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Meaningful use 2016


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Changes to the meaningful use program, applicable laws and measures as they apply to healthcare providers and organizations.

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Meaningful use 2016

  1. 1. Taino Consultants Inc. Dr. Jose I. Delgado
  2. 2. 2016 Program Requirements  Final Rule Released October 15, 2015  Modified Stage 2 (2015 to 2017)  Stage 3 (2018 and beyond)  Jan 11, 2016  “Meaningful use will likely end in 2016” - Andy Slavitt, Acting Administrator Centers for Medicare and Medicaid Services Taino Consultants Inc. 2
  3. 3. “The Meaningful Use program as it has existed, will now be effectively over and replaced with something better.”  focus will move away from the use of technology and towards patient’s outcome  providers will be able to customize their goals  leveling the technology playing field by requiring open application program interfaces (APIs)  interoperability Taino Consultants Inc. 3
  4. 4. Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)  Repeals the sustainable growth rate (SGR) methodology for determining updates to the Medicare physician fee schedule.  Establishes annual positive or flat fee updates for 10 years and institutes a two-track fee update beginning in 2019.  Establishes the Merit-based Incentive Payment System (MIPS) that consolidates existing Medicare quality programs.  Establishes a pathway for physicians to participate in an Alternative Payment Model (APM). Taino Consultants Inc. 4
  5. 5. Taino Consultants Inc. 5
  6. 6. Objectives and Measures  Core and menu objectives replaced with a single set of objectives and measures.  Eligible providers (EP) have 10 objectives,  Eligible hospitals and CAHs have 9 objectives.  All providers must use 2014 certified EHR technology  Providers may attest using 2015 certified technology EHR technology, or a combination of the two (if the 2015 Edition is available). Taino Consultants Inc. 6
  7. 7. EP Objectives and Measures 1. Protect electronic protected health information  HIPAA (Security Risk Analysis, updates, other) 2. Use clinical decision support to improve performance on high-priority health conditions.  Implement five clinical decision measures  Enabled and implemented the functionality for drug-drug and drug-allergy interaction check Taino Consultants Inc. 7
  8. 8. EP Objectives and Measures 3. Use computerized provider order entry for medication, laboratory, and radiology by licensed healthcare professional  More than 60 percent of medication orders  More than 30 percent of laboratory orders  More than 30 percent of radiology orders 4. Generate and transmit permissible prescriptions electronically (eRx).  More than 50 percent of all permissible prescriptions written by the EP are queried for a drug formulary and transmitted electronically using CEHRT. Taino Consultants Inc. 8
  9. 9. EP Objectives and Measures 5. Health Information Exchange  Transitions or refers their patient to another setting of care or provider of care must 1. Use CEHRT to create a summary of care record; and 2. Electronically transmit summary (10% or more). 6. Identify patient-specific education resources and provide those resources to the patient.  Provide education resources to patients for more than 10 % of all unique patients with office visits Taino Consultants Inc. 9
  10. 10. EP Objectives and Measures 7. Medication Reconciliation  Performs medication reconciliation for more than 50 % of transitions of care 8. Patient electronic access within 4 business days of the information being available to the EP.  Provide timely access to more than 50 % of all unique patients seen during the reporting period  2016, at least one patient during the EHR reporting period (or patient-authorized representative) views, downloads or transmits his or her health information to a third party during the EHR reporting period. Taino Consultants Inc. 10
  11. 11. EP Objectives and Measures 9. Secure electronic messaging communications.  At least 1 patient during the reporting period was sent a message using the electronic messaging function of CEHRT 10. Public Health - submit electronic public health  Three Measure Options ○ Immunization Registry Reporting ○ Syndromic Surveillance Reporting ○ Specialized Registry Reporting Taino Consultants Inc. 11
  12. 12. Changes to Specific Objectives  The Objective 9, Secure Electronic Messaging:  Phased approach for its measure’s threshold.  For 2016, the measure is “for at least 1 patient seen during the reporting period, a secure message was sent using the electronic messaging function of CEHRT, or in response to a secure message sent by the patient.  Objective 10, Public Health Reporting, 2016  EPs must meet two measures,  Eligible hospitals and CAHs must meet three measures. Taino Consultants Inc. 12
  13. 13. EHR Reporting Period for 2016  Returning participants  Full calendar year (Jan 1, 2016 through Dec 31, 2016.  For 1st year participants  Any continuous 90-day period. Taino Consultants Inc. 13
  14. 14. Regulations leading to audits  Meaningful Use,  HIPAA Omnibus Rule,  Affordable Care Act,  ICD-10 and  MACRA Taino Consultants Inc. 14
  15. 15. What to expect 1. Electronic letter from audit company from a CMS e-mail address;  Letter will be addressed to email address provided during registration 2. Attachment with a request for support documentation 3. About four weeks to submit documentation Taino Consultants Inc. 15
  16. 16. Sample Attachment Taino Consultants Inc. 16
  17. 17. Taino Consultants Inc. 17
  18. 18. Highlights  Measure 1 – Protect Patient Health Information  Security Risk Analysis with a date not earlier than the start of the reporting year and not later than the date of attestation  Implementation plan with completion dates if deficiencies were identified Taino Consultants Inc. 18
  19. 19. Highlights  Measures 3,4,5,6,7, and 8  Provide EHR report  Measures 2 and 9  Provide Support Documentation  Measure 10  Stage 1 – one measure  Stage 2 – two measure  Note: an exclusion of one measure doesn’t count unless they meet or exclude themselves from the other measures Taino Consultants Inc. 19
  20. 20. Trends Experienced  Expect e-mail with deficiencies indicating failure to meet meaningful use  Extensions timelines have been shortened  Explanations of trends may be asked  Letter from EHR company with basic information been requested Taino Consultants Inc. 20
  21. 21. Key Items to keep in mind  Proof of use Certified EHR.  Need Copy of licensing agreement with the vendor or invoices for the period.  Letter with same information from HER Vendor may be requested.  List of office or outpatient facility where Provider sees patients. Identify if records are kept outside of EHR.  Report showing compliance with specific Core Measures must display vendor’s logo or step by step screenshots which demonstrate that the report was generated by the EHR. KEEP INFORMATION FOR A MINIMUM OF SIX YEARS! Taino Consultants Inc. 21
  22. 22. Summary  Meaningful use not going away  Audits will continue  Maintain your own copies of information submitted for at least six years Taino Consultants Inc. 22
  23. 23. Questions Taino Consultants Inc. Dr. Jose I. Delgado BP 904-794-7830 E-mail Web Site: Taino Consultants Inc. 23