Medicare Physician Payment Proposed Rule Has Health IT Implications

July 11, 2015 in News

On Wednesday, CMS released a proposed rule with several health IT implications, including requirements for electronic health records, physician quality reporting and telehealth, Modern Healthcare reports.

The health IT-related changes are part of CMS’ proposed updates to the 2016 Medicare Physician Fee Schedule. CMS is accepting comments on the proposal through Sept. 8 (Robeznieks/Dickson, Modern Healthcare, 7/9).

EHR Implications

Under the proposed rule, federally qualified health centers and rural clinics would be required to use EHR technology certified for 2014 Edition meaningful use requirements to receive higher reimbursements for treating patients with at least two chronic conditions.

Under the 2009 economic stimulus package, health care providers who demonstrate meaningful use of certified EHR systems can qualify for Medicaid and Medicare incentive payments.

The proposal did not specify how much higher the payments would be for using the certified EHR technology.

CMS also proposed requiring:

  • Care plan information to be available 24/7 and sharing such information electronically when appropriate; and
  • Minimum EHR capabilities that support data sharing to better coordinate care.

In the proposed rule, CMS said, “Certified health IT must be used for the recording of demographic information, health-related problems, medications and medication allergies, a clinical summary record and other scope of service requirements that reference a health or medical record” (Goedert, Health Data Management, 7/10).

Telehealth Implications

CMS also proposed several changes to Medicare’s telehealth coverage policy, Modern Healthcare reports (Modern Healthcare, 7/9).

Under the proposed rule, CMS in 2016 would start paying for some in-home telehealth services, including those related to:

  • End-stage renal disease counseling; and
  • Prolonged observation “requiring unit/floor time beyond the usual service” for inpatient settings (Tahir/Pittman, “Morning eHealth,” Politico, 7/9).

In addition, CMS would add registered nurse anesthetists to Medicare’s list of qualified telehealth providers for services, such as evaluation and management (Modern Healthcare, 7/9).

Krista Drobac, executive director of the Alliance for Connected Care, said, “CMS’ creativity in allowing home use [of telehealth services] under certain circumstances is great, but we still need an act of Congress to make it available to all Medicare beneficiaries,” noting that only rural patients would have access under the current proposal (“Morning eHealth,” Politico, 7/9).

Physician Reporting Implications

Meanwhile, CMS also proposed using star ratings for its Physician Compare website, AHA News reports (AHA News, 7/8).

Further, the proposed rule would implement the use of a green check mark to identify providers who have received upward adjustments for cost and quality (Modern Healthcare, 7/9).

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