July 14, 2010 
It is official. The U.S. Department of Health and Human Services Secretary Kathleen Sebelius hosted a live video conference on July 13th to announce the final rules targeted to improve the delivery of health care, increase safety and quality, and reduce costs.
The rule is the result of The Center for Medicare and Medicaid Services (CMS) receiving over 2,000 comments from the public. These were used as a catalyst to shape the resulting final rule. The proposed ruling was composed of a broad set of 23 “hospital required” and 25 Eligible Professionals (EP) objectives. The all-or-nothing approach was felt to be too rigorous and unachievable for the providers.
The final regulation has been structured to be more flexible for the providers while still providing significant improvement in the delivery of care in the United States.  
Listed below are some of the key changes to the regulation:
  • In order to provide flexibility to achieve the Stage One criteria, the requirements will be segmented into “Core” and “Menu Set” requirements. All Eligible Hospitals and EPs will need to meet “Core” requirements, 14 and 15 respectively. The requirements vary slightly between the two settings of care. Additionally, ten (10) “Menu Set” requirements have been identified. These also vary slightly between the two settings of care. Both Eligible Hospitals and EPs will choose 5 items to meet for “Stage One.”
     
  • Computerized Order Physician Entry (CPOE) requirement has been modified to “more than 30% of patients with at least one medication in their medication list that has been ordered through CPOE.”
     
  • Several of the previously stated required measurements have been reduced or changed so that the criteria are achievable.
     
  • The number of required Clinical Quality Measures to report to CMS has been reduced.
     
  • Added “Menu Set” objectives (1) to provide conditional, specific educational materials to the patient and (2) to record advanced directives for patients older than 65 years of age.
     
  • Removed the objective for electronic claims submission and insurance validation.
     
  • “Hospital Based” defined as an EP who performs substantially all of their services in an inpatient setting or emergency room only.
An outline of the regulation highlights and the changes have been included as an attachment.  
Key Dates:
Timing Activity
July 1, 2010
 
ONC started accepting applications for ONC-Authorized Testing and Certification Entities
 
Fall 2010
 
ONC projects certified EHR software will be available
 
January 2011 
 
Eligible hospitals and EP may register for incentive program on CMS website
 
April 2011
 
Medicare program attestation may begin 
(mid) May 2011    
 
Medicare EHR pay will begin
 
May 2011
 
States could begin initiating incentive payment programs on a rolling basis, subject to CMS approval of the State Medicare HIT plan 
 
This regulation is a major piece of the HITECH legislation. It is felt that this final rule strikes a balance between what is achievable for the hospital and the EPs while still rigorous enough to lay the ground work for a 21st century healthcare system in the United States.  
As your partner, CareTech will continue to educate you through this process. We welcome your inquires and work on your behalf to help you achieve all of your IT strategic goals including Meaningful Use.
“Get ready to set your GPS. The road to a 21st century healthcare system, through the Meaningful Use of an electronic healthcare record, is ready.”
Paula Gwyn, Strategic Planning, CareTech Solutions
Contact us for more information