News & Events
Events
Texas Partnership for Patients Conference
Tuesday, April 30 - Wednesday, May 1, 2013
The Westin Hotel at the Domain
Attend on-site in Austin or remotely through a live Internet web stream.
11301 Domain Drive, Austin, Texas 78758 view map
Check-in at 7 a.m.; event begins at 8:15 a.m.
Earn up to 11 CME, CNE or social worker credits*
For our Educational Webinar Series, please visit our Webinar Page.
News
Listening Sessions on End-to-End Testing for March and April
National Government Services (NGS), under contract to CMS, is hosting a series of listening sessions to gather insights and feedback from the health care industry on end-to-end testing of ICD-10 and other HIPAA administrative simplification requirements.
NGS has posted draft checklists to the End-to-End Testing section of the CMS website for discussion during upcoming listening sessions. These checklists are focused on testing for payers, large practices, and small practices, as well as vendor to provider and vendor to payer testing. NGS and CMS will further refine these draft checklists based on industry feedback.
CMS and NGS look forward to receiving insights from:
- Vendors and Payers on March 21
- Vendors on March 26
- Large Providers on March 28
- Small and Medium Providers on April 2
- All industry groups on April 4
Small Providers include organizations comprised of 1-5 physicians and 25 or fewer staff, independent practices, dentists, durable medical suppliers, pharmacies, home health agencies/hospices, and specialty practices.
Medium Providers include organizations comprised of 6-24 physicians and 26-50 staff, independent practices, dentists, durable medical suppliers, pharmacies, home health agencies/hospices, and specialty practices.
Large Providers include organizations comprised of 25 or more physicians and 51 or greater staff, clinical laboratories, hospitals (small, large, and chain), critical access hospitals, nursing homes, rehabilitation centers, skilled nursing facilities, ambulatory surgical centers, pharmacies, and Federally Qualified Health Centers (FQHCs).
Payers include organizations that are commercial, Medicaid, Medicare, pharmacy benefit management (PBM), Indian Health Service, Veterans Affairs (VA), military (TRICARE), other government providers, and voluntarily compliant entities (Workers Compensation government contractors, Coordination of Benefits Contractors [COBCs])
Vendors include organizations that furnish billing or clearinghouse services, electronic health record (EHR) and electronic medical record (EMR) systems, network services, practice management systems, and value added networks.
Keep Up to Date on ICD-10
Visit the CMS ICD-10 website for the latest news and resources to help you prepare for the October 1, 2014, deadline.
Visit the CMS ICD-10 website for the latest news and resources to help you prepare for the October 1, 2014, deadline. For practical transition tips:
- Read recent ICD-10 email update messages
- Access the ICD-10 continuing medical education modules developed by CMS in partnership with Medscape
Texas Medicaid EHR Incentive Program:
Eligible Professional (EP) Participation Deadline for 2012 is March 16, 2013
For eligible professionals (EPs) that are participating in the Texas Medicaid Electronic Health Record (EHR) Incentive Program, a deadline is fast approaching. In order to receive a payment for 2012 participation, eligible professionals (EPs) must successfully complete their attestation in the Texas Medicaid EHR Incentive Program portal and be in the “Payment Pending” status by March 16, 2013.
This means that eligible professionals who wish to participate in 2012 must meet all program requirements by March 16, 2013, and EPs that are in “Payment Pending” status by that date will be allowed to finish through to payment.
Enrollments for program year 2012 will not be accepted after March 16, 2013, even for EPs that have completed their initial registration with the Centers for Medicare & Medicaid Services (CMS) to participate in the incentive program.
Eligible professionals that do not meet the March 16, 2013, deadline may still continue their enrollment in the Texas Medicaid EHR Incentive Program; however, their participation will be advanced to 2013 according to program rules.
Here are two examples for a shut-down date of March 16, 2013:
- EP 1: “Payment Pending” status by March 16, 2013 – Status remains active for program year 2012 and will be carried through to payment.
- EP 2: “In Progress” or “Not Started” status on March 16, 2013 – program year 2012 status is closed. The EP may begin attestation for program year 2013.
To learn more about the program and how to participate, visit www.texasehrincentives.com for a user-friendly e-learning tool, and http://www.tmhp.com/Pages/HealthIT/HIT_Home.aspx for the latest program news and resource documents.
For additional assistance on this and other aspects of the Texas Medicaid EHR Incentive Program, email HealthIT@tmhp.com or call the Contact Center at 1-800-925-9126 (option 4).
Medicare EP Attestation Reminder and Other Updates
POLICY UPDATE – Reminder: several deadlines related to the Electronic Health Record (EHR) Incentive Programs are approaching; there will be a CMS systems outage next week.
February 28 Deadline
Eligible professionals (EPs) who participated in the Medicare Electronic Health Record (EHR) Incentive Program in 2012 must complete attestation for the 2012 program year by February 28, 2013.
CMS has several resources located on the Educational Resource page of the EHR Incentive Programs website to help you properly meet meaningful use and attest. Register and attest today.
Medicare Part B Claims Deadline
February 28, 2013, is also the deadline for EPs to submit any pending Medicare Part B claims from calendar year (CY) 2012, as CMS allows 60 days after December 31, 2012, for all pending claims to be processed.
Medicare EHR incentive payments to EPs are based on 75% of the Part B allowed charges for covered professional services furnished by the EP during the entire payment year.
If the EP did not meet the $24,000 threshold in Part B allowed charges by the end of CY 2012, CMS expects to issue an incentive payment for the EP in March 2013 for 75% of the EP's Part B charges from 2012.
Medicaid EPs should check with their State Medicaid Agency for their attestation deadline and more details about payment.
Electronic Reporting Pilot Deadline
If you selected the electronic reporting pilot option for your submission of (CQMs) for the EHR Incentive Program (for the 2012 reporting year), you must submit 12 months of CQM data using a PQRS-qualified EHR system or data submission vendor. Failure to submit your CQMs electronically by 11:59 p.m. ET on February 28, 2013 will result in your attestation being rejected for the 2012 program year.
If you are unable to continue or determine that you no longer wish to participate in the electronic reporting pilot, you may opt out by:
- Returning to your EHR Incentive Program registration
- Changing your selection to “No” on the “e-Reporting” screen for CQMs
- Entering your CQM data into the portal as part of your meaningful use attestation
CMS Systems Outage This Weekend
Friday, February 22, 2013, 11:59 p.m. ET through Sunday, February 24, 2013, 11:59 p.m. ET (Providers will be unable to complete e-Reporting of electronic CQM data through the PQRS system.)
Please plan attestation around this outage.
EPs Can Use CMS' New Interactive Resource to Determine Timeline for Participation in the EHR Incentive Programs
POLICY UPDATE – CMS recently posted a new web resource for eligible professionals (EPs), My EHR Participation Timeline, to the EHR Incentive Programs website. This interactive tool allows EPs to determine what year you will meet Stage 1, Stage 2, and Stage 3 of meaningful use in the Medicare and Medicaid EHR Incentive Programs. It also provides information on:
- The length of time EPs are required to demonstrate meaningful use at each stage;
- The maximum incentive payment you can receive each year;
- The total incentive payment amount you will receive based on your initial year of participation; and,
- Links to helpful resources from the CMS website.
After choosing between the Medicare and Medicaid EHR Incentive Programs, select your first year of participation and the tool will create a personalized timeline with your results. This timeline can be printed and used as a reference for successful EHR Incentive Programs participation.
For more CMS resources, visit the Educational Resources section of the EHR website.
February 28th is the Last Day for EPs to Submit Medicare Part B Claims
POLICY UPDATE – February 28, 2013 is the deadline for EPs to submit any pending Medicare Part B claims from calendar year (CY) 2012, as CMS allows 60 days after December 31, 2012, for all pending claims to be processed. This means that EPs have 60 days in 2013 to submit claims for allowed charges incurred in 2012.
Medicare EHR incentive payments to EPs are based on 75% of the Part B allowed charges for covered professional services furnished by the EP during the entire payment year.
If the EP did not meet the $24,000 threshold in Part B allowed charges by the end of calendar year 2012, CMS expects to issue an incentive payment for the EP in March 2013 for 75% of the EP's Part B charges from 2012.
Reminder: Eligible professionals (EPs) who participated in the Medicare Electronic Health Record (EHR) Incentive Program in 2012 must also complete attestation for the 2012 program year by February 28, 2013. In order to be eligible to attest you must have completed your 2012 reporting period by December 31, 2012.
CMS Posts 2014 Meaningful Use Clinical Quality Measures, Electronic Specifications and Resources
HEALTHIT.GOV – (October 26, 2012) – Beginning in 2014, the reporting of clinical quality measures (CQMs) will change for all providers. Electronic Health Record (EHR) technology that has been certified to the 2014 standards and capabilities will contain new CQM criteria. Eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) will report using their respective new 2014 criteria regardless of whether they are participating in Stage 1 or Stage 2 of the Medicare and Medicaid EHR Incentive Programs.
The final 2014 CQMs for eligible professionals and eligible hospitals are now available, as well as the specifications for electronic reporting and access to the related data elements and value sets. The value sets define clinical concepts, providing a list of numerical values (e.g. code values from ICD-9, SNOMED CT, etc.) and individual descriptions for the clinical concepts (e.g. diabetes, clinical visit) used to define the quality measures. Each clinical concept referenced in a clinical quality measure is represented by a set of code values (a value set) it may take on.
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CMS Releases New EHR Rules
TEXAS MEDICAL ASSOCIATION – (September 17, 2012) – The Centers for Medicare & Medicaid Services (CMS) recently released the final rule on Electronic Health Records (EHR) Meaningful Use Stage 2. Physicians can earn the maximum EHR incentives by meeting meaningful use for five consecutive years under the Medicare program. (Medicaid is a six-year program, and the years do not have to be consecutive.)
TMA fought to make the new rule simpler and more physician friendly. Now that it is in place, we're here to help you get your bonus payments as easily as possible.
The earliest time frame that an eligible physician can start reporting for Stage 2 is 2014. The actual time period depends on when the physician started Stage 1. Each eligible physician will report at least two years for Stage 1, then two years for Stage 2, according to the current schedule.
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Don't Leave $5,000 on the Table!
TEXAS MEDICAL ASSOCIATION – (September 5, 2012) – Physicians planning to participate in the Medicare Electronic Health Record (EHR) Incentive Program must begin their 90 days of meaningful use by Oct. 1 or they will forfeit $5,000 of the maximum $44,000 bonus. Physicians who begin the program in 2013 will be eligible for only $39,000 over the next four years.
Physicians in the program must attest every year of the five-year program to continue receiving meaningful use incentive payments. Attestation is the process by which a physician proves to the Centers for Medicare & Medicaid Services that he or she meaningfully uses an EHR. For example, if a physician attested in the 2011 payment year but does not in 2012, he or she forfeits the 2012 payment and cannot make it up the next year. The physician can attest again in 2013 and receive the third payment-year incentive.
Physicians attesting for payment years 2011, 2012, and 2013 must meet stage 1 meaningful use criteria. The more-advanced stage 2 meaningful use will be required of participants beginning in 2014. CMS released the final stage 2 rules Aug. 23. Unfortunately, the government did not accept many of the recommendations TMA made. TMA staff is examining the rules and will continue to guide Texas physicians on what they need to do to continue receiving EHR incentive funds. Stage 3 meaningful use rules are not yet proposed and likely won't be introduced until 2013. TMA will apprise you of the rules as they become available.
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Meaningful Use Stage 2: Final Rule Announced
POLICY UPDATE – On August 23, the Centers for Medicaid and Medicare Services announced the final rule for Stage 2 of meaningful use in the EHR Incentive Payments Program. This announcement marks the next step in transforming America’s health care system to a health IT-enabled one. CMS published the following tools to help providers understand the new rule.
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CMS starts auditing recipients of meaningful use bonuses
AMERICAN MEDICAL NEWS – (August 13, 2012) – Some physicians who have received a meaningful use incentive check for adopting electronic health records may have received another piece of mail recently from the Centers for Medicare & Medicaid Services. The gist of that letter: You are being audited.
The company contracted by CMS to conduct post-payment auditing of hospitals and eligible professionals who successfully claimed meaningful use has started its work. The auditing process, a congressional requirement under the 2009 federal stimulus package that authorized the EHR bonuses, will be carried out by Figliozzi and Co., an accounting firm based in Garden City, N.Y.
The firm will audit recipients who obtained their bonuses from Medicare and hospitals that received incentive payments from both Medicare and Medicaid. States and their individual contractors will audit incentive program participants who received bonuses from Medicaid alone.
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AHIMA provides online help for ICD-10 work
HEALTHCARE IT NEWS – (August 7, 2012) – The American Health Information Association (AHIMA) has released new ICD-10-CM/PCS online coder training courses. The two course collections are designed to help health information management (HIM) professionals prepare for the ICD-10 transition.
AHIMA officials call the courses the cornerstone to AHIMA’s ICD-10 Online Coder Training Programs.
“AHIMA has been the industry’s leading authority on ICD-10 preparation for more than a decade,” said AHIMA CEO Lynne Thomas Gordon. “These comprehensive and engaging online training and educational products are just the latest examples of our leadership. They provide professionals with flexible training options and the critical tools they need to help implement ICD-10 in their healthcare organizations.”
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A Look at the Newly Released HIPAA Audit Program Protocols
iHEALTHBEAT – (July 30, 2012) – On June 26, HHS' Office for Civil Rights released the protocol it is using to audit compliance with various requirements under HIPAA. OCR is performing the audits as part of a pilot program designed to inform a larger, ongoing audit program mandated by the Health Information Technology for Economic and Clinical Health Act.
The protocol, which has been highly anticipated, offers a breakdown of the performance measures against which covered entities (i.e., health plans, health care clearinghouses or health care providers that transmit health information in electronic form in connection with certain transactions) are evaluated during an audit. Thus, it can help covered entities prepare for a HIPAA audit and/or simply self-evaluate their own HIPAA compliance efforts.
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GAO Report – Providers Working With RECs Twice As Likely To Receive Medicare EHR Payments
GAO – (July 26, 2012) – On July 26, 2012, the Government Accountability Office (GAO) released its report, Electronic Health Records: Number and Characteristics of Providers Awarded Medicare Incentive Payments for 2011 and there is positive news for Regional Extension Centers. Among other results, the report found that providers who partner with RECs are twice as likely to receive Medicare EHR Incentive Payments as those who don’t. Please note that this report only analyzes the Medicare EHR Incentive Program and not the Medicaid program. This point may require clarification in your communications with stakeholders.
This analysis presents you with an opportunity to showcase the positive impact of your work on specific segments of the medical community who make up your customer base, which is particularly important given that 2012 is the last year Eligible Providers can receive the full Medicare Meaningful Use incentive payment.
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Texas Tops in EHR Incentive Payments
TEXAS MEDICAL ASSOCIATION – (July 17, 2012) – The Centers for Medicare & Medicaid Services (CMS) says Texas leads the country in combined Medicare and Medicaid payments for adopting, implementing, upgrading, or demonstrating meaningful use of electronic health records (EHRs). At the end of May, 7,119 physicians and other health care professionals and 321 hospitals had received more than $505 million.
Nationally, more than 100,000 physicians and other eligible health care professionals and 2,400 eligible hospitals have received more than $3 billion in Medicare EHR incentive payments and more than $2.6 billion in Medicaid incentive payments. The Office of the National Coordinator says the goal of getting 100,000 health care professionals to adopt, implement, upgrade, or demonstrate meaningful use of EHRs by the end of 2012 has been achieved.
The Medicare and Medicaid incentive programs provide incentive payments for the adoption, implementation, and meaningful use of certified EHR technology. Both programs began in 2011, with the Medicare program continuing through 2016 and the Medicaid program through 2021.
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Comment Sought as Work Proceeds on Meaningful Use Stage 3
HEALTH DATA MANAGEMENT & HUMAN SERVICES – (June 19, 2012) – Workgroups of the HIT Policy and Standards Committees that advise federal officials have issued two requests for public comment as they start to piece together criteria for Stage 3 of the electronic health records meaningful use program.
One request for comments focuses on ways to advance delivery of high quality care in Stage 3 by using real-time clinical decision support, having the ability to query questions and get answers about patient populations, and utilizing prospective identification of care improvement opportunities.
The other request focuses on incorporation of patient-generated data from personal health records, glucose monitors and other sources in Stage 3 requirements.
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7,859 Providers In Texas Receive $539,203,452 Under EHR Incentive Programs
U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES – (June 19, 2012) – More than 100,000 health care providers have been paid under the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs, the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) announced today. Of those, 7,859 eligible providers in Texas have received $539,203,452 in payments.
CMS Acting Administrator Marilyn Tavenner and National Coordinator for Health Information Technology Farzad Mostashari, M.D., Sc.M., first proposed the 100,000 goal in March in a blog that declared 2012 the “Year of Meaningful Use” (http://blog.cms.gov/2012/03/23/2012-the-year-of-meaningful-use/).
“Meeting this goal so early in the year is a testament to the commitment of everyone who has worked hard to meet the challenges of integrating EHRs and health information technology into clinical practice,” said Acting Administrator Tavenner. “Not only have state Medicaid programs, public health departments, and many other stakeholders given their support to the Medicare and Medicaid EHR Incentive Programs, but numerous eligible health professionals and hospitals have recognized the potential of EHRs to provide better patient care, reduce medical errors, cut down on paperwork, and eliminate duplicate screenings and tests.”
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CMS spending $1 billion on healthcare innovation projects
GOVERNMENT HEALTH IT – (June 18, 2012) – Many of the 81 healthcare organizations receiving the latest federal grants for innovative projects will use health IT to collect and share data to better coordinate, analyze and deliver care, including for transitional care for rural patients, school health programs for teenagers and registries for high-risk patients in urban communities.
The Centers for Medicare and Medicaid Services Innovation Center announced June 15 the second and final batch of awardees for the Health Care Innovation Awards, bringing to 107 the number of projects designed to improve care for individuals enrolled in Medicare, Medicaid and the Children’s Health Insurance Program (CHIP), particularly those with the most complex and pressing needs.
CMS is spending up to $1 billion on all the pioneering projects, which the agency estimates will save $1.9 billion in healthcare costs over the three years of the grants. Individual awards range from $1 million to $30 million. CMS rolled out the first batch of 26 projects in May.
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Feds Release E-Prescribing Toolkits For Physicians, Pharmacies
INFORMATION WEEK – (June 15, 2012) – Four years after beginning the project, the Agency for Healthcare Research and Quality (AHRQ) has finally released two toolsets for electronic prescribing, one for physicians and the other for pharmacies. These step-by-step instructions for implementing e-prescribing and receiving e-prescriptions, respectively, are available on the AHRQ website.
According to Surescripts, a company that electronically connects physician practices to pharmacies, 58% of office-based prescribers wrote electronic prescriptions at the end of last year. The Centers for Medicare and Medicaid Services (CMS) is already trimming Medicare reimbursements to penalize those who don't e-prescribe and don't quality for hardship waivers.
Meanwhile, 91% of community pharmacies--including 98% of chain pharmacies and 79% of independent drugstores--were connected to the Surescripts network as of late 2011.
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ImmTrac Announces Meaningful Use Attestation Updates
June 11, 2012
Click to review updated document »
Medicaid Opens Meaningful Use Portal
TEXAS MEDICAL ASSOCIATION – (May 17, 2012) – If you participate in the Texas Medicaid Electronic Health Record (EHR) Incentive Program and already have successfully attested to first-year requirements, you now may begin attesting to receive 2012 Stage 1 meaningful use incentives. As a reminder, you must certify patient volume, eligibility, and other program requirements for each year of participation. Eligibility requires that physicians have 30-percent Medicaid patient volume (20 percent for pediatricians). Starting with the second year of participation, you must annually attest to meeting meaningful use requirements.
To attest to meeting Stage 1 meaningful use requirements and receive a payment for Program Year 2, log into your account on the Texas Medicaid Healthcare Partnership (TMHP) website, scroll to "Manage Provider Account" and click on the "Texas Medicaid EHR Incentive Program" link. The following resources also are available:
Email HealthIT@tmhp.com or call (800) 925-9126, option 4, if you have questions.
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Meaningful Use Public Health Measures
TEXAS MEDICAL ASSOCIATION – (May 1, 2012) – According to the Centers for Medicare & Medicaid Services (CMS) Meaningful Use Stage 1 measures, physicians must attest to at least one public health measure from the list of menu criteria in an effort to improve and public health.
The two public health measures and exclusions from the requirements are:
- Perform at least one test of a certified electronic health record (EHR) system's capacity to submit electronic data to immunization registries and follow-up submission if the test is successful (unless none of the immunization registries to which the physician submits such information can receive the information electronically). This does not apply to physicians who do not immunize patients during the EHR reporting period or where there is no immunization registry with the capacity to receive the information electronically.
- Perform at least one test of the certified EHR technology's capacity to provide electronic syndromic surveillance data (collection and analysis of health data about a clinical syndrome that has a significant impact on public health) to public health agencies and follow-up submission if the test is successful (unless none of the public health agencies to which a physician submits such information has the capacity to receive the information electronically). This does not apply to a physician who does not collect any reportable syndromic information on his or her patients during the EHR reporting period or who does not submit such information to any public health agency that has the capacity to receive the information electronically.
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Chicken Scratches vs. Electronic Prescriptions
NEW YORK TIMES – (April 28, 2012) – As e-mail and texting have become our favored means of written communication, handwriting has almost disappeared. Penmanship is becoming a modern form of hieroglyphics, intelligible only to literary scholars.
But one place where handwriting persists is on medical prescriptions, and that’s unfortunate. Sloppy writing or inappropriate directions can lead to what doctors delicately refer to as preventable A.D.E.’s, or adverse drug events. These can encompass minor but still avoidable problems, like rashes or diarrhea, and much more serious events like, well, death.
Studies show that errors are much less likely if a doctor clicks to select medications from an onscreen list and sends the prescription data via computer to the pharmacy. Rainu Kaushal, a professor of medical informatics at Weill Cornell Medical College, led a study published in 2010 in which she and four colleagues followed prescriptions issued by a sample of providers in outpatient settings in New York. (Providers included physicians, physician assistants and nurse practitioners.) Some were prescribing electronically for the first time, and some continued to use paper.
The researchers found an astonishing 37 errors for every 100 paper prescriptions, versus around 7 per 100 for those who used e-prescribing software.
These errors didn’t even include legibility issues, when the pharmacist couldn’t read the handwriting with confidence and called the provider to clarify.
Earlier, when the participants who would switch to e-prescribing were still using paper, they had almost 88 legibility errors per 100 prescriptions. (Some prescriptions had more than one error.) An illegible prescription requires time to sort out with the provider. “In the case of an urgent medication,” Dr. Kaushal says, “the delay can result in patient harm.”
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Cloud-based EHRs raise unique HIPAA challenges
FIERCE EMR – (March 29, 2012) – Cloud-based electronic health record systems have become increasingly popular. But they raise security issues that providers need to address, according to attorney Howard Burde, speaking at the 20th National HIPAA Summit in Washington, D.C. this week.
"The healthcare information is stored, used, and analyzed remotely from the users, and accessed through the Internet," Burde said. "It's going somewhere you don't know."
Some security issues that are particularly acute in cloud computing, according to Burde, include:
- Access to data, back-up plans, and business continuity in the event of a disaster
- What security incident procedures are in place in the cloud
- How physical access to the server in the cloud is limited
Burde recommended that providers need to conduct security management analysis of the cloud--which includes the ability to audit the cloud provider--to ask if its workforce is adequately trained in HIPAA, and a way to evaluate how the data is kept secure.
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Stage 2 Meaningful Use Rules Released
TEXAS MEDICAL ASSOCIATION – (March 1, 2012) – The Department of Health and Human Services has proposed new rules for Stage 2 of the Medicare and Medicaid electronic health record (EHR) incentive programs that detail proposed expectations for physicians. This is the second of three stages of meaningful use that physicians are required to meet to earn EHR incentives through the Medicare or Medicaid programs.
The three stages are:
Stage 1 (which began in 2011 and remains the starting point for all physicians): "meaningful use" consists of transferring data to EHRs and being able to share information, including electronic copies and visit summaries for patients.
Stage 2 (to be implemented in 2014 under the proposed rule): "meaningful use" includes standards such as online access for patients to their health information and electronic health information exchange between physicians and other providers.
Stage 3 (expected to be implemented in 2016): "meaningful use" includes demonstrating that the quality of health care has been improved.
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HIEs Active in Texas
TEXAS MEDICAL ASSOCIATION – (March 1, 2012) – Health information exchanges (HIE) in Texas are being established with $28 million in federal funds Texas received as a result of the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009. The Texas Health Services Authority (THSA), a public-private partnership whose board includes physicians, oversees distribution of the money.
THSA has prepared a six-page overview, Supporting Meaningful Use – Health Information Exchange Options for Texas Hospitals and Physicians, that summarizes HIEs in Texas and services available to Texas physicians.
THSA also announced that the Texas Rural White Space Strategy began Jan. 1. It establishes qualified health information service providers to provide health information exchange connectivity to health care professionals in rural counties, known as the Texas "White Space," that do not have local HIEs.
Read more about HIEs in Texas Medicine's February 2010 article, "The Gift of Sharing." Physicians needing help with information technology also may turn to the Texas regional extension centers, which provide on-site consulting at subsidized and below-market rates. Visit the TMA website for more information. For questions related to HIEs, regional extension centers, and health information technology, call TMA at (880) 880-5720 or email HIT.
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For HIT, Innovation, Not ROI, is the Benchmark
HEALTH LEADERS – (February 28, 2012) – Healthcare IT is expensive. Just for starters, consider that the per-bed cost to implement EHRs and CPOE runs between $14,000 and $65,000 in the US, according to the federal Office of Management and Budget. Even at the low end of the estimate, that's an astonishing amount of money, and it doesn't include higher-order IT systems such as clinical decision support.
The high cost of IT creates a catch-22 for healthcare leaders already strapped for cash and forecasting declining revenues in years to come. IT systems offer a way—perhaps the only way—to lower healthcare system cost in a sustainable manner. But where do you find the money to invest in IT?
A useful perspective comes from a US–European Union comparison. Jean-Pierre Thierry, MD, MPH, points out that the comparable cost for implementing EHR and CPOE is a magnitude lower in western European countries—under $6,000 per bed, on average, and as low as $3,000 per bed in Germany. Part of the discrepancy comes from higher administrative costs in the US due to the multiplicity of payer approaches and billing systems.
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New health care law helps expand primary care physician workforce
HHS.GOV – (February 13, 2012) – National Health Service Corps awards $9.1 million to place physicians in medically underserved communities.
The National Health Service Corps (NHSC) awarded $9.1 million in funding to medical students in 30 States and the District of Columbia who will serve as primary care doctors and help strengthen the health care workforce, U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced today at the Eisner Pediatric and Family Medical Center, a community health center in Los Angeles, Calif.
Made possible by the Affordable Care Act (the new health care law), the National Health Service Corps’ Students to Service Loan Repayment Program provides financial support to fourth year medical students who are committed to a career in primary care in exchange for their service in communities with limited access to care.
“This new program is an innovative approach to encouraging more medical students to work as primary care doctors,” said Secretary Sebelius. “This is an important part of the Administration’s commitment to building the future health care workforce.”
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Meaningful Use Deadline Coming
TEXAS MEDICAL ASSOCIATION – (January 17, 2012) – Physician have until Feb. 29 to register and attest to meeting meaningful use requirements to receive payments for 2011 through the Medicare & Medicaid EHR Incentive Program Registration and Attestation System.
Feb. 29 also is the deadline to submit any pending Medicare Part B claims from 2011, as the Centers for Medicare & Medicaid Services (CMS) allows 60 days after Dec. 31, 2011, for all pending claims to be processed.
Medicare EHR incentive payments to eligible professionals are based on 75 percent of the Part B allowed charges for covered professional services during the entire payment year.
If you did not meet the $24,000 threshold in Part B allowed charges by the end of calendar year 2011, CMS expects to issue an incentive payment in April 2012 for 75 percent of the Part B charges from 2011.
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Health IT Lowers Blood Pressure
NEXTGOV – (January 16, 2012) – Health IT appears effective in helping medical practices to keep their patients' high-blood pressure under control, according to a study published in the Archives of Internal Medicine.
The combination of electronic health records and clinical decision support (CDS) systems showed the best results, according to researchers from Boston's Brigham and Women's Hospital and the University of Massachusetts Medical System in Worcester. Practices using health IT reported greater success in keeping patients' blood pressure under control and fewer disparities in outcomes among racial and ethnic groups, according to an article by CMIO.net, a health-care online news site.
According to CMIO, the researchers found: (1) Providers using both an EHR and CDS managed to control the blood pressure of 78 percent of non-Hispanic whites and 85 percent of Hispanics. (2) Providers using neither health IT system had blood-pressure control rates of 75 percent of non-Hispanic whites and 69 percent of non-Hispanic blacks. A comparable rate for Hispanics was not included in the CMIO article.
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Dr. David Blumenthal: Success of HITECH Act "Inevitable"
BECKER'S ORTHOPEDIC, SPINE & PAIN MANAGEMENT REVIEW – (December 27, 2011) – David Blumenthal, MD, former head of the Office of the National Coordinator for Health Information Technology, recently wrote in the New England Journal of Medicine that the success of the HITECH Act and other health IT initiatives seem "inevitable, in part because its failure is unimaginable."
The HITECH Act encompasses several components, including meaningful use of electronic health records, EHR certification, Regional Extension Centers for health IT, health information exchange implementation and more.
Dr. Blumenthal said the federal government still faces several challenges — such as interoperability within HIEs, privacy concerns around electronic health information and EHR usability — but the age of electronic information offers a wealth of improved and more efficient patient care.
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Texas RECs Offer HIT Webinar Series
TEXAS MEDICAL ASSOCIATION – Texas regional extension centers (RECs) are hosting a free webinar series on current health information technology (HIT) topics for interested physicians and their staff. Physicians across Texas are turning to the technical experts at the RECs for on-site help implementing new or updated technology.
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EHR Workflow Analysis, Redesign Critical
TEXAS MEDICAL ASSOCIATION – (November 15, 2011) – A successful electronic health record (EHR) implementation begins with a practice workflow analysis and redesign. If you are an existing EHR user, use workflow analysis for continual quality improvement. While this process is often challenging, an effective workflow redesign is a key component in improving care coordination using EHRs. If your office lacks an efficient workflow, you might be experiencing lost productivity and extended workdays. A workflow analysis and redesign can help you identify and overcome variation that often leads to inefficiency.
If you need assistance with a workflow redesign in your office, turn to the Texas regional extension centers (RECs). RECs provide on-site support to Texas physicians to help with workflow analysis, EHR selection and implementation, EHR incentives, and meaningful use. Primary care physicians and specialists who can attest to providing primary care services are eligible for a reduced $300 rate (valued at $5,000) on consulting services. Visit TMA's Texas REC Resource Center for more information. Some of the Texas RECs are close to achieving their grant-allotted enrollment goals. Once that happens, the reduced rate will no longer be available for primary care physicians. Act soon to get the reduced rate!
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CMS Announces Version 5010, D.O and 3.0 Standard Enforcement Discretion Period
CMS.GOV – The Centers for Medicare & Medicaid Services' Office of E-Health Standards and Services (OESS), has announced that it would not initiate enforcement action with respect to any HIPAA covered entity non-compliant with the ASC X12 Version 5010 (Version 5010), NCPDP Telecom D.0 (NCPDP D.0) and NCPDP Medicaid Subrogation 3.0 (NCPDP 3.0) standards until 90 days after their January 1, 2012 compliance date, or until March 31, 2012. The compliance date for implementation of these updated standards remains January 1, 2012. More information, view the complete statement.
New ICD-10 Implementation Handbooks Now Available.
CMS has developed four Implementation Handbooks as additional resources to assist the health care industry with the transition from ICD-9 to ICD-10 codes. Each guide provides detailed information for planning and executing the ICD-10 transition process. Use the guides as a reference whether you're in the midst of the transition or just beginning the process.
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TMA Persuades AMA to Block ICD-10 Switch
TEXAS MEDICAL ASSOCIATION – (November 15, 2011) – Spurred by its Texas members, the American Medical Association House of Delegates voted to oppose a federal mandate that physicians switch to the ICD-10 claims-coding system in 2013. At its interim meeting in New Orleans, the AMA house adopted a Texas Medical Association resolution asking AMA to "immediately petition the Centers for Medicare & Medicaid Services to stop implementation and development of all new coding and billing standards including ICD-10."
AMA delegates voted to direct AMA to "vigorously work to stop the implementation of ICD-10 and to reduce its unnecessary and significant burdens on the practice of medicine," and to "work with other national and state medical and informatics associations to assess an appropriate replacement for ICD-9."
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Medicare, Medicaid Incentives Reach $30M
TEXAS MEDICAL ASSOCIATION – (October 17, 2011) – The Centers for Medicare and Medicaid Services has paid $30 million in electronic health record (EHR) incentive dollars to Texas physicians in 2011, according to a federal official.
The funds received by Texas physicians and hospitals comprise 20 percent of the $870 million already distributed throughout the country. Hospitals in Texas have received $158 million in incentives since the incentive program started Jan. 1, 2011. A total of 11,000 Texas physicians have registered to participate, while only 1,400 have completed the steps necessary to earn the incentive dollars.
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CMS Sets New E-Prescribing Exemptions
TEXAS MEDICAL ASSOCIATION – (September 1, 2011) – Physicians who did not successfully e-prescribe 10 prescriptions (and report it on a claim form with G-code G8553) by June 30, 2011, are subject to a 1-percent Medicare penalty on Jan. 1, 2012. Thanks to advocacy from TMA and others, the Centers for Medicare & Medicaid Services (CMS) announced on Aug. 31 four new hardship exemptions that physicians can claim to prevent the penalty:
1. Eligible professionals who register to participate in the Medicare or Medicaid electronic health record (EHR) incentive programs and adopt certified EHR technology; 2. Inability to prescribe electronically due to local, state, or federal law or regulation; 3. Limited prescribing activity; or 4. Insufficient opportunities to report the electronic prescribing measure.
Physicians have until Nov. 1 to request the exemption. This deadline also applies to the two previously announced hardship exemptions: eligible practices in a rural area without sufficient high-speed Internet access and eligible practices in an area without sufficient available pharmacies for electronic prescribing.
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Report offers telehealth as a solution to rural healthcare challenges
HEALTHCARE IT NEWS – (July 27, 2011) – A new report indicates rural Americans face an increasing need for quality healthcare at a time when access is proving difficult – and points to telemedicine and telehealth as a possible solution.
The report, issued July 27 by the UnitedHealth Center for Health Reform & Modernization, finds that people living in rural locations face greater difficulty accessing healthcare than their urban and suburban neighbors. In addition, the report indicated rural Americans experience more chronic conditions – such as diabetes and heart disease – and will be more likely to participate in Medicaid and other government-subsidized insurance programs by 2014.
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Meaningful Use: Clinical Summaries
HEALTHCARE IT NEWS – (July 22, 2011) – One of the most misunderstood Meaningful Use core measures for EPs is the objective: "Provide clinical summaries for patients for each visit." The required measure threshold for this objective is that: "Clinical summaries provided to patients for more than 50 percent of all office visits within 3 business days." EPs have the option to exclude this core measure if they "have no office visits during the EHR reporting period."
So let’s define a few terms. What is a clinical summary and what data must it contain? CMS provides very specific clarification and for this measure defines a clinical summary as:
“An after-visit summary that provides a patient with relevant and actionable information and instructions containing the patient name, provider’s office contact information, date and location of visit, an updated medication list, updated vitals, reason(s) for visit, procedures and other instructions based on clinical discussions that took place during the office visit, any updates to a problem list, immunizations or medications administered during visit, summary of topics covered/considered during visit, time and location of next appointment/testing if scheduled, or a recommended appointment time if not scheduled, list of other appointments and tests that the patient needs to schedule with contact information, recommended patient decision aids, laboratory and other diagnostic test orders, test/laboratory results (if received before 24 hours after visit), and symptoms.”
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Seeing Promise and Peril in Digital Records
NEW YORK TIMES – (July 16, 2011) – Technical standards may seem arcane, but they are often powerful tools of economic development and social welfare. They can be essential building blocks for innovation and new industries. The basic software standards for the Web are striking proof.
Safety is also a potent argument for standards. History abounds with telling examples, like the Baltimore fire of 1904. That inferno blazed for 30 hours, destroying more than 1,500 buildings across 70 city blocks. Fire engines from other cities came to help, but could not. Their hose couplings — each a different size — did not fit the Baltimore fire hydrants. Until then, cities saw little reason to adopt a standard size coupling, and local equipment manufacturers did not want competition. So competing interests undermined the usefulness of, and investment in, the technology of the day.
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E-health records should play bigger role in patient safety initiatives, researchers advocate
HOUSTON – (July 5, 2011) – Patient safety researchers are calling for the expanded use of electronic health records (EHRs) to address the disquieting number of medical errors in the healthcare system that can lead to readmissions and even death. Their commentary is in the July 6 issue of JAMA, The Journal of the American Medical Association.
“Leading healthcare organizations are using electronic health records to address patient safety issues,” said Dean Sittig, Ph.D., co-author and professor at The University of Texas Health Science Center at Houston (UTHealth) School of Biomedical Informatics. “But, the use of EHRs to address patient safety issues hasn’t hit the mainstream yet and we think everyone should be doing this.”
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