Category: Health Information Technology

Massachusetts Requires EHR Proficiency for Physician Licensure

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In December of 2014, Massachusetts finalized a state law that requires physicians to demonstrate proficiency in using EHRs and/or being a “meaningful user” under the Department of Health and Human Services’ Meaningful Use Electronic Health Record Incentive Program (“Meaningful Use Program”) as a condition of licensure.

Massachusetts’ changes to the license requirements are another indication of how the Meaningful Use Program is shifting from an incentive program to a long-term compliance program.  Health care providers, including those outside of Massachusetts, should weigh the importance of a compliance initiative for the Meaningful Use Program and have a firm understanding of how the Meaningful Use Program will affect clinical operations.

If you have questions regarding the Meaningful Use Program, please contact:


Proposed New Regulations for Meaningful Use Stage 3 and 2015 Editions Base EHR Definition

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Two proposed regulations under the Medicare & Medicaid EHR Incentive Program (“MU Program”) were submitted to the Office of Management and Budget (“OMB”) on December 31, 2014.  The two related proposed regulations relate to Stage 3 and the submission to OMB represents the first step toward the proposed regulations being published and available for review by the public.  Given the filing and typical processes, it is anticipated that the regulations will be published sometime in February.

The first of the two proposed regulations were submitted by the Centers for Medicare & Medicaid Services and represent the criteria for Stage 3 of the MU Program.  The OMB website provides the following statement with respect to the proposed regulations, “Stage 3 will also propose changes to the reporting period, timelines, and structure of the program, including providing a single definition of meaningful use. These changes will provide a flexible, yet, clearer framework to ensure future sustainability of the EHR program and reduce confusion stemming from multiple stage requirements.”  The statement of changes to reporting periods and providing a single definition of meaningful use are interesting and could mean many things, but changes that simplify the process would certainly be welcomed by hospitals and providers.

The second of the two proposed regulations were submitted by the Office of the National Coordinator for Health IT (“ONC”) and propose a new 2015 Edition Base Electronic Health Record definition (“2015 EHR”) and changes to the ONC certification program.  While details are still forthcoming, the changes will focus on making “it more broadly applicable to other types of health IT health care settings and programs.”  The 2015 Edition also establishes the technical capabilities and detail the related standards and implementation specifications that Certified Electronic Health Record Technology would need to include to support the achievement of meaningful use by eligible professionals, eligible hospitals and critical access hospitals under the MU Program.

Typically, no further information about the proposed regulations will be made available until they are released by OMB and published in the Federal Register.

If you have questions regarding meaningful use, please contact:


CMS Extends EHR Attestation Deadline for Eligible Hospitals

This week, the Centers for Medicare & Medicaid Services (“CMS”) announced that it is extending the deadline for eligible hospitals and critical access hospitals (“CAHs”) to attest to meaningful use for the Medicare Electronic Health Record  Incentive Program for the 2014 reporting year from 11:59 PM EST on November 30, 2014 to 11:59 PM EST on December 31, 2014.

This extension will allow more time for applicable hospitals to submit their meaningful use data and receive an incentive payment for the 2014 program year, as well as avoid the 2016 Medicare payment adjustment.

CMS is also extending the deadline for eligible hospitals and CAHs that are electronically submitting clinical quality measures to meet that requirement of meaningful use and the Hospital Inpatient Quality Reporting program. Hospitals now have until December 31, 2014 to submit their eCQM data via Quality Net.

If you have questions regarding meaningful use attestation deadlines, please contact:


OIG Fiscal Year 2015 Work Plan

On October 31, 2014, the U.S. Department of Health and Human Services Office of Inspector General (“OIG”) released the Work Plan for Fiscal Year 2015 (“Work Plan”). The Work Plan confirms OIG will continue to concentrate a great deal of their enforcement efforts on the security and vulnerabilities of protected health information (“PHI”) contained in electronic health records (“EHRs”). The continued focus on data security contained in EHRs aligns with the goals of the OIG Strategic Plan 2014-2018, where OIG identified EHRs as one of its key focus areas until at least 2018.

Given the increased frequency and publication of health information breaches, it is no surprise the OIG for the first time indicated it plans to examine hospitals’ contingency plan policies and procedures to determine if adequate safeguards are in place in the event systems containing PHI are damaged. OIG also indicated it will continue to examine the Centers for Medicare & Medicaid Services’ (“CMS”) oversight of hospitals’ security controls over networked medical devices, such as dialysis machines, radiology systems and medication dispensing systems. OIG will also continue to conduct audits of eligible hospitals and professionals who received Medicare and Medicaid Meaningful Use Incentive payments to determine whether such payments were proper.

It is worth noting the Work Plan did not include assessing the security and vulnerabilities of portable devices containing PHI as a priority. This may be an indication  OIG has completed its review of the issue.

Click here to read OIG’s Work Plan.

If you have any questions or would like additional information about these topics, please contact:


Health Insurance Exchanges Round Two – Is It Time to Expand Your Charity Care Program Through a Premium Support Initiative?

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WEBINAR As we move into the second year of open enrollment through the Health Insurance Exchanges, it is time to revisit the issue of Premium Support Programs, an issue that had a bit of a rollercoaster ride during last year’s open enrollment. Has the dust settled enough that you can safely implement a Support Program? We will look at the applicable regulatory guidance and cover the required elements of a compliant Premium Support Program. Financial executives and general counsel for hospitals and health care systems will want to consider attending this informative program.

Click here to register for this free webinar.


CMS Accepts Meaningful Use Hardship Applications for Medicare Meaningful Use Program Through November 30, 2014

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This week, the Centers for Medicare & Medicaid Services (“CMS”) announced its intent to reopen the submission period for hardship exception applications for eligible professionals and hospitals participating in the Medicare Meaningful Use Program in order to avoid the 2015 Medicare payment adjustments for not demonstrating meaningful use of Certified Electronic Health Record Technology (“CEHRT”).

The new deadline will be November 30, 2014.  Previously, the hardship exception application deadline was April 1, 2014 for eligible hospitals and July 1, 2014 for eligible professionals.  The reopened hardship exception application submission period is for eligible professionals and hospitals that:

  • Have been unable to fully implement 2014 Edition CEHRT due to delays in 2014 Edition CEHRT availability; and
  • Were unable to attest by October 1, 2014 and eligible hospitals that were unable to attest by July 1, 2014 using the flexibility options provided in the CMS 2014 CEHRT Flexibility Rule.

These are the only circumstances that CMS will consider for this reopened hardship exception application submission period.

Click here to read CMS’s full announcement regarding the hardship exception application extension.

If you have questions regarding meaningful use and the hardship exception application process, please contact:


Costly Software License Audits Could Affect IT Partnerships

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Hospitals, health systems and other large users of Microsoft, Adobe and similar software are experiencing increased license auditing.  Because of the dynamic nature of the IT environment, most users operate in varying degrees of compliance with their license agreements.  In the event of an audit, the cost of compliance, known or unknown, can be significant and turn traditional partnerships into adversarial relationships.  Users may mistakenly produce records with good intentions that ultimately complicate the ability to efficiently resolve license compliance issues.  When faced with an audit, it is important to understand the role of each party (licensor, auditor, licensee and reseller) and their respective financial interest in resolving any compliance issue. … Continue Reading →


Impacts of Heartbleed Exploit Come to Light

Following recent news about the Heartbleed exploit, CloudFlare, a San Francisco-based security services company, challenged hackers to use Heartbleed to get private encryption keys that would unlock secure data. It reported multiple winners to its challenge. By obtaining the private key for an SSL/TLS certificate, an attacker could set up a fake website that passes the security verification. They could also decrypt traffic passing between a client and a server, known as a man-in-the-middle attack, or possibly unscramble encrypted communications they’ve collected in the past…. Continue Reading →


No Further Delays for ICD-10

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Marilyn Tavenner, the administrator of CMS, indicated that providers, payers and claims clearinghouses can look for no relief from the looming October 1 compliance deadline for the nationwide conversion to the ICD-10 family of diagnostic and procedural codes. She made this statement in her February 27, 2014 address to the HIMSS convention in Orlando as reported by Modern Healthcare. … Continue Reading →


CMS Extends Meaningful Use Attestation Deadline for Eligible Professionals

CMS announced last week that it is extending the deadline for eligible professionals to attest to meaningful use for the Medicare Electronic Health Record (“EHR”) Incentive Program 2013 reporting year from 11:59 PM ET on February 28, 2014 to 11:59 PM ET March 31, 2014.  This extension will allow more time for eligible professionals to submit their meaningful use data and receive an incentive payment for the 2013 program year as well as avoid the 2015 payment adjustment…. Continue Reading →