D.C. Report: Stage 2 MU Timeline, ACO Comments, Testing Day for HIPAA, Attestation Resources, ACO Court Challenge

HIT Policy Committee Inches Towards Stage 2 MU Timeline Agreement. During a meeting held Wednesday in Washington, a federal advisory panel debated measures and timing options for Stage 2 Meaningful Use. Building on the heels of a Meaningful Use Workgroup gathering Tuesday, the Health IT Policy Committee (HITPC) wrestled with proposed recommendations (.ppt) to increase minimum thresholds for some measures of Meaningful Use; moving other measures from menu to core; and in other areas, incorporating all new measures for Stage 2. Apart from the specific focus on individual measures for Stage 2, a broader debate flared when workgroup chair Paul Tang outlined three options for Stage 2 timing. The workgroup presented the HITPC with a rubric, scoring three options against select outcomes. The options presented were: (1) stay the course; (2) require a 90-day reporting period instead of one year for Stage 2 attestation; and (3) delay Stage 2 by one year. During the MU workgroup, Option 3 emerged as the clear favorite, but it ran into some resistance at the full HITPC meeting.

Patient advocates worried that a delay would hinder MU progress, as those attesting in 2011 would be eligible for three payments for Stage 1 certification. Others said a delay in Stage 2 gives early adopters an extra year, but does little to alleviate timing pressures for the bulk of providers who will attest in 2012. Another option offered by the HITPC was to simply lessen Stage 2 requirements that were deemed troublesome, rather than push the whole stage back a year. The MU workgroup will present final draft recommendations to HITPC on June 8 with final Stage 2 MU recommendations going to ONC and CMS later that same month.

CHIME Among First To Submit Comments On CMS Plan For Accountable Care. Earlier this week CHIME became one of the first healthcare groups to voice concerns to CMS regarding proposed rules for accountable care organizations (ACOs). In its comments, CHIME sought to address problems surrounding data opt-out provisions, meaningful use alignment, and proposed performance measures, among other health IT issues. CHIME said that “allowing ACO patients the ability to opt-out of data sharing, while maintaining their ability to see the primary care physician participating in an ACO, contraindicates efforts to provide accountable care.” Further, CHIME suggested that if a patient wishes to opt-out of claims data sharing, he or she should be required to see a primary care physician (PCP) not affiliated with an ACO. Picking up on the proposed quality measures and other governance issues, the American Medical Group Association (AMGA) issued similar concerns the day after CHIME.

The comment period closes June 6 and multiple groups are expected to raise similar concerns, but CMS says they are aware of potential issues related to patient information sharing and are interested in collecting ideas and suggestions to make the rules better. Currently, the agency is hosting a series of calls (.pdf) with providers and other interested participants to understand how the Shared Savings Program could be best implemented. To read CHIME’s full comments, click here (.pdf)

June 15 is National Testing Day for HIPAA 5010. CMS has designated June 15 as National Testing Day to assist healthcare providers with the new HIPAA 5010 data transmission standards. With a deadline of Jan. 1, 2012 for implementation of 5010 standards that regulate the transmission of certain healthcare transactions, there is much work ahead including installing and testing upgrades in conjunction with external business partners. National Testing Day is an opportunity to assess progress to-date. CMS is urging Medicare Fee-for-Service (FFS) trading partners (providers, clearinghouses and vendors) to contact their Medicare Administrative Contractors (MACs) to gain a better understanding of MAC testing protocols and the transition to Version 5010. Several State Medicaid Agencies will be participating in the National 5010 testing day as well. CMS National 5010 Testing Day does not preclude trading partners from testing transactions immediately with their MAC. For more information on HIPAA Version 5010, please visit http://www.CMS.gov/Versions5010andD0.

Attestation and Other Incentive Program Resources. CMS has developed new worksheets for eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) to record additional data for core and menu measures that might not be available only through their certified electronic health record (EHR) system. Some of the needed information may originate from paper-based records or other sources. However, clinical quality measures must be reported directly from certified EHR technology. CMS indicates the attestation worksheets can be completed electronically or manually, keeping the worksheet on hand so that the data are easily accessible. Click here for the following: Attestation Worksheet for Eligible Professionals and Attestation Worksheet for Eligible Hospitals and Critical Access Hospitals.

Additionally, CMS has posted the latest FAQs document which sorts the FAQs by topic. FAQs are current as of the end of April.

Court of Appeals Takes Up ACA Challenge. Earlier this week a panel of three judges at the Fourth U.S. Circuit Court of Appeals in Richmond, VA heard arguments on two Virginia-based lawsuits that challenge the constitutionality of the Accountable Care Act and its individual mandate. Federal district court judges have delivered conflicting rulings on the two cases filed by Virginia state officials and Liberty University, a private Christian college in the state. In a December 2010 ruling, U.S. District Court Judge Henry Hudson agreed with the state's argument, that the mandate is unconstitutional, exceeding Congress' power to regulate interstate commerce. Judge Hudson, however, did not attempt to nullify the law or obstruct its implementation.
The Liberty lawsuit along with five state residents asserted that Congress exceeded its constitutional authority to require the university and similar businesses employing more than 50 people to provide health insurance coverage. On a second point, the plaintiffs noted the law violated their religious beliefs in that a portion of the premium costs could be used to cover abortions. In a November 2010 ruling, U.S. District Court Judge Norman Moon rejected the university's lawsuit and upheld the law’s constitutionality.

Fourth Circuit court appeals decisions are usually released in about 45 days. Virginia Attorney General Cuccinelli has indicated he would skip the next step—having the full 14-member appellate court hear the case. Rather, his intent was to file a petition in the U.S. Supreme Court. The high court already rejected Cuccinelli’s petition for an expedited review of the lawsuit.