Officials Encourage Health IT Stakeholders' Comments on Forthcoming MU Regulations

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By Genevieve Douglas  

LAS VEGAS—Health information technology industry stakeholders should comment extensively both on what they like and do not like about soon-to-be-released proposed regulations for Stage 2 of the Medicare and Medicaid electronic health record incentive programs from the Centers for Medicare & Medicaid Services and the Office of the National Coordinator for Health IT, an ONC official said Feb. 22.

Public comments on regulations often focus on the aspects of rules that commenters deem inappropriate, but ONC and CMS need comments on the parts of the regulations that commenters consider correct as well, Steven Posnack, director of the federal policy division in ONC's Office of Policy and Planning told attendees of the Healthcare Information and Management Systems Society 2012 conference.

Aspects of the rules that stakeholders support could be omitted from the final version of the regulations without enough feedback, he said.

Posnack and Robert Anthony, specialist in the CMS Office of E-Health Standards and Services, also reviewed CMS attestation data and draft recommendations from ONC's HIT Policy Committee for Stage 2 criteria that were used to help develop the forthcoming proposed regulations.

Attestation Data From Stage 1.

According to attestation data from Stage 1 of the Medicare and Medicaid EHR incentive programs, providers and hospitals are consistently achieving above the requirements for objectives related to health care quality, safety, and efficiency, Anthony said.

“I think as we get a little further into 2012 … we will see whether this data is just the early [EHR] adopters, or whether this is what meaningful use is going to look like,” Anthony said.

Alternately, providers and hospitals continue to have difficulty implementing objectives related to care coordination and public health reporting, and the deferral rate among providers remains high, Anthony said.

Other “meaningful use” Stage 1 criteria challenges include:

  •  confusion over how to receive exemptions from meeting Stage 1 objectives for recording vital signs;
  •  confusion about what actions constitute “exchange of key clinical information”;and
  •  confusion on how denominators should be calculated for computer physician order entry objectives. 
Possible New Criteria.

Anthony recommended that HIT stakeholders look to the draft Stage 2 criteria from the HIT Policy Committee for new meaningful use objectives.

Proposed Stage 2 regulations could include criteria for electronic medication administration, secure patient messaging for eligible providers, and incorporating imaging results and family history data into patients' EHRs, Anthony said.

Payment adjustment penalties for providers and hospitals who do not participate in the EHR incentive programs will begin in 2015.

Providers may apply for “significant hardship exemptions,” such as a lack of internet access, new providers or newly formed hospitals that have not been practicing long, or specialties such as anesthesiology, radiology, and pathology, Anthony said.

Information on the EHR incentive programs is available at


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