D.C. Report: Looking Ahead to the Fiscal Cliff, Stage 3 Meaningful Use

•        Were unable to e-prescribe because of certain laws or regulations;
•        Generated fewer than 100 prescriptions during a six-month reporting period;
•        Practice in an area that has a limited number of pharmacies with e-prescribing capabilities;
•        Prescribe large volumes of narcotics; or
•        Work in a rural area that has limited access to high-speed Internet."

CMS proposed two new extensions - eligible providers or groups participating in meaningful use are now eligible for the exemption to prevent them from having to implement a separate e-prescribing module while implementing an EHR based on conflicting different deadlines for the two programs.  E-prescribing is not available until an EHR has been fully implemented, thus if a provider chose an attestation period later in 2012, they would have missed the deadline to submit ten e-prescriptions by June 30, 2012.  The new deadline for filing a hardship extension is January 31, 2013. Read more about the exemptions here.

Study: Patient Centered Medical Homes on the Rise Half of the nation has implemented new payment changes to expand access to patient-centered medical homes in Medicaid or the State Children's Health Insurance Program, a report in Health Affairs found.  The initiatives vary widely, according to the report. For example, 12 states include multiple public and private payers; 19 pay providers a monthly care management fee in addition to the standard fee-for-service payment; 14 provide performance-based payments; and five provide payments to support up-front costs. Although no state has implemented global payments that hold a group of providers at financial risk for the care that patients receive in a given time period, five states are using their experience with medical home initiatives to move toward accountable care payment models, the study notes. The medical home model uses care teams led by primary care providers to coordinate and integrate care for chronically ill and other patient populations in an effort to improve care and lower costs.