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Breaking News

CMS is extending the submission deadline for 2016 Quality Reporting Document Architecture (QRDA) data

CMS is extending the submission deadline for 2016 Quality Reporting Document Architecture (QRDA) data submission for the EHR reporting mechanism. Individual eligible professionals (EPs), PQRS group practices, qualified clinical data registries (QCDRs), and qualified EHR data submission vendors (DSVs) now have until March 13, 2017 to submit 2016 EHR data via QRDA. The original submission deadline was February 28, 2017.

March 13, 2017 deadline:

  • EHR Direct or Data Submission Vendor (DSV) submitting QRDA I or III ==> 3/13/17
  • Qualified Clinical Data Registries (QRDA III) ==> 3/13/17

The deadline for Qualified Registries (Registry XML) and QCDRs has also been pushed out to 3/31/17. Submission ends at 8:00 p.m. Eastern Time (ET) on the end date listed.

On the hospital side, CMS had previously announced an extension to March 13, 2017 for submission of eQCM data to IQR.

National Emergency Preparedness Requirements Includes Rural Health Clinics

On September 16th 2016, CMS released a final rule which established national emergency preparedness requirements for Medicare and Medicaid participating providers to prepare and plan for disasters. CMS's goal is to ensure that the providers and suppliers are prepared during emergencies and disasters. CMS found that previous requirements did "not go far enough" to guarantee the safety of patients during emergencies.

This includes Rural Health Clinic regulations which have been significantly expanded as we will discuss below... (read more)

State Rates of 2015 Physician EHR Adoption and Interoperability Now Available

The Health IT Data Summaries Web-App is now live with updates to physician EHR adoption, interoperability and patient engagement statistics. The app provides direct access to state level estimates for a variety of different metrics that measure the percent of physicians who have certified EHRs; who are able to send, receive, find and use patient health information; and who provide their patients the ability to view, download and transmit their personal health information. The app is mobile-responsive, so check it out on your phone or tablet

Rural Health Clinics Must Comply with Section 1557 Provisions by Oct 16, 2016

On October 16, Section 1557 of the Affordable Care Act goes into effect. This section is designed to provide meaningful access to individuals with Limited English Proficiency (LEP) among other things. Those affected by the provisions include all physicians receiving financial assistance from HHS (except solely Medicare Part B). According to the final rule, rural health clinics are considered covered entities and will need to comply with the provisions.

In general, RHCs must post taglines and notices concerning the availability of language assistance for non-English speaking individuals. A tagline is a "short statement written in non-English informing individuals that language assistance services are available free of charge." The taglines must be posted in the 15 most spoken languages in each state; a list of most spoken languages was published by CMS here.

Section 1557 is intended to prevent any health programs that receive federal money from discriminating on the basis of race, color, national origin, sex, age, or disability. The rules require no-cost language assistance for individuals with LEP. The rules also specify how written and oral communication must be interpreted; stating that a "qualified translator" must be used when translating written content and oral interpretation must be provided when it is a reasonable step to provide meaningful access. Section 1557 also requires that if the covered entity has 15 or more employees, there must be an employee designated to handle 1557 compliance and grievance procedures.

Besides its protections for individuals with LEP, the section also: extends protections against sex discrimination, incorporates laws that aim to prevent disability-based discrimination, and prohibits discriminatory health insurance benefit designs.

HHS has provided the following resources to assist with compliance:

HITECH Answers, Sep 30, 2016

Weekly News Digest: National Health IT Week; Health Information Exchange and Meaningful Use

HCPCS Reporting Changes - Oct. 1

From the Desks of Bill Finerfrock and Nathan Baugh

Hopefully everyone is aware of the HCPCS reporting changes set to kick in next week. The best place to review those changes is here: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE1611.pdf

We also wanted to clarify a few things regarding these changes.

1-The CG modifier should be used even when the only service listed on the UB-04 claim is a preventive service.

2-HCPCS codes G0436 and G0437 will be discontinued effective for dates of service after 10/1/2016. The proper codes for tobacco cessation counseling are 99406 and 99407.

3-For purposes of RHC billing, modifiers 25 and 59 are interchangeable. We have confirmed this with CMS.

National Health IT Week is Sept 26-30, 2016

It's National Health IT Week! Learn more to make the most of it.

EHR Availability in Missouri - Reports Available

In addition to the local public health agencies report available earlier, the following provider reports presenting survey results are now available.

Important Dates for Missouri State Level Registry

Missouri's State Level Registry (SLR) will open for Program Year 2015 for Eligible Hospitals starting September 1, 2016 and remain open through November 30, 2016.

In addition, the SLR will open for Program Year 2016 attestations for Eligible Professionals (EPs) starting September 1, 2016 and remain open through March 31, 2017.

At this time, the SLR will only accept applications for EPs attesting to either AIU (Adopt, Implement, or Upgrade) or their first year of Meaningful Use (MU) in Program Year 2016.

CMS has issued a proposed rule that would change the EHR reporting period to 90 days for PY 2016 for all EPs returning to attest to MU for at least their second time (years 3 – 6). We will announce the date that the SLR will accept applications for EPs returning to attest to MU, after we know the outcome of the proposed rule.

Couldn't Meet 2015 MU? You May Qualify for a Hardship Exception!

CMS has streamlined the hardship exception application process for eligible providers (EPs), eligible hospitals (EHs), and CAHs who experienced significant hardship preventing successful participation. They now allow "categories" of EPs, EHs, and CAHs, and groups of providers to apply for a hardship exception on a single application.

EPs, EHs, and CAHs who did not meet MU for 2015 can apply for a hardship exception prior to July 1, 2016.

Even if you are in the Medicaid EHR incentive program, you will receive penalties to Medicare Part B billings in 2017 if you didn't attest to MU in 2015.

Applications and instructions are available on the EHR Incentive Programs website.

Download the Hardship Exception Application now.

PQRS GPRO Reporting Webinars

NYeC is hosting an overview webinar for 2016 PQRS GPRO reporting on May 26 and June 7. Any group practice with 2 or more providers who bill under the same TIN are invited to register and participate in the webinar. To learn about 2016 changes, strategies to meet PQRS requirements, and how to avoid a 2% potential penalty. Practices that plan to use the GPRO reporting method for 2016 PQRS must take action before June 30th.

Missouri's State Level Registry will be open for Program Year 2015 attestations for Eligible Professionals only on Friday, April 29 and remain open through June 30, 2016.

The attestation period for Program Year 2015 for Eligible Hospitals will begin in September - exact dates will be announced in the fall.

Program Year 2016 is the last year that providers can begin participation - attestations for that program year will be accepted starting later this year.

For more information: http://mo.arraincentive.com/

On April 6th, 2016, the Centers for Medicare & Medicaid Services (CMS) posted the annual update for electronic clinical quality measures (eCQMs) for eligible hospitals and eligible professionals. Providers will use these updated measures to electronically report 2017 quality data for CMS quality reporting programs.

CMS updates the specifications annually to improve their alignment with current clinical guidelines and code systems so that they remain relevant and actionable within the clinical care setting.

Where to Find the Updated Measures

The updated measure specifications are available on the CMS website eCQM Library and the Electronic Clinical Quality Improvement (eCQI) Resource Center.

  • 29 updated measures for eligible hospitals for the 2017 reporting period

Reporting period for eligible hospitals is defined as the measure data capture period of the calendar year between January 1 and December 31.

  • 64 updated measures for eligible professionals for the 2017 performance period

Performance period for eligible professionals is defined as the measure data capture period of the calendar year between January 1 and December 31.

All of the updated measure specifications have been re-specified using QDM 4.2 based-HQMF version R 2.1.

How to Download the Measures

To download the measures from CMS.gov, pull down the entire set of EH or EP measures in their respective zip files using the links.

To obtain the value sets for the eCQMs, you can download packages in multiple file formats from the "Downloads" page at the Value Set Authority Center (VSAC). The value sets are available as a complete set, as well as value sets per measure. You will be required to login with Unified Medical Language System® Metathesaurus License credentials, also available through the VSAC website. The Data Element Catalog, an additional resource linked on the VSAC home page, contains the complete list of updated eCQMs and value set names.

Additional eCQM Resources can be found on the eCQI Resource Center.


Continuing Education Credits

Learning and Action Virtual Annual Conference on Thursday, April 7

Please plan to attend the TMF QIN-QIO "Learning and Action Virtual Annual Conference" on Thursday, April 7! This is a free all-day virtual event offering continuing education credits. The agenda is packed full of excellent topics and speakers, and there's something for everyone.

For more information, please visit the Event Web page: https://www.tmfqin.org/2016-Virtual-LAN-Event

Please Register at your earliest convenience: Registration page: Register Now!

We are excited to share the Health IT Buzz Blog announcing the release of the Million Hearts® EHR Optimization Guides. These vendor-specific guides offer step by step instructions for providers to leverage their EHR systems to find, use, and improve data on cardiovascular measures. We anticipate these guides will facilitate the identification of at-risk patients, and hope that they will help providers and clinical teams protect their patients from heart attacks, strokes, and other cardiovascular events. So far, we have completed guides for Allscripts, Cerner, and NextGen, though we are working with other EHR vendors to develop additional guides to be posted on the Million Hearts® Resource Center of HealthIT.gov.


About Million Hearts®

Million Hearts® is a national initiative to prevent 1 million heart attacks and strokes by 2017. It unites communities, health systems, nonprofit organizations, federal agencies, and private-sector partners from across the country to fight heart disease and stroke by improving the ABCS: Aspirin therapy, Blood pressure control, Cholesterol management, and Smoking cessation.

Important Reminder to Medicaid Providers: The Medicaid EHR Meaningful Use Incentive Program is in effect until 2021.

Attestations for Program Year 2015 will be accepted in Missouri's State Level Registry beginning in April, specific dates to be announced soon.

Program Year 2016 is the last year that providers can begin participation - attestations for that program year will be accepted starting later this year.

EHR Payment Adjustments & Hardship Information
The streamlined hardship applications reduce the amount of information that eligible professionals (EPs), eligible hospitals, and CAHs must submit to apply for an exception. The new applications and instructions for a hardship exception from the Medicare Electronic Health Records Incentive Program 2017 payment adjustment are available here. This link also includes information regarding payment adjustment reconsideration application instructions for the Medicare EHR incentive program.

EHR Incentive Programs: Where We Go Next (Centers for Medicare & Medicaid Services)

As we mentioned in a speech last week, the Administration is working on an important transition for the Electronic Health Record (EHR) Incentive Program. We have been working side by side with physician organizations and have listened to the needs and concerns of many about how... (more)

CMS to End Meaningful Use in 2016

The Centers for Medicare and Medicaid Services (CMS) announced this week that it will be ending the "meaningful use" EHR Incentive Program in 2016.

The announcement-delivered by CMS Acting Administrator Andy Slavitt in a speech at a J.P. Morgan Healthcare Conference on Tuesday-follows months of requests from physician and other health stakeholder groups to slow the program down and loosen its requirements.

CMS had announced stage 3 meaningful use guidelines in October which followed a series of proposed changes to the program, including payment adjustments and the creation of hardship exemptions.

In remarks at the J.P. Morgan conference and on Twitter, Slavitt said further specifics on exactly what will replace meaningful use will be forthcoming, though it will be tied to the implementation of Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and include streamlining various quality reporting programs.

What remains to be seen, however, is whether CMS will still penalize eligible providers for not meeting stage 1 meaningful use requirements, or whether eligible providers should even bother continuing to track their progress on the meaningful use measures for reporting this year. Albright declined to respond to those questions at press time.

CMS seeks public comment on HIT and EHR products

Hardship Exemption from 2015 Meaningful Use Penalties

CMS Releases Final Meaningful Use Program Rules


"EHRJumpStart" Webinar for March: "Selecting an EHR"

March 2, 2012 - Our very popular "EHR JumpStart" Webinar series continues this month with the topic "Selecting an EHR" at noon on Thursday, March 15, 2012. Margalit Gur-Arie, founding partner, EHR Pathway, a Missouri Health Information Technology Assistance Center Partner, will show you how to narrow the field of hundreds of EHR products to find just the right one to fit your needs and budget. Margalit will talk about:

   Your goals
   Your constraints
   Your requirements Read more »

MO HealthNet and CMS Make Important Announcements

March 1, 2012 - MO HealthNet recently announced that Missouri providers now have until March 30, 2012, to submit to the State Level Registry (SLR) system an attestation for a 2011 adoption, implementation, or update (AIU) of a certified EHR. The original date for a 2011 attestation to AIU of an EHR was February 29, 2012. There will be no future extensions for 2011 AIU attestations. Read more »

Moving Forward with E-prescribe: Requirements, State Law, and Meaningful Use Webinar (MO HIT Assistance Center Advanced Webinar Series)

February 29, 2012 - As part of Stage 1 Meaningful Use, providers are required to demonstrate their ability to use E-prescribing to check for patient drug-allergy and drug-drug interaction. This month, the MO HIT Assistance Center will host an advanced Webinar that will dive into E-prescribing and its connection to meaningful use. Please join us at 11:30 am on Wednesday, March 7th for this one-hour presentation given by Sandra Pogones, program manager at Primaris, a MO HIT Assistance Center partner. Read more »

Missouri's Health Data Summit: Improving Health Through Innovative Data Utilization

February 15, 2012 - Health data aggregation is one of the greatest benefits of electronic health records. These data provide new insight on health to fuel innovation. On February 24, you are invited to discuss ways to improve the use of health data at the Missouri Health Data Summit in St. Louis. The event will be held at the Danforth Plant Science Center located at 975 North Warson Road. Read more »

New Tool Streamlines Patient-Centered Medical Home Accreditation: MO HIT Assistance Center Partners Offers Free Web-Based Tool for Practices

February 14, 2012 - Keeping pace with electronic regulatory documentation processes, like Patient-Centered Medical Home accreditation, can stress and overwhelm even the most organized and experienced practice. As the regional extension center for Missouri, we see how it can strain, confuse, and frustrate providers. But, we know with the right support, you can survive, and even thrive in this new, evolving electronic landscape. Read more »

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Are You Eligible?

Check this CMS Flow Chart to help determine your eligibility for the Medicare and Medicaid EHR incentive programs.

EHR Success Stories

Here's a recap of some of the highlights in 2015! Read a holiday message from MU Health CEO & COO Mitch Wasden:

The devastating tornado that swept through Joplin, Missouri on May 22 completely destroyed a number of physician offices, including that of Tracy Godfrey, MD, a Family Practitioner with the Family Health Center of Joplin. But thanks to electronic health records, Godfrey had access to all of her patients' information, and in less than three days after the catastrophe, the practice was able to reopen its doors at a temporary location. More EHR Success Stories