National Health IT Week wrapped up on Friday. This may have been the most eventful week in the ten year history of the event, which is organized by the Health Information Management Systems Society (HIMSS). Below are a few of the highlights (each of which could likely carry its own blog post):
- Stage 3 Meaningful Use Rule Finalized. Despite calls for a delay by the American Medical Association and Senator Lamar Alexander, among other, HHS issued the final rule for 2015 Edition Health IT Certification Criteria (2015 Edition) and a final rule with a 60-day comment period for the Medicare and Medicaid Electronic Health Records Incentive Programs – Stage 3. Stage 3 will begin as optional for eligible providers and hospitals in 2017 and will be required in 2018. HHS proclaimed that the rules eliminate unnecessary requirements, simplify and increase flexibility for those that remain and focus on interoperability, information exchange and patient engagement. For example, the 2015 Edition rules reduce the number of objectives eligible hospitals must meet from twenty to nine. There will be much to come as providers and hospitals sort through the 752 page rule.
- TRUST IT Act Introduced. The Transparent Ratings on Usability and Security to Transform Information Technology (TRUST IT) Act of 2015 was introduced in the Senate. The bill would establish a rating system for EHR technology in three areas: security, usability and interoperability. The bill would also define “information blocking” in almost the same way as it is defined in the 21st Century Cures legislation.
ONC Releases Shared Nationwide Interoperability Roadmap v.1. After receiving more than 250 comments on its draft Roadmap released in January, ONC released version 1 of its Interoperability Roadmap. The Roadmap lays out milestones and calls to action that stakeholders should focus on achieving, particularly in the near-term. The Roadmap focuses on five pathways:
- Improve technical standards and implementation guidance;
- Rapidly shift and align federal, state and commercial payment policies (from fee-for-service to value-based models to stimulate demand for interoperability);
- Clarify and seek alignment of federal and state privacy and security requirements;
- Coordinate among stakeholders to promote and align consistent policies and business practices (that support interoperability);
- Align and promote the use of consistent policies and business practices (that support interoperability).
HHS Inspector General Weighs in on Information Blocking and the Federal Anti-Kickback Law. The OIG released a Policy Reminder reminding the public about how information blocking may affect safe harbor protection under the Federal anti-kickback statute. OIG extends safe harbor protection to certain arrangements involving donations of interoperable EHR items and services to potential referral sources. If the donor takes any action to limit or restrict the use, compatibility or interoperability of the donated EHR items or service, the arrangement will not receive safe harbor protection. The Policy Reminder provided some examples of information blocking that would run afoul of the safe harbor:
- An agreement with a recipient to preclude or inhibit any competitor from interfacing with the donated system;
- Arrangements in which vendors agree with donors to charge high interface fees to non-recipient providers or suppliers or to competitors; and
- Arrangements where parties improperly lock-in data and referral
OIG encouraged the public to report instances where a donor acts to limit the interoperability of donated EHR items or services by calling OIG’s hotline at 1-800-HHS-TIPS.
- Veterans Telehealth Bill Introduced. The Veterans E-Health and Telemedicine Support Act was introduced in the Senate. The bill would expand eligible sites for veterans to receive telemedicine and allow VA clinicians to practice telemedicine regardless of patient location (currently, the patient and physician must be in the same state for at-home telemedicine visits and state licensing requirements may be waived only when the patient and physician are in a federally owned facility). This and the TELE-MED Act, which would allow physicians to treat by telemedicine Medicare patient in any state, are worth watching in the coming weeks.
- Social Security Administration Joins CommonWell. The Social Security Administration (SSA) has been a long-time participant in the eHealthExchange (f/k/a/ the Nationwide Health Information Network) for purposes of querying other eHealthExchange participants for disability determination information. SSA announced this week that it will join CommonWell, the up-and-coming data exchange alliance spearheaded by EHR vendors such as Cerner, Allscripts and athenahealth. The move seems to signal that SSA will not play favorites among the emerging national data sharing efforts.
- CMS Promises Less Onerous Data Reporting for Physicians. CMS is currently taking comments on its Merit-Based Incentive Payment System (MIPS), which was part of the sustained growth rate repeal earlier this year. Kate Goodrich, CMS’s director for quality measurement and value-based incentives, noted this week that CMS will partner with providers on MIPS quality measures focused on results, not process. The MIPS final rule is expected in the spring and will provide bonuses and penalties for quality-improvement activities, including Meaningful Use. MIPS is scheduled to replace existing Medicare quality measures in 2019 by consolidating Meaningful Use, physician quality reporting and other measures. A MedPac senior analyst has already been quoted as expressing concern about the health system’s ability to make a system like MIPS work in practice. Additionally, the Electronic Health Records Association, which is the EHR vendor trade group, expressed concern over the possibility of changes to the Stage 3 Meaningful Use rule after the current MIPS comment period ends.
- CMS to Reconsider Meaningful Use Penalties. CMS will accept applications to reconsider penalties from hospitals that are slated for Meaningful Use penalties next year for failing to attest in 2014. CMS will accept applications through November 30.