The document discusses changes in the Stage 2 final rule for meaningful use, including new core and menu objectives for both eligible professionals and hospitals in Stage 2, more stringent requirements for patient engagement, a focus on electronic exchange of health information, and maintaining the current clinical quality measure reporting structure through 2013.
This presentation featured inforamation about stage 2 meaningful use, new clinical quality measures, details on Medicare payment adjustments and other program changes.
This document presents the Workers Compensation Research Institute's Medical Price Index for Workers' Compensation, Third Edition (MPI-WC). It introduces the MPI-WC, which measures annual price changes for nonhospital medical services covered by workers' compensation insurance. The MPI-WC was developed using claims data to create a "market basket" of typical services, and it tracks prices across states from 2002 to 2010. It analyzes price trends for overall nonhospital services and specific groups like evaluation and management, surgery, and radiology. State-level data and interstate comparisons of price indices in 2010 are also provided.
This document summarizes an EMR system called MDsuite.EMR. It provides incentives for eligible professionals to adopt certified EHR technology through government stimulus programs. MDsuite.EMR offers a fully integrated EMR and practice management system. It has customizable templates, order management, e-prescribing, and connects to external data sources. Pricing is based on the number of providers and users, with options for licensed or hosted models.
This document provides a test scenario and script to evaluate an electronic health record's (EHR) medication management functionality according to certification criteria. The scenario involves ordering, dispensing, and administering a medication and ensures the EHR maintains accurate and consistent medication information throughout. It tests criteria such as computerized provider order entry, drug interaction checks, medication reconciliation, and electronic medication administration. The scenario is intended to reflect a typical clinical workflow and thread information between criteria to confirm the EHR's integrated performance.
This document provides an overview of the Meaningful Use program and regulations. It discusses the stages of Meaningful Use which focus on data capture, sharing, and advanced clinical processes. It also outlines the financial incentives available through Medicare and Medicaid for eligible providers that successfully meet Meaningful Use objectives. The document reviews eligibility, objectives and measures for Stages 1 and 2 of Meaningful Use, and penalties for providers that do not successfully demonstrate Meaningful Use. It provides guidance on determining which version of Meaningful Use objectives a provider must attest to based on their EHR certification year.
This document provides an overview of the Medicare and Medicaid EHR Incentive Programs, including:
- Eligible professionals can receive incentive payments for adopting and meaningfully using certified EHR technology.
- Incentive payment amounts and schedules differ between the two programs, with Medicaid generally offering higher incentives.
- Professionals must meet certain eligibility criteria including patient volume thresholds and choose whether to participate in Medicare or Medicaid.
This webinar discusses how medical practices can prepare for Stage 2 Meaningful Use requirements. Stage 2 focuses on more advanced EHR use, including higher thresholds for existing objectives and new objectives like secure messaging. The presentation reviews key Stage 2 objectives and thresholds, considerations for EHR upgrades, assessing current workflows, and strategies for patient engagement like implementing a patient portal. Medical practices are encouraged to evaluate their EHR vendor's 2014 certification plans and ensure they will meet all Stage 2 requirements by 2014.
This presentation featured inforamation about stage 2 meaningful use, new clinical quality measures, details on Medicare payment adjustments and other program changes.
This document presents the Workers Compensation Research Institute's Medical Price Index for Workers' Compensation, Third Edition (MPI-WC). It introduces the MPI-WC, which measures annual price changes for nonhospital medical services covered by workers' compensation insurance. The MPI-WC was developed using claims data to create a "market basket" of typical services, and it tracks prices across states from 2002 to 2010. It analyzes price trends for overall nonhospital services and specific groups like evaluation and management, surgery, and radiology. State-level data and interstate comparisons of price indices in 2010 are also provided.
This document summarizes an EMR system called MDsuite.EMR. It provides incentives for eligible professionals to adopt certified EHR technology through government stimulus programs. MDsuite.EMR offers a fully integrated EMR and practice management system. It has customizable templates, order management, e-prescribing, and connects to external data sources. Pricing is based on the number of providers and users, with options for licensed or hosted models.
This document provides a test scenario and script to evaluate an electronic health record's (EHR) medication management functionality according to certification criteria. The scenario involves ordering, dispensing, and administering a medication and ensures the EHR maintains accurate and consistent medication information throughout. It tests criteria such as computerized provider order entry, drug interaction checks, medication reconciliation, and electronic medication administration. The scenario is intended to reflect a typical clinical workflow and thread information between criteria to confirm the EHR's integrated performance.
This document provides an overview of the Meaningful Use program and regulations. It discusses the stages of Meaningful Use which focus on data capture, sharing, and advanced clinical processes. It also outlines the financial incentives available through Medicare and Medicaid for eligible providers that successfully meet Meaningful Use objectives. The document reviews eligibility, objectives and measures for Stages 1 and 2 of Meaningful Use, and penalties for providers that do not successfully demonstrate Meaningful Use. It provides guidance on determining which version of Meaningful Use objectives a provider must attest to based on their EHR certification year.
This document provides an overview of the Medicare and Medicaid EHR Incentive Programs, including:
- Eligible professionals can receive incentive payments for adopting and meaningfully using certified EHR technology.
- Incentive payment amounts and schedules differ between the two programs, with Medicaid generally offering higher incentives.
- Professionals must meet certain eligibility criteria including patient volume thresholds and choose whether to participate in Medicare or Medicaid.
This webinar discusses how medical practices can prepare for Stage 2 Meaningful Use requirements. Stage 2 focuses on more advanced EHR use, including higher thresholds for existing objectives and new objectives like secure messaging. The presentation reviews key Stage 2 objectives and thresholds, considerations for EHR upgrades, assessing current workflows, and strategies for patient engagement like implementing a patient portal. Medical practices are encouraged to evaluate their EHR vendor's 2014 certification plans and ensure they will meet all Stage 2 requirements by 2014.
The Medicare and Medicaid EHR Incentive Programs offer financial incentives for the
“meaningful use” of certified EHR technology to improve patient care. Read More.. www.curemd.com
The document provides details about the Medicare and Medicaid EHR Incentive Program for eligible professionals. It covers who is eligible to participate, including specific provider types for each program. It discusses the incentive payment amounts for both programs over multiple years. It also outlines the meaningful use requirements including objectives and clinical quality measures that must be met to receive incentive payments.
CMS Rule Change Webinar - September 10, 2014MassEHealth
The document summarizes a presentation about the CMS Final Rule regarding EHR certification flexibility for 2014. It allows providers to demonstrate Meaningful Use using 2011 or a combination of 2011 and 2014 certified EHR technology in 2014. It extends Stage 2 through 2016 and delays Stage 3 until 2017. The presentation provides options for providers on which objectives and measures they can report on in 2014 based on their scheduled Stage of Meaningful Use.
The document discusses the HITECH Act and the criteria for meaningful use of electronic health records (EHRs) in order to qualify for Medicare and Medicaid reimbursement bonuses starting in 2011. It outlines three stages of meaningful use criteria that providers must meet over multiple years to receive incentive payments. Stage one focuses on basic EHR usage and data capture, while stages two and three emphasize more advanced usage like clinical decision support and electronic data sharing. The criteria become more stringent over time to encourage higher levels of EHR utilization.
Stage 2 Meaningful Use - Transforming into a Superhero (Alabama MGMA)Greenway Health
The document provides an overview of stage 2 meaningful use requirements and incentives in the US. It discusses proposed changes to stage 1 measures, timing for stage 2, incentives for eligible providers, and goals around health information exchange and use of certified electronic health record technology.
This document summarizes changes to meaningful use stage 2 requirements for eligible professionals. It outlines new objectives like improved patient engagement and electronic exchange of health information. Providers must meet 17 core objectives and select 3 additional objectives from a menu. Clinical quality measures have also changed, with providers reporting measures from 3 quality domains. Payment adjustments will be applied to Medicare providers who do not demonstrate meaningful use, starting at 1% in 2015 and increasing annually. Hardship exemptions are available in limited circumstances.
This document discusses changes to Meaningful Use Stage 1 requirements for eligible professionals in 2014. Key changes include reducing the EHR reporting period to 3 months, removing one core objective, modifying measures for CPOE and vital signs, and providing more flexibility for public health objectives and clinical quality measures. Eligible professionals must also upgrade to 2014 certified EHR technology and may be subject to Medicare payment adjustments if Meaningful Use requirements are not met.
A guide to the HITECH Act and guidelines for meeting Meaningful Use for Eligible Professionals.
Intended to help doctors with the adoption of an Electronic Medical Records solution.
For additional questions please contact us at www.cal-med.com
Important Events & Dates for Medical Practices in 2014Manage My Practice
This year will have many challenges and one of them is keeping up with important dates to be met. Here is an overview of the most pertinent dates and a way to download a handy calendar of these dates to keep nearby.
What does ARRA, HITECH and Meaningful Use mean to youHealth 2.0
The document discusses the concepts of ARRA, HITECH, and Meaningful Use as they relate to adopting and using electronic health records (EHRs) in a meaningful manner. It provides an overview of the regulatory definitions and goals of Meaningful Use, as well as the three main regulations from CMS and ONC that specify requirements and standards. It also summarizes key aspects of the proposed EHR incentive programs for eligible professionals and hospitals, including eligibility, payment amounts and timelines, reporting requirements, and clinical quality measures.
The document discusses electronic health records (EHR) and the financial incentives provided by the HITECH Act to encourage physicians and hospitals to adopt EHR systems and achieve meaningful use. It outlines the purpose of the incentives, who is eligible, what meaningful use entails, how much payments are and how to qualify. It also addresses frequently asked questions about EHR incentives and requirements.
State of Michigan HIE Update (without Tina Scott)mihinpr
This document summarizes health information technology (HIT) and health information exchange (HIE) efforts in the state of Michigan. It discusses the state's strategic priorities around improving population health, care delivery systems, and health care reform through initiatives like the State Innovation Model. It provides an overview of HIT programs and incentives like the Medicaid EHR Incentive Program. Key organizations involved include the Health Information Technology Commission and stakeholders working to advance HIT and HIE. The goal is to use health data and technology to improve care, outcomes and costs.
The document summarizes the key aspects of the American Recovery and Reinvestment Act (ARRA) related to economic stimulus incentives for healthcare providers to adopt electronic medical record (EMR) technology. It outlines the incentive payments available through Medicare and Medicaid programs for providers who can demonstrate meaningful use of certified EMR systems. It also describes the core objectives and clinical quality measures that providers must meet to qualify for the incentive payments. The summary concludes by advising healthcare providers to start researching their EMR options soon to take advantage of the front-loaded incentive payments.
The document discusses the impact of the American Recovery and Reinvestment Act (ARRA) and the Health Information Technology for Economic and Clinical Health (HITECH) Act on adoption of electronic health records and health information technology in the US. It outlines the large amounts of funding provided through these acts to incentivize meaningful use of EHRs and health information exchange through programs like Medicaid and Medicare incentives and regional extension centers. Stage 1 meaningful use criteria are focused on electronically capturing health information and using it for care coordination and quality reporting.
Economic Stimulus Presentation August 2010Thinsolutions
The document provides an overview of the economic stimulus package passed in 2009 and incentives for healthcare providers to adopt electronic medical records (EMRs). It details the Medicare and Medicaid incentive programs that began in 2011, including payment amounts, eligibility requirements, and criteria for demonstrating meaningful use of EMRs. Providers can receive up to $44,000 from Medicare or $63,750 from Medicaid for adopting a certified EMR system and meeting usage goals focused on improving care delivery.
Health care providers today face an overwhelming number of change initiatives that aim to move the provider community in a given direction by leveraging incentives and penalties. Learn about all of the incentives and penalties CMS is leveraging to drive health care reform.
The Impact of Proposed MU Rule Changes 2015 2017MassEHealth
The presentation summarizes proposed changes to the Meaningful Use program for 2015-2017 outlined in a CMS Notice of Proposed Rulemaking. Key changes include shortening the EHR reporting period to 90 days in 2015, reducing the total number of objectives from 13-17 down to 10 for both Stages 1 and 2, and adjusting the timeline so all providers can attest to Stage 3 by 2018. The goals are to better align the stages, streamline redundant measures, and simplify the transition between stages, without requiring new technology functionality. The impact on providers would be minimal changes to workflow and movement toward continued practice transformation.
This document discusses the path toward achieving meaningful use of electronic health records (EHRs) according to government regulations. It outlines key dates for EHR incentive programs, including publication of final rules in 2010 and incentive payments beginning for eligible professionals in 2011 and hospitals in 2010. It also summarizes the eligibility criteria, reporting periods, payment amounts and schedules for Medicare and Medicaid EHR incentive programs for both professionals and hospitals.
Meaningful Use is a CMS program that provides incentives for healthcare providers to adopt and meaningfully use electronic health records (EHRs) to improve patient care. It has 3 stages - stage 1 focuses on data collection, stage 2 on information exchange, and stage 3 on improved health outcomes. Providers can earn incentives through Medicare or Medicaid by meeting criteria for meaningful use over time. Failure to comply will result in penalties being applied to Medicare reimbursements.
This document summarizes the changes between the proposed and final rule versions of standards and certification criteria for electronic health records. Some of the key changes include clarifying clinical data standards, adopting updated versions of standards, and revising transport standards for care coordination criteria. The final rule enhances standards-based exchange, promotes safety and security, and reduces regulatory burden compared to the proposed rule.
The document discusses ONC's proposed strategy for governance of the nationwide health information network following public comments on its RFI. It received feedback that regulations could stifle an emerging market for health information exchange and that ONC should guide the market while ensuring basic protections. ONC's new proposed approach is to lead through action by using available levers to accomplish goals, lead through guidance by disseminating principles and good practices, engage and listen to stakeholders offering solutions, and monitor the marketplace and attitudes.
The Medicare and Medicaid EHR Incentive Programs offer financial incentives for the
“meaningful use” of certified EHR technology to improve patient care. Read More.. www.curemd.com
The document provides details about the Medicare and Medicaid EHR Incentive Program for eligible professionals. It covers who is eligible to participate, including specific provider types for each program. It discusses the incentive payment amounts for both programs over multiple years. It also outlines the meaningful use requirements including objectives and clinical quality measures that must be met to receive incentive payments.
CMS Rule Change Webinar - September 10, 2014MassEHealth
The document summarizes a presentation about the CMS Final Rule regarding EHR certification flexibility for 2014. It allows providers to demonstrate Meaningful Use using 2011 or a combination of 2011 and 2014 certified EHR technology in 2014. It extends Stage 2 through 2016 and delays Stage 3 until 2017. The presentation provides options for providers on which objectives and measures they can report on in 2014 based on their scheduled Stage of Meaningful Use.
The document discusses the HITECH Act and the criteria for meaningful use of electronic health records (EHRs) in order to qualify for Medicare and Medicaid reimbursement bonuses starting in 2011. It outlines three stages of meaningful use criteria that providers must meet over multiple years to receive incentive payments. Stage one focuses on basic EHR usage and data capture, while stages two and three emphasize more advanced usage like clinical decision support and electronic data sharing. The criteria become more stringent over time to encourage higher levels of EHR utilization.
Stage 2 Meaningful Use - Transforming into a Superhero (Alabama MGMA)Greenway Health
The document provides an overview of stage 2 meaningful use requirements and incentives in the US. It discusses proposed changes to stage 1 measures, timing for stage 2, incentives for eligible providers, and goals around health information exchange and use of certified electronic health record technology.
This document summarizes changes to meaningful use stage 2 requirements for eligible professionals. It outlines new objectives like improved patient engagement and electronic exchange of health information. Providers must meet 17 core objectives and select 3 additional objectives from a menu. Clinical quality measures have also changed, with providers reporting measures from 3 quality domains. Payment adjustments will be applied to Medicare providers who do not demonstrate meaningful use, starting at 1% in 2015 and increasing annually. Hardship exemptions are available in limited circumstances.
This document discusses changes to Meaningful Use Stage 1 requirements for eligible professionals in 2014. Key changes include reducing the EHR reporting period to 3 months, removing one core objective, modifying measures for CPOE and vital signs, and providing more flexibility for public health objectives and clinical quality measures. Eligible professionals must also upgrade to 2014 certified EHR technology and may be subject to Medicare payment adjustments if Meaningful Use requirements are not met.
A guide to the HITECH Act and guidelines for meeting Meaningful Use for Eligible Professionals.
Intended to help doctors with the adoption of an Electronic Medical Records solution.
For additional questions please contact us at www.cal-med.com
Important Events & Dates for Medical Practices in 2014Manage My Practice
This year will have many challenges and one of them is keeping up with important dates to be met. Here is an overview of the most pertinent dates and a way to download a handy calendar of these dates to keep nearby.
What does ARRA, HITECH and Meaningful Use mean to youHealth 2.0
The document discusses the concepts of ARRA, HITECH, and Meaningful Use as they relate to adopting and using electronic health records (EHRs) in a meaningful manner. It provides an overview of the regulatory definitions and goals of Meaningful Use, as well as the three main regulations from CMS and ONC that specify requirements and standards. It also summarizes key aspects of the proposed EHR incentive programs for eligible professionals and hospitals, including eligibility, payment amounts and timelines, reporting requirements, and clinical quality measures.
The document discusses electronic health records (EHR) and the financial incentives provided by the HITECH Act to encourage physicians and hospitals to adopt EHR systems and achieve meaningful use. It outlines the purpose of the incentives, who is eligible, what meaningful use entails, how much payments are and how to qualify. It also addresses frequently asked questions about EHR incentives and requirements.
State of Michigan HIE Update (without Tina Scott)mihinpr
This document summarizes health information technology (HIT) and health information exchange (HIE) efforts in the state of Michigan. It discusses the state's strategic priorities around improving population health, care delivery systems, and health care reform through initiatives like the State Innovation Model. It provides an overview of HIT programs and incentives like the Medicaid EHR Incentive Program. Key organizations involved include the Health Information Technology Commission and stakeholders working to advance HIT and HIE. The goal is to use health data and technology to improve care, outcomes and costs.
The document summarizes the key aspects of the American Recovery and Reinvestment Act (ARRA) related to economic stimulus incentives for healthcare providers to adopt electronic medical record (EMR) technology. It outlines the incentive payments available through Medicare and Medicaid programs for providers who can demonstrate meaningful use of certified EMR systems. It also describes the core objectives and clinical quality measures that providers must meet to qualify for the incentive payments. The summary concludes by advising healthcare providers to start researching their EMR options soon to take advantage of the front-loaded incentive payments.
The document discusses the impact of the American Recovery and Reinvestment Act (ARRA) and the Health Information Technology for Economic and Clinical Health (HITECH) Act on adoption of electronic health records and health information technology in the US. It outlines the large amounts of funding provided through these acts to incentivize meaningful use of EHRs and health information exchange through programs like Medicaid and Medicare incentives and regional extension centers. Stage 1 meaningful use criteria are focused on electronically capturing health information and using it for care coordination and quality reporting.
Economic Stimulus Presentation August 2010Thinsolutions
The document provides an overview of the economic stimulus package passed in 2009 and incentives for healthcare providers to adopt electronic medical records (EMRs). It details the Medicare and Medicaid incentive programs that began in 2011, including payment amounts, eligibility requirements, and criteria for demonstrating meaningful use of EMRs. Providers can receive up to $44,000 from Medicare or $63,750 from Medicaid for adopting a certified EMR system and meeting usage goals focused on improving care delivery.
Health care providers today face an overwhelming number of change initiatives that aim to move the provider community in a given direction by leveraging incentives and penalties. Learn about all of the incentives and penalties CMS is leveraging to drive health care reform.
The Impact of Proposed MU Rule Changes 2015 2017MassEHealth
The presentation summarizes proposed changes to the Meaningful Use program for 2015-2017 outlined in a CMS Notice of Proposed Rulemaking. Key changes include shortening the EHR reporting period to 90 days in 2015, reducing the total number of objectives from 13-17 down to 10 for both Stages 1 and 2, and adjusting the timeline so all providers can attest to Stage 3 by 2018. The goals are to better align the stages, streamline redundant measures, and simplify the transition between stages, without requiring new technology functionality. The impact on providers would be minimal changes to workflow and movement toward continued practice transformation.
This document discusses the path toward achieving meaningful use of electronic health records (EHRs) according to government regulations. It outlines key dates for EHR incentive programs, including publication of final rules in 2010 and incentive payments beginning for eligible professionals in 2011 and hospitals in 2010. It also summarizes the eligibility criteria, reporting periods, payment amounts and schedules for Medicare and Medicaid EHR incentive programs for both professionals and hospitals.
Meaningful Use is a CMS program that provides incentives for healthcare providers to adopt and meaningfully use electronic health records (EHRs) to improve patient care. It has 3 stages - stage 1 focuses on data collection, stage 2 on information exchange, and stage 3 on improved health outcomes. Providers can earn incentives through Medicare or Medicaid by meeting criteria for meaningful use over time. Failure to comply will result in penalties being applied to Medicare reimbursements.
This document summarizes the changes between the proposed and final rule versions of standards and certification criteria for electronic health records. Some of the key changes include clarifying clinical data standards, adopting updated versions of standards, and revising transport standards for care coordination criteria. The final rule enhances standards-based exchange, promotes safety and security, and reduces regulatory burden compared to the proposed rule.
The document discusses ONC's proposed strategy for governance of the nationwide health information network following public comments on its RFI. It received feedback that regulations could stifle an emerging market for health information exchange and that ONC should guide the market while ensuring basic protections. ONC's new proposed approach is to lead through action by using available levers to accomplish goals, lead through guidance by disseminating principles and good practices, engage and listen to stakeholders offering solutions, and monitor the marketplace and attitudes.
The document provides an update on two new S&I Framework initiatives - Health eDecisions and Automate Blue Button. [1] It describes the progress made on Health eDecisions, including defining its scope, target outcomes, and approach. [2] It outlines the standards and models being considered for Health eDecisions and provides timelines for developing an artifact sharing standard.
The agenda lists the schedule for the HIT Standards Committee meeting on September 19, 2012 at the Washington Marriott hotel from 9:00 am to 2:45 pm Eastern Time. It includes remarks from the National Coordinator for Health IT, a briefing on the Meaningful Use Stage 2 final rules, updates on ONC policy activities and standards work, as well as presentations from various workgroups and periods for public comments.
This document summarizes a meeting of the HIT Standards Committee. Key topics discussed include:
1. The committee approved the summary of their previous July 2012 meeting with one minor correction.
2. The committee discussed criteria for evaluating the maturity and readiness of health IT standards. They approved the recommendations from the NwHIN Power Team on this subject, with an additional recommendation to establish a process for re-evaluating standards over time.
3. Various members discussed challenges around aligning health IT standards and policy given compressed timelines and the need for flexibility. While a draft letter outlining concerns was withdrawn, the committee agreed more discussion is needed on planning for potential issues.
This document discusses the current activities and next steps of the Implementation Workgroup. It lists the member organizations and provides an overview of test scenario development, the 2014 test methods timeline, and plans for public review and comment. Scenario-based testing is proposed to replace unit-based testing, and a medication management test scenario example is presented. Complexities of scenario-based testing are noted. The timeline outlines two waves of public commenting on draft 2014 test procedures. Next steps include incorporating 2014 criteria into test scenarios and reviewing scenarios against new test procedures.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
One health condition that is becoming more common day by day is diabetes.
According to research conducted by the National Family Health Survey of India, diabetic cases show a projection which might increase to 10.4% by 2030.
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In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
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Stage2hit standards committee_9-19-12
1. Medicare & Medicaid
EHR Incentive Programs
Stage 2 Final Rule
Travis Broome
HIT Standards Committee
9-19-2012
2. What is in the Rule
Changes to Stage 1 of meaningful use
Stage 2 of meaningful use
New clinical quality measures
New clinical quality measure reporting mechanisms
Payment adjustments and hardships
Medicare Advantage program changes
Medicaid program changes
2
3. Stages of Meaningful Use
AUTHOR’S NOTES:This is the structure to get us where we want to be. It is divided into three stages. The first stage involves collecting health information in
a structured way and takes the first steps towards using that data. Structured data is crucial to meaningful use of EHRs. What we mean by structured data is
that the system recognizes the data for what it is and knows how that data interacts with other data available in the system. For instance, Microsoft Word
knows that aspirin is a seven letter word and even how it should be spelled, but it does not know that it is a drug and one that should be given to patients
showing signs of a heart attack or not given to one that is also taking an anticoagulant. This is what we mean by structured data. The second stage involves
designing and implementing processes that will use the data collected in a way that we believe will generate improved outcomes. The third stage involves
finding out if we were right and determining the effects of meaningful use on outcomes.
3
4. What is Your Meaningful Use Path?
For Medicare EPs:
(Author’s Notes: You start Stage 2 in 2014 or your third year of meaningful use whichever is latter. Please note that not
only does giving providers in 2011 a third year of Stage 1 enable the time for Stage 2, but by putting those providers in
Stage 2 for two years the breathing room for implementing Stage 3 is also created based on the currently anticipated
regulation timeline. Medicaid providers can always do a year of AIU preceding their 2 years of Stages 1, 2 and 3. )
First Year of Stages of Meaningful Use for Eligible Hospitals (Fiscal Year)
Participation 2011 2012 2013 2014 2015 2016
2011 1 1 1 2 2 3
$44,000 $18,000 $12,000 $8,000 $4,000 $2,000
2012 1 1 2 2 3
$44,000 $18,000 $12,000 $8,000 $4,000 $2,000
2013 1 1 2 2
$39,000 $15,000 $12,000 $8,000 $4,000
2014 1 1 2
$24,000 $12,000 $8,000 $4,000
5. What is Your Meaningful Use Path?
For Medicare Hospitals:
Stages of Meaningful Use for Eligible Hospitals (Fiscal Year)
First Year of
Participation 2011 2012 2013 2014 2015 2016
2011 1 1 1 2 2 3
2012 1 1 2 2 3
2013 1 1 2 2
2014 1 1 2
*Payments will decrease for hospitals that start receiving payments in 2014 and later
6. What is Your Meaningful Use Path?
For Medicaid EPs:
Annual Incentive Payment by Stage of Meaningful Use
YEAR 1 YEAR 2 YEAR 3 YEAR 4 YEAR 5 YEAR 6
(AIU) 1 1 2 2 3
1
- - 1
- - 1
- - - -
$2t250 $8,500 $8,500 $8,500 $8,500 $8,500
Maximum incentive amount is $63,750. Payments are made over
6 years and do not have to be consecutive.
*2016 is the last year that Medicaid EPs can begin participation in
the program.
6
7. Meaningful Use:
Changes from Stage 1 to Stage 2
Stage 1 Stage 2
Eligible Professionals Eligible Professionals
15 core objectives 17 core objectives
5 of 10 menu objectives 3 of 6 menu objectives
20 total objectives 20 total objectives
Eligible Hospitals & Eligible Hospitals &
CAHs CAHs
14 core objectives 16 core objectives
5 of 10 menu objectives 3 of 6 menu objectives
19 total objectives 19 total objectives
7
8. Changes to Meaningful Use
Changes No Changes
Half of Outpatient Encounters– at
Menu Objective Exclusion– While you
least 50% of EP outpatient encounters
can continue to claim exclusions if
must occur at locations equipped with
applicable for menu objectives,
certified EHR technology.
starting in 2014 these exclusions will
no longer count towards the number Measure compliance = objective
of menu objectives needed. compliance
Denominators based on outpatient
locations equipped with CEHRT and
AUTHOR’S NOTE: This change was made to prevent EPs include all such encounters or only
from selecting and excluding menu objectives when there those for patients whose records are
are other menu objectives they can legitimately meet,
thereby making it easier for them to demonstrate meaningful
in CEHRT depending on the measure.
use than EPs who attempt to legitimately meet the full AUTHOR’S NOTE: By the time an EP, eligible hospital, or
complement of menu objectives. If an EP does meet the CAH has reached Stage 2 of meaningful use all or nearly all
exclusion criteria for four or more objectives in the menu set of their patient population should be included in their
then they would attest to meeting the exclusions for one or Certified EHR Technology, making the distinction between
more in attestation and would be attesting that they meet patients whose records are kept in CEHRT and those that
the exclusions for the objective not selected as well. are not no longer relevant.
8
9. 2014 Changes
1. EHRs Meeting ONC 2014 Standards – starting in 2014,
all EHR Incentive Programs participants will have to
adopt certified EHR technology that meets ONC’s
Standards & Certification Criteria 2014 Final Rule
2. Reporting Period Reduced to Three Months – to allow
providers time to adopt 2014 certified EHR technology
and prepare for Stage 2, all participants will have a three-
month reporting period in 2014.
9
10. Stage 2: Batch Reporting
Stage 2 rule allows for batch reporting.
What does that mean?
Starting in 2014, groups will be allowed to submit
attestation information for all of their individual
EPs in one file for upload to the Attestation System,
rather than having each EP individually enter data.
AUTHOR’S NOTE: CMS did not include a group performance option for meaningful use in the Stage 2 final rule, but
will plan to signal our intention to implement such an option in future rulemaking once we are able to address
operational and system issues.
10
11. Stage 2 EP Core Objectives 1 of 2
EPs must meet all 17 core objectives:
Core Objective Measure
Use CPOE for more than 60% of medication, 30% of
1. CPOE
laboratory, and 30% of radiology
2. E-Rx E-Rx for more than 50%
3. Demographics Record demographics for more than 80%
4. Vital Signs Record vital signs for more than 80%
5. Smoking Status Record smoking status for more than 80%
Implement 5 clinical decision support interventions +
6. Interventions
drug/drug and drug/allergy
7. Labs Incorporate lab results for more than 55%
8. Patient List Generate patient list by specific condition
Use EHR to identify and provide reminders for
9. Preventive Reminders preventive/follow-up care for more than 10% of patients
with two or more office visits in the last 2 years
11
12. Stage 2 EP Core Objectives 2 of 2
EPs must meet all 17 core objectives:
Core Objective Measure
Provide online access to health information for more than
10. Patient Access
50% with more than 5% actually accessing
Provide office visit summaries for more than 50% of office
11. Visit Summaries
visits
Use EHR to identify and provide education resources more
12. Education Resources
than 10%
13. Secure Messages More than 5% of patients send secure messages to their EP
Medication reconciliation at more than 50% of transitions of
14. Rx Reconciliation care
Provide summary of care document for more than 50% of
transitions of care and referrals with 10% sent
15. Summary of Care electronically and at least one sent to a recipient with a
different EHR vendor or successfully testing with CMS
test EHR
16. Immunizations Successful ongoing transmission of immunization data
Conduct or review security analysis and incorporate in risk
17. Security Analysis management process
12
13. Stage 2 EP Menu Objectives
EPs must select 3 out of the 6:
Menu Objective Measure
More than 10% of imaging results are accessible through
1. Imaging Results
Certified EHR Technology
2. Family History Record family health history for more than 20%
Successful ongoing transmission of syndromic
3. Syndromic Surveillance
surveillance data
Successful ongoing transmission of cancer case
4. Cancer
information
Successful ongoing transmission of data to a specialized
5. Specialized Registry
registry
Enter an electronic progress note for more than 30% of
6. Progress Notes
unique patients
AUTHOR’S NOTE: With the exception of syndromic surveillance data these are all new objectives
for Stage 2. An EP must select 3 out of the 6.
13
14. Stage 2 Hospital Core Objectives
Eligible hospitals must meet all 16 core objectives:
Core Objective Measure
Use CPOE for more than 60% of medication, 30% of
1. CPOE
laboratory, and 30% of radiology
2. Demographics Record demographics for more than 80%
3. Vital Signs Record vital signs for more than 80%
4. Smoking Status Record smoking status for more than 80%
Implement 5 clinical decision support interventions +
5. Interventions
drug/drug and drug/allergy
6. Labs Incorporate lab results for more than 55%
7. Patient List Generate patient list by specific condition
eMAR is implemented and used for more than 10% of
8. eMAR
medication orders
14
15. Stage 2 Hospital Core Objectives
Eligible hospitals must meet all 16 core objectives:
Core Objective Measure
Provide online access to health information for more than
9. Patient Access
50% with more than 5% actually accessing
Use EHR to identify and provide education resources
10. Education Resources
more than 10%
Medication reconciliation at more than 50% of transitions
11. Rx Reconciliation
of care
Provide summary of care document for more than 50% of
transitions of care and referrals with 10% sent
12. Summary of Care electronically and at least one sent to a recipient with a
different EHR vendor or successfully testing with CMS
test EHR
13. Immunizations Successful ongoing transmission of immunization data
Successful ongoing submission of reportable laboratory
14. Labs
results
Successful ongoing submission of electronic syndromic
15. Syndromic Surveillance
surveillance data
Conduct or review security analysis and incorporate in
16. Security Analysis
risk management process
15
16. Stage 2 Hospital Menu Objectives
Eligible Hospitals must select 3 out of the 6:
Menu Objective Measure
Enter an electronic progress note for more than 30% of
1. Progress Notes
unique patients
More than 10% electronic prescribing (eRx) of discharge
2. E-Rx
medication orders
More than 10% of imaging results are accessible through
3. Imaging Results
Certified EHR Technology
4. Family History Record family health history for more than 20%
Record advanced directives for more than 50% of patients
5. Advanced Directives
65 years or older
Provide structured electronic lab results to EPs for more
6. Labs
than 20%
AUTHOR’S NOTE: With the exception of syndromic surveillance data these are all new objectives
for Stage 2. An EP must select 3 out of the 6.
16
17. Closer Look at Stage 2:
Patient Engagement
• Patient engagement – engagement is an important focus of
Stage 2.
Requirements for Patient Action:
• More than 5% of patients must send secure messages to their EP
• More than 5% of patients must access their health information
online
• EXCLUSIONS – CMS is introducing exclusions based on
broadband availability in the provider’s county.
AUTHOR’S NOTES: More than 5% of patients must access their health information online (of the more than 50% of
patients who received access).
Requirements for Patient Action:
• More than 5% of patients must send secure messages to their EP
• More than 5% of patients must access their health information online
17
18. Closer Look at Stage 2:
Electronic Exchange
Stage 2 focuses on actual use cases of electronic
information exchange:
• Stage 2 requires that a provider send a summary of care record for more
than 50% of transitions of care and referrals.
• The rule also requires that a provider electronically transmit a summary of
care for more than 10% of transitions of care and referrals.
• At least one summary of care document sent electronically to recipient
with different EHR vendor or to CMS test EHR.
AUTHOR’S NOTES: Credit given when the receiving providers successfully “pulls” info down from HIE. This is in
addition to the “push” methods of electronic HIE that were proposed.
Stage 2 requires that a provider send a summary of care record for more than 50% of transitions of care and
referrals.
The rule also requires that a provider electronically transmit a summary of care for more than 10% of
transitions of care and referrals.
18
20. CQM Reporting in 2013
• CQM reporting will remain the same through 2013.
• 44 EP CQMs
• 3 core or alternate core (if reporting zeroes in the core) plus 3 additional CQMs
• Report minimum of 6 CQMs (up to 9 CQMs if any core CQMs were zeroes)
• 15 Eligible Hospital and CAH CQMs
• Report all 15 CQMs
• In 2012 and continued in 2013, there are two reporting
methods available for reporting the Stage 1 measures:
• Attestation
• eReporting pilots
• Physician Quality Reporting System EHR Incentive Program Pilot for EPs
• eReporting Pilot for eligible hospitals and CAHs
• Medicaid providers submit CQMs according to their
state-based submission requirements.
20
21. CQM Specifications in 2013
• Electronic specifications for the CQMs for reporting in 2013
will not be updated.
• Flexibility in implementing CEHRT certified to the 2014
Edition certification criteria in 2013
• Providers could report via attestation CQMs finalized in both Stage 1 and
Stage 2 final rules
• For EPs, this includes 32of the 44 CQMs finalized in the Stage 1 final rule
• Excludes: NQF 0013, NQF 0027, NQF 0084
• Since NQF 0013 is a core CQM in the Stage 1 final rule, an alternate core CQM must be
reported instead since it will not be certified based on 2014 Edition certification criteria.
• For Eligible Hospitals and CAHs, this includes all 15 of the CQMs
finalized in the Stage 1 final rule
21
22. CQM Selection and HHS Priorities
All providers must select CQMs from at least 3 of the 6
HHS National Quality Strategy domains:
Patient and Family Engagement
Patient Safety
Care Coordination
Population and Public Health
Efficient Use of Healthcare Resources
Clinical Processes/Effectiveness
AUTHOR’S NOTES:
• Such as measures in which performance rates are currently low or for which there is wide variability in performance,
or that address known drivers of high morbidity and/or cost for Medicare and Medicaid.
• For example, Medicare- and Medicaid-eligible physicians, and Medicaid-eligible nurse-practitioners, certified nurse-
midwives, dentists, physician assistants)
• Based on the March 2011 report to Congress, "National Strategy for Quality Improvement in Health Care" (National
Quality Strategy) (http://www.healthcare.gov/law/resources/reports/nationalqualitystrategy032011.pdf) and the Health
Information Technology Policy Committee's (HITPC's) recommendations
(http://healthit.hhs.gov/portal/server.pt?open=512&objID=1815&parentname=CommunityPage&parentid=7&mode=2&
in_hi_userid=11113&cached=true).
22
23. Changes to CQMs Reporting
Prior to 2014 Beginning in 2014
Report 6 out of Report 9 out of 64 CQMs
44 CQMs Selected CQMs must cover at
• 3 core or alt. least 3 of the 6 NQS domains
EPs core EPs
Recommended core CQMs:
• 3 menu 9 for adult populations
9 for pediatric populations
Eligible Eligible Report 16 out of 29 CQMs
Report 15 out of Hospitals
Hospitals Selected CQMs must cover at
15 CQMs and CAHs
and CAHs least 3 of the 6 NQS domains
23
24. EP CQM Reporting Beginning in 2014
EP CQM Reporting Beginning in 2014
Eligible Professionals reporting for the Medicare EHR Incentive Program
Category Data Level Payer Level Submission Type Reporting Schema
EPs in 1st Year of Aggregate All payer Attestation Submit 9 CQMs from EP measures table (includes adult
Demonstrating and pediatric recommended core CQMs), covering at least
MU* 3 domains
EPs Beyond the 1st Year of Demonstrating Meaningful Use
Option 1 Aggregate All payer Electronic Submit 9 CQMs from EP measures table (includes adult
and pediatric recommended core CQMs), covering at least
3 domains
Option 2 Patient Medicare Electronic Satisfy requirements of PQRS EHR Reporting Option using
CEHRT
Group Reporting (only EPs Beyond the 1st Year of Demonstrating Meaningful Use)**
EPs in an ACO Patient Medicare Electronic Satisfy requirements of Medicare Shared Savings Program
(Medicare Shared of Pioneer ACOs using CEHRT
Savings Program
or Pioneer ACOs)
EPs satisfactorily Patient Medicare Electronic Satisfy requirements of PQRS group reporting options using
reporting via CEHRT
PQRS group
reporting options
*Attestation is required for EPs in their 1st year of demonstrating MU because it is the only reporting method that
would allow them to meet the submission deadline of October 1 to avoid a payment adjustment.
**Groups with EPs in their 1st year of demonstrating MU can report as a group, however the individual EP(s) who
are in their 1st year must attest to their CQM results by October 1 to avoid a payment adjustment.
24
25. Hospital CQM Reporting Beginning in
Hospital
2014
CQM
Reporting
Beginning
in 2014
Eligible Hospitals reporting for the Medicare EHR Incentive Program
Category Data Level Payer Level Submission Type Reporting Schema
Eligible Hospitals Aggregate All payer Attestation Submit 16 CQMs from Eligible Hospital/CAH
in 1st Year of measures table, covering at least 3 domains
Demonstrating
MU*
Eligible Hospitals/CAHs Beyond the 1st Year of Demonstrating Meaningful Use
Option 1 Aggregate All payer Electronic Submit 16 CQMs from Eligible Hospital/CAH
measures table, covering at least 3 domains
Option 2 Patient All payer Electronic Submit 16 CQMs from Eligible Hospital/CAH
(sample) measures table, covering at least 3 domains
Manner similar to the 2012 Medicare EHR
Incentive Program Electronic Reporting Pilot
*Attestation is required for Eligible Hospitals in their 1st year of demonstrating MU because it is the only reporting
method that would allow them to meet the submission deadline of July 1 to avoid a payment adjustment.
25
26. CQM – Timing
Time periods for reporting CQMs – NO CHANGE from
Stage 1 to Stage 2 Author’s Note: These time periods apply regardless of
Stage of meaningful use.
Provider Reporting Submission Period for Reporting Period Submission Period
Type Period for 1st 1st year of MU for Subsequent for Subsequent
year of MU years of MU (2nd years of MU (2nd
year and beyond) year and beyond)
EP 90 Anytime immediately 1 calendar year 2 months following
consecutive following the end of the (January 1 – the end of the EHR
days within 90-day reporting period, December 31) reporting period
the calendar but no later than (January 1 –
year February 28 of the February 28)
following calendar year*
Eligible 90 Anytime immediately 1 fiscal year 2 months following
Hospital/ consecutive following the end of the (October 1 – the end of the EHR
CAH days within 90-day reporting period, September 30) reporting period
the fiscal but no later than (October 1 –
year November 30 of the November 30)
following fiscal year*
*In order to avoid payment adjustments, EPs must submit CQMs no later than October 1 and
Eligible Hospitals must submit CQMs no later than July 1.
26
27. 2014 CQM Quarterly Reporting
For Medicare providers, the 2014 3-month reporting period is fixed to the quarter of either
the fiscal (for eligible hospitals and CAHs) or calendar (for EPs) year in order to align with
existing CMS quality reporting programs.
In subsequent years, the reporting period for CQMs would be the entire calendar year (for
EPs) or fiscal year (for eligible hospitals and CAHs) for providers beyond the 1st year of MU.
Provider Optional Reporting Period Reporting Period for Submission Period for
Type in 2014* Subsequent Years of Subsequent Years of
Meaningful Use Meaningful Use
EP Calendar year quarter: 1 calendar year 2 months following the
January 1 – March 31 (January 1 - December end of the reporting
April 1 – June 30 31) period
July 1 – September 30 (January 1 - February
October 1 – December 31 28)
Eligible Fiscal year quarter: 1 fiscal year 2 months following the
Hospital/CAH October 1 – December 31 (October 1 - September end of the reporting
January 1 – March 31 30) period
April 1 – June 30 (October 1 - November
July 1 – September 30 30)
*In order to avoid payment adjustments, EPs must submit CQMs no later than October 1 and
Eligible Hospitals must submit CQMs no later than July 1.
27
29. Who, How Much and When?
• The HITECH Act stipulates that for Medicare EP,
subsection (d) hospitals and CAHs a payment
adjustment applies if they are not a meaningful
EHR user.
• How much?
• EPs: 1% of Part B Physician Fee Schedule
potentially rising to 5%
• Subsection (d) hospitals: 1/4 of their annual
update rising to 3/4
• CAHs: 1/3 of a percent rising to a full percent
• Starting in 2015 with annual determinations
29
30. EP EHR Reporting Period
Payment adjustments are based on prior years’ reporting periods. The
length of the reporting period depends upon the first year of
participation.
For an EP who has demonstrated meaningful use in 2011 or 2012:
Payment Adjustment Year 2015 2016 2017 2018 2019 2020
Based on Full Year EHR Reporting
2013 2014* 2015 2016 2017 2018
Period (unless 2013 is your 1st year)
* Special 3 month EHR reporting period
To Avoid Payment Adjustments:
EPs must continue to demonstrate meaningful use every year to avoid
payment adjustments in subsequent years.
Author’s Notes: As displayed in the charts, for EPs who demonstrated meaningful use in 2011 or 2012,
their 2013 reporting period (the full year) will determined their 2015 payment adjustment.
30
31. EP EHR Reporting Period
EP who demonstrates meaningful use in 2014 for the first time:
Payment Adjustment Year 2015 2016 2017 2018 2019 2020
Based on 90 day EHR Reporting Period 2014* 2014
Based on Full Year EHR Reporting Period 2015 2016 2017 2018
*In order to avoid the 2015 payment adjustment the EP must attest no later
than October 1, 2014, which means they must begin their 90 day EHR
reporting period no later than July 1, 2014.
Author’s Notes: This continues for EPs who demonstrate meaningful use in 2015 for the first time. Demonstration in
2015 assuming it is no later than Oct 1, 2015 would count for 2016 and 2017.
31
32. Subsection (d) Hospital HER Reporting Period
Payment adjustments are based on prior years’ reporting periods. The length of the
reporting period depends upon the first year of participation.
For a hospital that has demonstrated meaningful use in 2011 or 2012 (fiscal years):
Payment Adjustment Year 2015 2016 2017 2018 2019 2020
Based on Full Year EHR Reporting Period 2013 2014* 2015 2016 2017 2018
For a hospital that demonstrates meaningful use in 2013 for the first time:
Payment Adjustment Year 2015 2016 2017 2018 2019 2020
Based on 90 day EHR Reporting Period 2013
Based on Full Year EHR Reporting Period 2014* 2015 2016 2017 2018
*Special 3 month EHR reporting period
To Avoid Payment Adjustments:
Eligible hospitals must continue to demonstrate meaningful use every year to avoid
payment adjustments in subsequent years.
AUTHOR’S NOTES: As displayed in the charts, for hospitals that demonstrated meaningful use in 2011 or 2012, their
2013 reporting period (the full year) will determined their 2015 payment adjustment.
For hospitals that demonstrate meaningful use in 2013 for the first time, their 90-day reporting period determines their 2015
payment adjustment.
32
33. Subsection (d) Hospital EHR
Reporting Period
For a hospital that demonstrates meaningful use in 2014 for the first time:
Payment Adjustment Year 2015 2016 2017 2018 2019 2020
Based on 90 day EHR Reporting Period 2014* 2014
Based on Full Year EHR Reporting Period 2015 2016 2017 2018
*In order to avoid the 2015 payment adjustment the hospital must attest no
later than July 1, 2014 which means they must begin their 90 day EHR
reporting period no later than April 1, 2014
AUTHOR’S NOTES: This continues for hospitals that demonstrate meaningful use in 2015 for the first time.
Demonstration in 2015 assuming it is no later than July 1, 2015 would count for 2016 and 2017.
33
34. CAH EHR Reporting Period
Payment adjustments for CAHs are also based on prior years’ reporting
periods. The length of the reporting period depends upon the first year
of participation.
For a CAH who has demonstrated meaningful use prior to 2015 (fiscal
years):
Payment Adjustment Year 2015 2016 2017 2018 2019 2020
Based on Full Year EHR Reporting Period 2015 2016 2017 2018 2019 2020
For a CAH who demonstrates meaningful use in 2015 for the first time:
Payment Adjustment Year 2015 2016 2017 2018 2019 2020
Based on 90 day EHR Reporting Period 2015
Based on Full Year EHR Reporting Period 2016 2017 2018 2019 2020
To Avoid Payment Adjustments:
CAHs must continue to demonstrate meaningful use every year to avoid payment
adjustments in subsequent years.
AUTHOR’S NOTE: Fiscal years. The difference in EHR reporting period is due to the unique cost reimbursement structure of
CAHs. Currently, interim payments are made to a CAH based on a prior year cost report and then the report in reconciled at
the end of the fiscal year and adjustments to interim payments are made. It is this existing reconciliation structure that allows
us to propose to based the EHR reporting period in the same year as the payment adjustment.
34
35. EP Hardship Exceptions
EPs can apply for hardship exceptions in the following categories:
1. Infrastructure 4. EPs must demonstrate that they meet
EPs must demonstrate that they are in the following criteria:
an area without sufficient internet
• Lack of face-to-face or telemedicine
access or face insurmountable barriers interaction with patients
to obtaining infrastructure (e.g., lack of • Lack of follow-up need with patients
broadband).
5. EPs who practice at multiple locations
2. New EPs must demonstrate that they:
Newly practicing EPs who would not • Lack of control over availability of
have had time to become meaningful CEHRT for more than 50% of patient
users can apply for a 2-year limited encounters
exception to payment adjustments.
AUTHOR’S NOTE: New EPs- Example- those who
3. Unforeseen Circumstances begin practice in calendar year 2015 would receive an
Examples may include a natural exception to the penalties in 2015 and 2016, but would
have to begin demonstrating meaningful use in
disaster or other unforeseeable barrier. calendar year 2016 to avoid payment adjustments in
2017.
35
36. Eligible Hospital and
CAH Hardship Exceptions
Eligible hospitals and CAHs can apply for hardship exceptions
in the following categories
limited to one full year after the
1. Infrastructure
CAH accepts its first patient.
Eligible hospitals and CAHs must
demonstrate that they are in an area • For eligible hospitals the hardship
without sufficient internet access or face exception is limited to one full-year
insurmountable barriers to obtaining cost reporting period.
infrastructure 3. Unforeseen Circumstances
(e.g., lack of broadband). Examples may include a natural disaster
2. New Eligible Hospitals or CAHs or other unforeseeable barrier.
New eligible hospitals and CAHs with
AUTHOR’S NOTE: Payment adjustments
new CMS Certification Numbers (CCNs) for eligible hospitals and CAHs will be
applied beginning with the fiscal year 2015
that would not have had time to become
cost reporting period.
meaningful users can apply for a limited
exception to payment adjustments.
• For CAHs the hardship exception is
36