Stage 2 Proposed Rules Published

CMS has published a proposed rule providing standards and guidance for Stage 2 of the Medicare and Medicaid EHR Incentive Program (the “Program”).  The CMS proposed rule explains the requirements that eligible professionals and hospitals must meet to qualify for meaningful use incentive payments under the Program.

The Office of the National Coordinator for Health Information Technology (“ONC”) has also issued Stage 2 certification standards.  The ONC standards establish the technical requirements that electronic health records (“EHR”) must meet to become certified as supporting Stage 2 meaningful use criteria.

Basically, the CMS proposed rule governs the requirements that providers must meet in order to qualify for meaningful use and successfully obtain EHR incentive payments.  The ONC certification standards govern the requirements that EHR must meet so that such EHR can be used by providers to qualify for meaningful use.

Stage 2 of the Program is set to begin no earlier than 2014 (for participants who met the Stage 1 requirements in 2011 or 2012).  Comments on both proposed rules are due by 5:00 p.m. on May 7, 2012.

© 2012 Parsonage Vandenack Williams LLC

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E-Prescribing Significant Hardship Exemption Deadline is November 1

Just a reminder that the deadline for requesting significant hardship exemptions under the Medicare electronic prescribing (“eRx”) incentive program is November 1, 2011

Starting in 2012, eligible professionals who are not successful electronic prescribers under the eRx incentive program will be subject to a payment adjustment. The final rule incorporates four additional hardship exemptions for purposes of the 2012 payment adjustment, including the following exemptions:

  • Registration to participate in the Medicare or Medicaid EHR incentive programs and adoption of certified EHR technology.
  • Inability to electronically prescribe due to local, state or federal law or regulation
  • Limited prescribing activity.
  • Insufficient opportunities to report the electronic prescribing measure.

The exemption requests must be made using a web-based tool available on the eRx incentive program website at

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Proposed Rule Gives Physicians a Break on Requirement to Electronically Submit Quality Measures

The Centers for Medicare and Medicaid Services (CMS) gave physicians a break (albeit brief) its recent proposed rule on meaningful use reporting requirements for electronic health records (EHRs).

The proposed rule would permit eligible providers to continue to report certified EHR clinical quality measure results by attestation through 2012. Absent the proposed rule’s enactment, EPs will need to submit quality measures electronically to CMS in 2012.

Note that eligible providers who are willing and able to submit clinical quality measures electronically in 2012 can maximize incentive payments and meet meaningful use requirements by participating in the newly-announced Physician Quality Reporting System-Medicare EHR Incentive Pilot.

Physicians who submit clinical quality measures for the entire year using one of the specified electronic options would be eligible for incentive payments from both the physician quality reporting system and the EHR programs.

Physicians who initially attest that they will participate in the Physician Quality Reporting System-Medicare EHR Incentive Pilot but are then unable to participate can still submit quality measures using the CMS attestation module.

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Reminder to Physicians: Meaningful Use Checks are Arriving

On May 19, the Centers for Medicare and Medicaid Services (“CMS”) mailed the first checks for the Medicare incentive program to physicians who had attested that they had achieved meaningful use of their electronic health records (EHRs).

EHR incentive payments are also available to eligible professionals from state Medicaid programs.  However, the Medicaid program has different incentive requirements.

The actual arrival of checks from Medicare should encourage more doctors to acquire EHRs and demonstrate meaningful use. The checks show that meaningful use and successful EHR implementation is certainly achievable.

Given EHR is going to be the standard of practice and physicians will eventually need to implement EHR systems, there is no better time than the present to get started.

We do not have our EHR incentive program outline on the PVWLaw website because we were only providing to clients.  I could do the same thing we did with some of the health care bill articles and state “PVWLaw has prepared a comprehensive outline on the EHR incentive programs called “EHR Incentive Program Outline”.  If you would like to receive a copy of the outline, please email the following information to and we will reply promptly including a pdf attachment of the document requested:

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© 2011 Parsonage Vandenack Williams LLC

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