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Washington Debrief: CMS Extends Attestation Period for 2013 Reporting Year

February 10, 2014
by Jeff Smith, Director of Public Policy at CHIME
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Jeff Smith, Director of Public Policy at CHIME

CMS Extends Attestation Period for 2013 Reporting Year; 2014 Requirements Remain

Key Takeaway: CMS has granted a reprieve to providers unable to attest to Meaningful Use for fiscal year 2013 because of technical problems with the attestation website. The original deadline for attesting was Feb. 28, 2014, but CMS announced last week that eligible professionals now have until March 31. Eligible hospitals' reporting deadline has already passed, but CMS is allowing them to retroactively attest to meaningful use through March 15.

Why it Matters: The extension will provide more time for providers to submit data and receive an incentive payment for 2013, as well as avoid the 2015 penalties. CIOs should continue to monitor the performance of the attestation website and contact the EHR Incentive Program Help Desk to report problems.

Faced with mounting complaints over a slow and non-functioning attestation website, CMS announced last week that it was giving additional time for providers to attest to Meaningful Use for program year 2013. CIOs were reporting system freezes and slow-loading pages associated with CMS’s attestation website for weeks. In response, CMS pushed out the deadline for eligible professionals (EPs) to attest until the end of March and gave hospitals (some of which have been trying attest since November) until March 15. CMS said it also will look to improve site performance by conducting upgrades.

Any CIOs whose organizations are continuing to have problems should contact the “EHR Incentive Program Help Desk” and consider communicating their issues with CHIME staff. However, these deadline extensions don’t affect 2014 reporting year requirements: eligible hospitals (EHs) have to begin collecting data using 2014 Edition CEHRT by July 1, and EPs have until Oct. 1 to meet new meaningful use requirements.

 
Administration

Federal Health Agencies Preview Standards, Interoperability Work in 2014

Key Takeaway: The Office of the National Coordinator (ONC) has been quietly teasing out a roadmap for interoperability over the last few weeks. Food and Drug Administration (FDA) officials say they have plans to release draft guidance in 2014 on how manufacturers can improve the interoperability of medical devices.

Why it Matters: The regulatory realms of FDA, ONC and other federal agencies is converging. Developing a clear standards strategy and roadmap for interoperability will be one of the most important policy conversations in 2014. Moreover, each agency described the need to create “test beds,” and that could directly impact healthcare CIOs.

During an event held in Washington last week, officials from ONC and FDA discussed their views on the current state of interoperability and offered thoughts on where their agencies may collaborate in the future. ONC’s Chief Science Officer, Doug Fridsma, M.D. and Jeffrey Shuren, M.D., Director of the FDA's Center for Devices and Radiological Health, said both agencies are working to align standards for medical devices and electronic health records. During a presentation at the Health IT Policy Committee, Dr. Fridsma unveiled his Office’s strategy to develop standards that “leverages government as a platform” and builds “incremental steps,” towards standards interoperability. Likewise, Dr. Shuren said his office would issue, “draft guidance this coming year about how we think about interoperability and issue recommendations for how devices manufactures should be thinking about it.”

Several policy pieces are beginning to surface, and CHIME Public Policy will ensure that healthcare IT executives continue to have a voice in the conversations. If you’re interested in lending your experience, please contact Jeff Smith, Senior Director of Federal Affairs, at jsmith@cio-chime.org.

ONC Looks to Fill Seats on Federal Advisory Committees

Key Takeaway: ONC is looking to fill four spots on its Health IT Policy Committee and Health IT Standards Committee.

Why it Matters: Much of the policymaking for meaningful use and other health IT programs comes from these committees. Very few CIOs sit on these groups, and their experience as implementers is greatly needed.

The Office of the National Coordinator for Health IT (ONC) is seeking applications to fill vacant positions on its Federal Advisory Committees (FACAs). There are three vacant positions on the Health IT Standards Committee and one vacant position on the Health IT Policy Committee.

Interested candidates can apply for the following positions:

All applications are due to ONC by Monday, March 3, 2014 at 12 pm ET using its applications database. Interested CIOs should contact Jeff Smith for more information.

Legislation & Politics

Doc-Fix Compromise Bill Published, Changes Coming to Incentive Programs

Key Takeaway: Last week, lawmakers from both the House and Senate published a bill that would repeal and replace the Sustainable Growth Rate (SGR) formula.

Why it Matters: The bill combines three incentive programs into one single program, which would alter the penalties for Meaningful Use, the Physician Quality Reporting System and Value-Based Modifier beginning in 2018. Language also mandates that EHR systems must be interoperable by 2017.

Members of the House Ways & Means, Energy & Commerce and Senate Finance committees agreed to a plan that would repeal the current SGR and replace it with a 0.5% payment increase for Medicare physicians each year from 2014 until 2018, when new risk-based adjustments will begin. The bill emphasizes participation in alternative payment models, such as ACOs, and attempts to move away from traditional fee-for-service reimbursement. The bill also combines three incentive programs into one single program, called the Merit-Based Incentive Payment System (MIPS). The current penalties and/or incentives for Meaningful Use, PQRS and value-based modifiers will continue through 2017, but in 2018, Medicare physicians would receive bonus payments or penalties based on a composite score of these programs. Scores will be determined by performance based on quality measures published each year, meaningful use of EHRs and clinical practice improvement activities.

According to a bill summary, from 2018 to 2023, physicians may be awarded a 5% increase in payments each year if they receive a significant share of their revenues through an alternative payment model. The bill also mandates that EHR systems must be interoperable by 2017 and “prohibits providers from deliberately blocking information sharing with other EHR vendor products.” The committees now have to find a way to pay for the bill and pass it by March 31. The Congressional Budget Office estimated that repealing the SGR formula will cost $120 billion to $150 billion over ten years.

CHIME News & Notes

CHIME CIOs Explain ‘Why Public Policy Matters’

During a recent College LIVE event, two CHIME Board members discussed “the Alphabet Soup” of federal government. Charles Christian, VP and CIO at St. Francis Hospital, and Indranil Ganguly, VP and CIO at JFK Health System, explained how CHIME works with federal agencies and discussed why CIOs should care. “Part of every CIO’s job is to anticipate the future and to plan for that future. If I plan for a future without an understanding of the political and policy context, especially in healthcare, I’m not doing my job,” said Christian during the online event. “We can either try to predict how the future looks, or – through CHIME Public Policy – we can shape the future we want,” added Mr. Ganguly. For an archive of the session and slides, click here.

Going to HIMSS14 and Interested in Meeting Government Officials?

CHIME Public Policy is busy coordinating meetings with leaders at CMS, ONC and other federal agencies. Please contact Jeff Smith, Sr. Director of Federal Affairs, for more information on times and dates.

Edited by Gabriel Perna for style.


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