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News & Alerts

March 20	CMS Issues Proposed Regulation for Meaningful Use Stage 2 The proposed rule issued on March 7th would specify the Stage 2 criteria that eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) must meet in order to qualify for Medicare and/or Medicaid electronic health record (EHR) incentive payments. The proposed rule would also revise certain Stage 1 criteria, as well as criteria that apply regardless of Stage, as finalized in the final rule titled Medicare and Medicaid Programs; EHR Incentive Program published on July 28, 2010 in the Federal Register.
March 20	ONC Issues Proposed Rule for Health Information Technology: Standards, Implementation Specifications, and Certification Criteria for EHR Technology, 2014 Edition The Office of the National Coordinator (ONC) is proposing to revise the initial set of standards, implementation specifications, and certification criteria adopted in an interim final rule published on January 13, 2010, and a subsequent final rule that was published on July 28, 2010, as well as to adopt new standards, implementation specifications, and certification criteria. The proposed new and revised certification criteria would establish the technical capabilities and specify the related standards and implementation specifications that Certified Electronic Health Record (EHR) Technology would need to include to, at a minimum, support the achievement of meaningful use by eligible professionals, eligible hospitals, and critical access hospitals under the Medicare and Medicaid EHR Incentive Programs beginning with the EHR reporting periods in fiscal year and calendar year 2014.
March 8	AHIMA Public Policy Statement: We Need IDC-10-CM/PSC Now The American Health Information Management Association (AHIMA) recommends all healthcare entities be required to meet the compliance date of October 1, 2013, for implementation of the ICD-10-CM and, where applicable, the ICD-10-PCS classifications. AHIMA calls on the Department of Health and Human Services (HHS) to reconfirm its commitment to employ the ICD-10-CM/PCS classification systems and include an ICD-10 electronic health record (EHR) requirement to its Meaningful Use Stage 2 certification requirements. Taking these steps will enable the United States to benefit from the numerous improvements in health information classification offered by ICD-10-CM/PCS. The longer the U.S. delays implementation of ICD-10-CM/PCS, the more healthcare data will continue to deteriorate at a time when the need for data integrity is urgent. Accurate healthcare data is required to support other national healthcare initiatives such as quality measurement, patient safety, value based purchasing, widespread use of health information technology and interoperability. Read More
November 14	AHIMA Comments Regarding IOM Report on Health IT Patient Safety Risks AHIMA calls for national dialogue between all stakeholders to address the recommendations made in the Institute of Medicine’s (IOM) report, “Health IT and Patient Safety: Building Better Systems for Safer Care.” Health information technology can be more beneficial to providers and patients if it becomes more usable, more interoperable, and easier to implement and maintain. Toward that end, issues regarding health IT safety risks must be addressed in an open and collaborative manner. Errors or defects in health IT software that present patient safety risks should be made known and mitigated promptly. Further research should be funded to objectively analyze and assess the safety of Health IT and its use, and provide a roadmap to a solution. Our ultimate goal should be the delivery of safe and improved patient care. We cannot ignore that health IT patient safety events result in greater health care costs resulting from increased length of stay, need for higher levels of care, and additional procedures. Health information management professionals are eager to contribute an expanded patient safety and quality improvement initiative by offering our knowledge and expertise.
September 23	AHIMA Responds to Metadata ANPRM AHIMA responded to an advance notice of proposed rulemaking issued by ONC that addresses the development of metadata standards to support nationwide electronic health information exchange. Subject areas focused on privacy, provenance, and patient identity.
September 23	CMS Publishes Final Rule Medicaid RAC The Centers for Medicare and Medicaid Services (CMS) published a final rule that provides guidance to States related to Federal/State funding of State start-up, operation and maintenance costs of Medicaid Recovery Audit Contractors (Medicaid RACs) and the payment methodology for State payments to Medicaid RACs. This rule also directs States to assure that adequate appeal processes are in place for providers to dispute adverse determinations made by Medicaid RACs.
August 31	AHIMA Comments on Proposed Rule for Payment Policies Under the Physician Fee Schedule 2012 AHIMA responded to a proposed regulation issued by the Centers for Medicare and Medicaid Services (CMS) that addresses changes to the physician fee schedule and other Medicare Part B payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. It also addresses the Physician Quality Reporting System.
August 16	CMS Publishes Final Rule SNF PPS The Centers for Medicare and Medicaid Services (CMS) published a final rule that updates the payment rates used under the prospective payment system for skilled nursing facilities (SNFs) for fiscal year 2012.
August 16	CMS Publishes Final Rule IRF-PPS This final rule will implement section 3004 of the Affordable Care Act, which establishes a new quality reporting program that provides for a two percent reduction in the annual increase factor beginning in 2014 for failure to report quality data to the Secretary of Health and Human Services. This final rule will also update the prospective payment rates for inpatient rehabilitation facilities (IRFs) for Federal fiscal year 2012.
August 16	AHIMA Comments on Proposed Rule for Availability of Medicare Data AHIMA responded to a proposed regulation issued by the Centers for Medicare and Medicaid Services (CMS) to implement new statutory requirements regarding the release and use of standardized extracts of Medicare claims data to measure the performance of providers and suppliers in ways that protect patient privacy. The rule explains how entities can become qualified by CMS to receive standardized extracts of claims data under Medicare Parts A, B, and D for the purpose of evaluation of the performance of providers of services and suppliers.
July 12	CMS Issues Home Health Proposed Rule The Centers for Medicare and Medicaid Services (CMS) published a notice of proposed rulemaking comment period [76FR40988], “Medicare Program; Home Health Prospective Payment System Rate update for Calendar Year 2012.” This rule would update the Home Health Prospective Payment System (HH PPS) rates, including: the national standardized 60-day episode rates, the national per visit rates, the low utilization payment amount (LUPA), and the quality reporting program effective January 1, 2012. For more information, go to http://www.gpo.gov/fdsys/pkg/FR-2011-07-12/pdf/2011-16938.pdf.
July 11	HHS Publishes Semiannual Regulatory Agenda The Agenda presents the results of the statutorily required semi-annual inventory of rulemaking actions currently under development within the U.S. Department of Health and Human Services.
July 8	CMS Proposes MU Attestation for 2012 According to proposed regulations for 2012 released on July 1 (Physician Fee Schedule and Outpatient Prospective Payment system) the Centers for Medicare and Medicaid Services recommends continuing to report clinical quality measures for meaningful use via attestation in 2012, just as they must do in 2011. Also, just like 2011, the measures must be calculated using meaningful use-certified electronic health records. "We also stated in the final rule that certified EHR technology will be required to calculate the clinical quality measure results and transmit under the Physician Quality Reporting Initiative Registry XML Specification," the proposed physician fee schedule rule notes. "Since the publication of the final rule, we have determined that it is not feasible to receive electronically the information necessary for clinical quality measure reporting based solely on the use of PQRI 2009 Registry XML Specification content exchange standards as is required for certified EHR technology." The outpatient payment rule has similar language. The rules can be found here http://www.ofr.gov/inspection.aspx?AspxAutoDetectCookieSupport=1.
July 6	CMS Publishes Physician Fee Scheule Proposed Rule The Centers for Medicare and Medicaid Services (CMS) published a display notice of proposed rulemaking Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2012 on July 1^st. The rule addresses, implements or discusses certain provisions of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable Care Act) and discusses Physician Quality Reporting System; the Electronic Prescribing (eRx) Incentive Program; and the EHR incentive program. The rule will be published in the Federal Register on July 19^th but for a display copy, go to http://www.ofr.gov/OFRUpload/OFRData/2011-16972_PI.pdf.
July 6	CMS Publishes OPPS Proposed Rule The Centers for Medicare and Medicaid Services (CMS) published a display notice of proposed rulemaking Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment. Of particular note, CMS is proposing to revise the requirements for the Hospital Outpatient Quality Reporting (IQR) Program, add new requirements for ASC Quality Reporting System, and make additional changes to provisions of the Hospital Inpatient Value-Based Purchasing (VBP) Program. We also are proposing to allow eligible hospitals and CAHs participating in the Medicare Electronic Health Record (EHR) Incentive Program to meet the clinical quality measure reporting requirement of the EHR Incentive Program for payment year 2012 by participating in the 2012 Medicare EHR Incentive Program Electronic Reporting Pilot. The rule will be published in the Federal Register on July 18^th but for a display copy, go to http://www.ofr.gov/OFRUpload/OFRData/2011-16949_PI.pdf.
June 30	CMS Publishes Interim Final Rule on Adoption of Operating Rules CMS published the interim final rule with comment period (IFC), adopting the first set of operating rules for two of the adopted ASC X12 standards: eligibility for a health plan and “health care claim status” transactions. The IFC adopts, with a few exceptions, the existing Council for Affordable and Quality Healthcare’s Committee on Operating Rules for Information Exchange (CAQH CORE), operating rules for eligibility and claims status transactions, excluding those for retail pharmacy exchanges. Certain elements of the operating rules were excluded from adoption, including the operating rule requirement for standard acknowledgement transactions because a standard for the acknowledgement must be formally adopted through notice and comment rule making rather than the IFC process. Also not adopted was the CAQH CORE requirement to obtain (and pay for) CAQH CORE specified certification and testing.
June 9	Meaningful Use Work Group Recommends Stage 2 Delay for Early Attestation During the HIT Policy Committee meeting held on June 8, the committee approved recommendations presented by the meaningful use workgroup to delay Stage 2 by one year for those providers who attest to Stage 1 in 2011. All others who participate in the program beginning 2012 would be required to follow the original timeline. To view the recommendations and letter submitted to the National Cooridnator, Dr. Mostashari, please select this link.
June 9	Availability of Medicare Data for Performance Measurement This rule proposes to implement new statutory requirements regarding the release and use of standardized extracts of Medicare claims data to measure the performance of providers and suppliers in ways that protect patient privacy. This rule explains how entities can become qualified by CMS to receive standardized extracts of claims data under Medicare Parts A, B, and D for the purpose of evaluation of the performance of providers of services and suppliers.
June 6	CMS Publishes Final Rule Medicaid HCAC On Monday, the Centers for Medicare & Medicaid Services (CMS) published a final regulation implementing section 2702 of the Patient Protection and Affordable Care Act which directs the Secretary of Health and Human Services to issue Medicaid regulations effective as of July 1, 2011 prohibiting Federal payments to States for any amounts expended for providing medical assistance for health care-acquired conditions specified in the regulation. It will also authorize States to identify other provider-preventable conditions for which Medicaid payment will be prohibited.
May 31	ONC Addresses Improper Conduct in ONC-AAs The Office of the National Coordinator (ONC) issued a proposed rule to propose a process for addressing instances where the ONC-Approved Accreditor (ONC–AA) engages in improper conduct or does not perform its responsibilities under the permanent certification program. This rule also proposes to address the status of ONC-Authorized Certification Bodies (ONC–ACBs) in instances where there may be a change in the accreditation organization serving as the ONC–AA and clarifies the responsibilities of the new ONC–AA.
May 31	OCR Releases Rule for Accounting of Disclosures and Access As noted in the Special e-Alert published last Friday, the HHS Office of Civil Rights (OCR) has published its Notice of Proposed Rule Making (NPRM) in the May 31, 2011 Federal Register (76FR31426-49), which can be found at http://www.gpo.gov/fdsys/pkg/FR-2011-05-31/pdf/2011-13297.pdf. These changes come about from HITECH legislation passed in 2009. Comments on the NPRM are due on or before August 1, 2011. Essentially the NPRM expands the HIPAA accounting of disclosure requirements (§164.528) to include disclosures of information from the electronic designated record set (§164.501) for treatment, payment, and operations. OCR also designates which disclosures (paper or electronic) must be accounted for rather than the current identification of exclusions to the requirement. In addition, OCR expands the HIPAA requirements to include reporting of access by individuals to electronic protected health information. Information regarding both access and disclosures would be required to be held for three years rather than the current HIPAA requirement for disclosures that lasts six years. The notice of privacy protection (§164.520) would require a revision to identify these patient rights. OCR is proposing that covered entities and business associates comply with the modifications to the accounting for disclosures requirement beginning 180 days after the effective date of the final regulation (240 days after publication), and the accounting for access beginning January 1, 2013 for electronic designated record set systems acquired after January 1, 2009, and beginning January 1, 2014, for electronic designated record set systems acquired as of January 1, 2009. More information on the NPRM can be found at the JAHIMA Web site at http://journal.ahima.org. AHIMA plans on commenting on the requirements and urges readers to do the same. An analysis of the proposed rule will be available shortly on the AHIMA Website www.ahima.org under “Advocacy and Policy.”
May 9	E-Prescribing Features Viewed as Cumbersome to Physicians A new report funded by AHRQ and conducted by McMaster University, Hamilton, Ontario, Canada, examines the impact of health information technology applications on medication management (MMIT). The review of more than 400 studies found that health IT-enabled applications, especially clinical decision support and computerized physician order entry systems, show moderate evidence of improved care processes. Few studies examined economic or clinical outcomes. Where these topics were examined, studies found mixed results of clinician effectiveness and cost-effectiveness. Further research is needed on the effectiveness of MMIT in order communication, dispensing, administering and medication reconciliation. For more information about the HSC Research Brief, Experiences of Physician Practices Using E-Prescribing: Access to Information to Improve Prescribing Decisions, go to http://healthit.ahrq.gov/portal/server.pt/community/ahrq_national_resource_center_for_health_it/650 or to go directly to the report, visit: www.hschange.org/CONTENT/1202/ .
May 6	CMS Issues VBP Final Regulation The Centers for Medicare and Medicaid (CMS) published the Hospital Inpatient Value-Based Purchasing program (Hospital VBP program), under which value-based incentive payments will be made in a fiscal year to hospitals that meet performance standards with respect to a performance period for the fiscal year involved. The program will apply to payments for discharges occurring on or after October 1, 2012. Scoring in the Hospital VBP program will be based on whether a hospital meets or exceeds the performance standards established with respect to the measures. By adopting this program, CMS will reward hospitals based on actual quality performance on measures, rather than simply reporting data for those measures. The regulations are effective on July 1, 2011. Theregulation will be published in the Federal Register on Friday, May 6.
April 28	Hospital Inpatient PPS Proposed Rule for FY 2012 on Display The hospital inpatient prospective payment system (IPPS) proposed rule for fiscal year (FY) 2012 has been placed on display at the Federal Register. CMS issued fact sheets providing more information about the proposed rule. The proposed rule would update payment policies and rates for acute care hospitals paid under the IPPS, as well as hospitals paid under the Long Term Care Hospital Prospective Payment System (LTCH PPS).
April 28	CMS to Host Calls Explaining Meaningful Use Attestation Process The Centers for Medicare and Medicaid (CMS) will hold calls on May 3 and May 5 for hospitals and physicians respectively that will walk through the attestation process for the Medicare electronic health record incentive program. Information on registering for the calls will be forthcoming. If they choose, hospitals and physicians eligible to participate in the program can begin attesting that they meet the program’s meaningful use requirements. Hospitals need not attest to meaningful use in fiscal year 2011 to benefit fully from Medicare EHR incentive payments. Hospitals wishing to attest in FY 2011 must report on the meaningful use measures for a 90-day period during the federal fiscal year, which ends September 30. Learn more.
April 26	CMS Issues IRF Proposed Regulation The Centers for Medicare and Medicaid (CMS) published the proposed regulation for the Medicare program, Inpatient Rehabilitation Facility (IRF) Prospective Payment System for Federal Fiscal Year 2012. The regulation is on file at the Office of the Federal Register (OFR) and will be published in the Federal Register on April 29th. This proposed rule would implement section 3004 of the Affordable Care Act, which establishes a new quality reporting program that provides for a 2 percent reduction in the annual increase factor beginning in 2014 for failure to report quality data to the Secretary of Health and Human Services. This proposed rule would also update the prospective payment rates for IRFs for fiscal year 2012.
April 19	Attestation for the Meaningful Use Program Opened April 18th On April 18, attestation for the Medicare Meaningful Use Program began. This means that eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) can attest through the CMS web-based attestation system and be on their way to receiving Medicare EHR incentive payments.
April 8	Farzad Mostashari Replaces Dr. Blumenthal as National Coordinator for Health IT
April 7	AHIMA Comments on NQF eMeasure Format Driven by the EHR Incentive program and the Meaningful Use regulation, the Department of Health and Human Services (HHS) requested that the National Quality Forum (NQF) convert 113 NQF-endorsed clinical quality measures from a paper-based format to an electronic “eMeasure” format. These 113 eMeasures were released for public and member comment to ensure the retooled measures retain the same content and intent as originally developed. AHIMA engaged a group of health information management coding and terminology experts to evaluate a subset of the 113 eMeasures. The group spent a majority of their time validating the ICD-9-CM, ICD-10-CM, and SNOMED CT code lists associated with approximately 22 eMeasures from four disease domains, including diabetes, coronary artery disease, ischemic vascular disease, and heart failure. Visit the AHIMA Advocacy and Public Policy Web site to read more.
April 7	Over $37 Million in Medicaid EHR Incentives Paid Since February As of February, over $37 million has been paid out in Medicaid EHR incentives. Registration for the Medicare EHR incentive program and some Medicaid EHR incentive programs opened on January 3. The attestation for the Medicare EHR incentive program will open April 18. A preview of the Medicare attestation is currently available. Learn more.
April 7	AHIMA Submits Comments on C&M Code Proposals AHIMA submitted comments to the Centers for Medicare and Medicaid Services and the National Center for Health Statistics on ICD-9-CM and ICD-10-CM/PCS diagnosis and procedure code proposals presented at the March ICD-9-CM Coordination and Maintenance (C&M) Committee meeting. These code proposals, if approved, would go into effect on October 1. This is the last date for code modifications to be implemented before the partial code set freeze goes into effect. Read AHIMA's comments.
April 7	CMS Publishes Quarterly Listing of Program Issuances The Centers for Medicare and Medicaid Services (CMS) issued its quarterly listing of program issuances for October through December 2010. The notice lists CMS’ manual instructions, substantive and interpretive regulations, and other Federal Register notices published during this time. View a complete listing.
April 1	CMS Publishes Accountable Care Organizations (ACOs) Proposed Regulation The long awaited and much anticipated proposed regulation for the Medicare Shared Savings Program Accountable Care Organizations (ACOs) was published on March 31st. With over 400 pages and something for everyone, the Centers for Medicare and Medicaid Services (CMS) outline five key domains within the dimension of improved care and improved health to provide focus to ACO quality improvement activity. These domains are: · Patient/Caregiver Experience · Care Coordination · Patient Safety · Preventive Health · At-Risk Population/Frail Elderly Health CMS also proposes 65 measures for use in the calculation of the ACO Quality Performance Standard. Many of these measures are National Quality Forum endorsed and are part of the meaningful use and Physician Quality Reporting System programs. Comments are due June 6^th and for more information, go to http://www.ofr.gov/OFRUpload/OFRData/2011-07880_PI.pdf.

News & Alerts Archive