D.C. Report: Health IT Committee Makes Workplans for 2012, Meaningful Use

Jan. 17, 2012
During the first meeting of 2012, Health Information Technology Policy Committee members were briefed by CMS officials on the progress of Meaningful Use and discussed the regulatory timeline for the year ahead. According to official numbers from CMS, over $2.5 billion in incentive payments have been paid to successful attesters for the meaningful use EHRs.

Health IT Policy Committee Talks MU, Workplans for 2012 During the first meeting of 2012, Health Information Technology Policy Committee members were briefed by CMS officials on the progress of Meaningful Use and discussed the regulatory timeline for the year ahead.  According to official numbers from CMS, over $2.5 billion in incentive payments have been paid to successful attesters for the meaningful use EHRs.  Other highlights include:

· 277 hospitals have received payments under both Medicare and Medicaid – of those, twelve were CAH;

· The Medicare program distributed $464.7 million in incentive payments to 4,997 eligible health care providers and 193 eligible hospitals; and

· States distributed $229.4 million in Medicaid incentive payments to 2,794 eligible health care providers and 230 eligible hospitals.

CMS has also updated a quarterly report, listing hospitals that have been paid via the EHR program.  In a related move, ONC announced the release of a data setthat merges information about the EHR Incentive Program attestations with ONC’s Certified Health IT Products List.  According to a data.gov description, the dataset enables analysis of the distribution of certified EHR vendors and products among those providers that have attested to meaningful use within the CMS EHR Incentive Programs. The data set can be analyzed by state, provider type, provider specialty, and practice setting.  Brian Ahier has an interesting look at the data in a blog, found here.

The HIT Policy Committee also talked about their workplanfor the year that will include Meaningful Use Stage 2, various updates to HIPAA, preliminary talks on Stage 3 and a governance regulation for the Nationwide Health Information Network (NwHIN). According to ONC officials, Meaningful Use Stage 2 proposed regulations and the NwHIN Governance regulations will be released before the end of March.

Unofficially, Stage 2 proposed regulations– and related standards / certifications criteria – are expected around the second week of February.  The NwHIN Governance regulation will be introduced as an “Advanced Notice of Proposed Rulemaking” which indicates that ONC will ask a number of questions on how best to move forward with governance policies.  Unconfirmed information suggests the NwHIN Governance ANPRM will come out before the Meaningful Use Stage 2 NPRM.  Stay tuned!

For an outlook on other possible regulations coming down the pipeline, read CHIME’s Regulatory Outlook.  The Regulatory Outlook will be updated as needed throughout 2012.

‘Doc Fix’ Awaits Renewal As Congress Returns to Work Lawmakers return to Washington next week to begin work on their 2012 legislative agenda.  The House of Representatives will be back in session on Monday and the Sustainable Growth Rate (SGR) for physicians who participate in Medicare is among the high priority issues early of the New Year.  Congressional observers will remember that late in 2011 lawmakers agreed to a two-month deal to override Medicare physician pay cuts and extend payroll-tax cuts and unemployment insurance.  A joint House-Senate conference panel charged with reaching a deal on the Medicare “doc fix” is expected to meet for the first time on January 24.  But this week a bipartisan, bicameral meeting took place among committee staff where a Senate Republican aide said the most likely outcome will be an additional 10-month override of the Sustainable Growth Rate formula that determines physician pay, but some lawmakers will likely push for a two-year deal.

Still up in the air are rumors that the GOP Doctors Caucus, co-chaired by Rep. Phil Gingrey (R-Ga.), wants to include legislative language to delay ICD-10 compliance deadlines.  Rep. Gingrey is the co-chairman of the GOP Doctors Caucus and his caucus has askedto delay the move to the new codes for at least as long as the “doc fix.” 

NQF Looks at CMS Quality Measures, Releases Pre-Rulemaking Report A group assembled by the National Quality Forum (NQF) released a reportthis week identifying the most important quality measures under consideration for use by CMS in the coming regulatory cycle.  Spanning eighteen federal programs, CMS is considering 368 quality measures in order to evaluate nursing homes, hospitals, diabetes facilities and other providers.  Members of the Measure Applications Partnership (MAP) looked at each of 368 measures using a framework that considered a number of factors like:

· The program measure set adequately addresses each of the National Quality Strategy priorities;

· The measure set adequately addresses high-impact conditions relevant to the program’s intended populations (e.g., children, adult non-Medicare, older adults, or dual eligible beneficiaries); and

· The program measure set promotes alignment with specific program attributes, as well as alignment across programs.

 MAP concluded that 45 percent of the quality measures do not align with NQS precepts and they could not be supported by the public-private partnership.  Meaningful Use was among the eighteen CMS programs MAP looked at, reviewing 92 measures.  Map supports the inclusion of 67 clinical quality measures that are NQF-endorsed, and suggests 25 measures currently not NQF-endorsed be submitted for endorsement.  MAP also suggeststhat HHS establish a process in Meaningful Use that will allow clinicians to receive credit for electronically reporting measures through PQRS, provided the measures are in the Meaningful Use program.  The panel’s recommendations are not binding on CMS, but they are likely to be influential.  This is the first time the government has asked an outside group to make recommendations on quality measures it is considering, before the government formally proposes them.  After the panel reviews public comments, it will submit a final report to CMS on February 1.

On a related note, CHIME has developed a crosswalk of Medicare programs that allow EHR reporting of quality measures.

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