Hospital and Health System

CMS Proposes Standards for EHR Incentives, Definitions of Meaningful EHR Use

Two regulations proposed by CMS and the Office of the National Coordinator for Health Information Technology (ONC) lay the groundwork for EHR incentive programs and set forth a definition of "meaningful use" of EHR technology.

The rule proposed by CMS outlines provisions governing the EHR incentive programs, including defining the central concept of “meaningful use” of EHR technology. An interim final regulation (IFR) issued by ONC sets initial standards, implementation specifications and certification criteria for EHR technology. Both regulations are open to public comment.

The CMS rule would define meaningful use for the Medicare EHR incentive programs — one definition for eligible professionals participating in the Medicare fee-for-service and Medicare Advantage EHR incentive programs and a second definition for eligible hospitals and critical access hospitals.

The proposed rule would define the term "meaningful EHR user" as an eligible professional or hospital that, during the specified reporting period, demonstrates meaningful use of certified EHR technology in a form and manner consistent with certain objectives and measures in the regulation, including e use of certified EHR technology in a manner that improves quality, safety, and efficiency of healthcare delivery, reduces healthcare disparities, engages patients and families, improves care coordination, improves population and public health and ensures adequate privacy and security protections for personal health information.

These definitions also would serve as the minimum standard for eligible professionals and hospitals participating in the Medicaid EHR incentive program. The rule proposes that states could request CMS approval to implement additional meaningful use measures, as appropriate, but could not request approval of fewer or less rigorous meaningful use measures than required by the rule.

“These regulations are closely linked,” said Charlene Frizzera, CMS acting administrator. “CMS’s proposed regulation would define and specify how to demonstrate ‘meaningful use’ of EHR technology, which is a prerequisite for receiving the Medicare incentive payments. Our rule also outlines the proposed payment methodologies for the Medicare and Medicaid EHR incentive programs. ONC’s regulation sets forth the standards and specifications that will enhance the interoperability, functionality, utility and security of health information technology.”

This rule proposes a phased approach to implement the proposed requirements for demonstrating meaningful use. This approach would initially establish reasonable criteria for meaningful use based on currently available technological capabilities and providers’ practice experience. CMS will establish stricter and more extensive criteria for demonstrating meaningful use over time, as anticipated developments in technology and providers’ capabilities occur.

The Recovery Act established programs to provide incentive payments to eligible professionals and eligible hospitals participating in Medicare and Medicaid that adopt and make “meaningful use” of certified EHR technology. Incentive payments may begin as soon as October 2010 to eligible hospitals. Incentive payments to other eligible providers may begin in January 2011.

Source: Centers for Medicare & Medicaid Services, December 30, 2009