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Washington Debrief: CMS Wants Formal Commitment from EHRs Vendors for New Payment Model

April 18, 2016
by Leslie Kriegstein, Vice President of Congressional Affairs, CHIME
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Federal Affairs

Medicare Primary Care Model Would Include MOU with EHR Developers

Key Takeaway: The new Comprehensive Primary Care Plus (CPC+) model unveiled by the Centers for Medicare and Medicaid Services (CMS) would warrant those physicians in the great risk track, Track 2, to commit to enhanced health IT.

Why It Matters: CMS cites that given the high expectations of those physicians assuming greater risk, vendors will need to formally offer their support the CPC+ participants in a Memorandum of Understanding (MOU) directly with the agency.

Practices, regardless of chosen track, will be required to use Certified Electronic Health Record Technology (CEHRT), and will be expected to submit electronic clinical quality measures (eCQMs) at the practice-level. CMS offers the increased emphasis on population-health and team-based structure as key components of the advanced health IT capabilities necessary for CPC+.

Beginning in January 2017, CPC+ is a five-year model, that is expected include 20,000 clinicians and 25 million Medicare beneficiaries. The model would work with Medicare, Medicaid and private payers to pay doctors a bonus, $15 or $28 per patient, depending on track, in an effort to combat chronic illness.

NIST Seeking Healthcare Participants for Federated Identity Pilot Grant

Key Takeaway: The National Institute for Standards and Technology (NIST) is soliciting applications for a grant to pilot the use of federated online identity solution for patients and providers across multiple healthcare providers.

Why It Matters: NIST, through the National Strategy for Trusted Identities in Cyberspace (NSTIC) initiative is offering grant funding of up to $2 million to healthcare providers who can pilot federated credential solution in which at least two hospitals or regional healthcare systems accept a federated, verified identity that leverages multi-factor authentication and an effective identity proofing process. 

NSTIC will be holding a webinar on Monday, April 18 from 3:00 – 4:30 p.m. for those interested in learning more about the grant opportunity.

Applications are due on June 1, 2016.  NIST expects notifying successful applications in September 2016, with the earliest expected start date of a pilot to be October 1, 2016. 

Congressional Affairs

Senator Asks FBI About Precedent of Hospitals Paying Ransom to Regain Data Access

Key Takeaway: A Senator sent a letter earlier this month to the Federal Bureau of Investigation (FBI) inquiring about the precedent set when ransoms are paid by healthcare organizations following ransomware attacks.

Why It Matters: Expressing concern with the uptick in hospitals falling victim to ransomware attacks, Senator Barbara Boxer, questioned whether paying the bad actors will only perpetuate the increasing trend of threats to healthcare institutions. She also asked what the FBI is doing to combat such threats and what action is being taken to investigate these crimes.

Earlier this year Senator Boxer penned a letter to the head officials at the five largest medical device manufacturers requesting they articulate their efforts to secure devices against cyber threats.

All Eyes on MACRA

Key Takeaway: The House Energy & Commerce Committee will hear from physician groups this week in a hearing concerning preparation for the transition to pending reimbursement policy changes resulting from the Medicare Access and Chip Reauthorization Act (MACRA).

Why It Matters: With the draft rules for the new MACRA payment policies, the Merit-based Incentive Payment System (MIPS) and alternative payment models (APMs), under review at the Office of Management and Budget (OMB), Congress and the provider community continue efforts to prepare for the first program year under the new policies which is expected to begin on January 1, 2017.

The Committee heard from Dr. Patrick Conway, M.D., deputy administrator for innovation and quality at CMS, last month, during a hearing that focused largely on current capabilities of the industry to measure value and outcomes in the fashion that will be necessary for participation in MIPS or an APM. During that hearing, Dr. Conway alluded to forthcoming coming flexibility under the Meaningful Use program, which becomes one of four performance categories for those physicians participating in MIPS.