New Rule Makes It Easier for M.D.s to Get HIT Reimbursement
Publication: Psychiatric News
A federal program to help physicians buy and install new health information technology (HIT) systems in their practices is one step closer to launching. The latest step is a new regulatory rule issued July 13 that eases compliance requirements for physicians from those proposed in January.
In the final rule, the Centers for Medicare and Medicaid Services defined how a physician can qualify as a “meaningful user” of certified electronic health record (EHR) technology to receive some of the $17 billion in federal assistance meant to encourage adoption of EHRs.
The rule implements a key provision of the 2009 Health Information Technology for Economic and Clinical Health Act (PL 111-5), which will reimburse Medicare physicians up to $44,000 and Medicaid physicians up to $63,750 over five years—beginning in 2011—for installing digital medical record systems.
The final rule is a less stringent version of the proposed rule defining “meaningful use”; the proposed rule had drawn widespread criticism from physician advocates and others for being too burdensome and requiring clinicians to collect patient data unrelated to treatment (Psychiatric News, February 5).
In announcing the new rule at a press conference, David Blumenthal, M.D., the national HIT coordinator, said, “[W]e have sought and received extensive input from the health care community, and we have drawn on their experience and wisdom to produce objectives that are both ambitious and achievable.” He noted that regulators received more than 2,000 comments after the proposed rule was issued.
One of the revisions to the proposed rule is a reduction in the number of mandatory initial objectives that physicians must meet in the first stage of the three-stage program to qualify for HIT reimbursement. The number of objectives was reduced from 25 to 15.
Each objective, such as using EHRs to submit digital prescriptions, has an accompanying measure to determine if a physician meets the goal. In the case of digital prescribing, a physician must order at least 30 percent of all prescriptions in his or her practice through EHR technology.
An additional 10 objectives must be met, but they allow for some flexibility. Physicians can choose five of the 10 objectives to meet in the first two years of the program and may delay complying with the rest until the second stage of the program.
The new meaningful-use regulations specify only the EHR objectives that physicians must achieve to receive payments in 2011 and 2012. Additional objectives will be added in future years.
The reporting requirements regarding clinical quality measures that physicians must track have been eased as well. Physicians can now choose from a core set of six clinical quality measures, plus three additional measures from a larger pool. These measures include patient vital statistics, such as body mass index and blood pressure, for example.
APA and other physician organizations were studying the new rule as this issue went to press, and their comments were not yet available.
Federal health officials said they hope the new rule helps spur the widespread adoption of HIT and its core component, the EHR, to improve the quality of care that clinicians provide. Only 20 percent of physicians and 10 percent of hospitals already use basic EHRs, according to Kathleen Sebelius, secretary of Health and Human Services.
The federal health officials also reiterated the goal first urged by former President George W. Bush that all Americans have an EHR by 2014.
“These changes will be challenging for clinicians and hospitals, but the time has come to act,” Blumenthal said at the press conference. “Adoption and meaningful use of EHRs will help providers deliver better and more effective care, and the benefits for patients and providers alike will grow rapidly over time.”
Another rule, issued the same day by the Office of the National Coordinator for Health Information Technology, identified the standards and certification criteria for EHR system manufacturers. The rule defines whether a digital-information system a clinician is considering purchasing will perform the functions in compliance with federal regulations.
More about the incentive payment program is posted on APA's Web site at <www.psych.org/ehrincentive>. 
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Published online: 6 August 2010
Published in print: August 6, 2010
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