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CMS and ONC Release Final EHR Rules

Tuesday, July 13, 2010

UPDATE: CMS and ONC Release Final EHR Rules

On July 13, 2010, the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) announced two final rules intended to lay the groundwork for the nation’s transition to electronic health records (EHRs). These rules will govern the health information technology initial set of standards, implementation specifications and certification criteria for EHRs as well as the criteria to award incentive payments for the adoption and meaningful use of certified EHRs.

Under the final rule, only those anesthesiologists who provide 90% or more of their covered services in an inpatient or emergency room setting will be exempt from the penalties that will begin in 2015 if a provider fails to meet the meaningful use requirements. In addition, those anesthesiologists who are not exempt and are deemed “eligible professionals” will find it difficult to meet the meaningful use requirements because the measures either do not apply to anesthesiology or they are not reportable through an AIMS.

While ASA raised these concerns in both its written comments and discussions with Administration officials, the final rule still does not account for anesthesiology’s unique practice and use of AIMS. For example, in March, ASA submitted comprehensive comments to CMS on its proposed “meaningful use” rule and recently met with top CMS officials to discuss how the rule would uniquely impact the practice of anesthesiology and the adoption and use of anesthesia information management systems (AIMS): EHRs for anesthesia.

Despite ASA’s best efforts to date, the use of AIMS was not specifically addressed or considered in CMS’ proposed or final rule. Indeed, based on CMS’ own Medicare figures, many anesthesiologists would be subject to future payment penalties because the new requirements to demonstrate meaningful use of EHRs do not apply to the way anesthesiologists practice medicine. This situation stands in stark contrast to what Congress intended in the original statute when it sought to exempt certain hospital-based physicians such as pathologists, anesthesiologists and emergency physicians from the meaningful use requirements and future penalties.

ASA strongly supports the goal of expanding the adoption and meaningful use of electronic health records in all patient care settings, but we need a system and incentives and rewards that reflect anesthesiology practice patterns. To this end we will continue to lobby CMS and HHS in an effort to ensure that the rules are appropriately applied to anesthesiologists, wherever they practice. Further details will be provided as we review the over 1000 pages of these complex new rules.

The links to the final rules are posted below. Please continue to check ASAhq.org for updates.

CMS Rule on Electronic Health Record Incentive Program

ONC Rule on Initial Set of Standards, Implementation, Specifications, and Certification Criteria for Electronic Health Record Technology

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