Jessica L. O'Hara
The Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) issued two sets of regulations Wednesday, December 30, 2009, that aim to improve health care quality, safety, and efficiency through the adoption of electronic health records (EHRs). Both rules provide guidelines for the implementation of EHR incentive programs that were established under the American Recovery and Reinvestment Act of 2009 (PL 111-5). CMS and ONC are currently accepting public comments on the proposed rules.
According to the US Department of Health and Human Services press release, the CMS proposed rule outlines provisions of EHR incentive programs, which include the definition of the “meaningful use” of EHR technology and the payment methodologies for the Medicare and Medicaid EHR incentive programs. CMS proposes one definition that would apply to eligible professionals participating in the Medicare fee-for-service and the Medicare Advantage EHR incentive programs as well as a definition that would apply to eligible hospitals and critical access hospitals. These definitions also would serve as the minimum standard for eligible professionals and hospitals participating in the EHR incentive program. While the rule would allow states to request CMS approval to implement additional meaningful use measures, states could not request approval of fewer or less rigorous meaningful use measures than required by the proposed rule.
The ONC interim final rule provides an initial set of standards and implementation and certification criteria for EHR technology. Among these standards are those that EHRs must meet to accurately and securely exchange information among providers and between providers and their patients. The rule outlines standards for “clinical summaries and prescriptions; standard terms to describe clinical problems, procedures, laboratory tests, medications, and allergies; and standards for the secure transportation of this information using the Internet.” Eligible hospitals and professionals must meet these criteria in order to receive incentive payments.
Both the CMS and ONC regulations are open for public comment over a 60-day period. The ONC interim final rule will go into effect 30 days after its publication in the Federal Register. Final regulations will be published in 2010.