treated fairly, I’m pleased with the rule CMS set forth for distributing this important funding,” Baucus said.