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Our attorneys stay on top of changes in legislation, agency regulations, case law, and industry trends—then craft timely legal alerts to keep clients up to date on legal developments important to their business.

March 9, 2012

Meaningful Use "Stage 2" Criteria Introduced in Proposed Rule

The public comment period for the proposed Stage 2 criteria for meaningful use is now open. This rule has significant implications both for providers who have already begun the transition to electronic health records (EHRs) and for those providers who have not yet started the migration to EHRs.

The proposed rule, published on March 7, 2012, sets forth the anticipated Stage 2 criteria and also modifies some of the existing rules and deadlines, a move which the Office of the National Coordinator (ONC) submits will assist eligible providers obtain "meaningful use." For example, no provider will need to attest to the Stage 2 criteria until 2014 (previously it was 2013) and the rules for a Medicaid EHR incentive will be changed to allow more Medicaid providers to earn incentive payments.

The Stage 2 criteria follows what is now a familiar scheme: eligible providers (EPs) must meet or qualify for an exclusion to certain "core set" criteria and must also meet certain criteria they choose from a "menu set." The EPs will be eligible to receive the incentive payments based on their report of "Clinical Quality Measures" (CQMs) in connection to these criteria. As expected, Stage 2 places an emphasis on the interoperability of records, which will compel providers to work with their local health information exchange to connect with other providers and with the public health departments. The rule specifies that EPs must be able to use their EHR systems to transmit "summary of care" documents with referrals, to engage in electronic prescribing, to make health information available online to patients, and to submit certain public health information to the proper authorities.

The "summary care record" is a fresh concept with the Stage 2 proposed rule. EHR systems must generate a "summary of care" record which will include the patient name, referring EP's contact information, procedures, relevant past diagnosis, laboratory test results, vital signs, smoking status, demographic information, and, if applicable, discharge instructions. The previous iterations of the "meaningful use"' rule required the exchange of much of the same data that the summary care record will capture, but instead contemplated that each piece of data would be transmitted separately. Feedback from providers who have already achieved Stage 1 meaningful use suggests that the summary record will cut down on administration and reporting costs, thus making meaningful use easier to achieve.

Hiscock & Barclay can use its extensive knowledge and experience regarding the use of health information technology across New York State to help steer your organization as it transitions from paper to electronic health records. Hiscock & Barclay can counsel your organization to help it maximize meaningful use incentive payments, and assist with compliance plans to ensure that your electronic health record system does not compromise the maze of patient privacy laws and regulations. Also, if your organization has concerns that it will be unable to meet the meaningful use requirements, Hiscock & Barclay can limit your organization's exposure to the penalties which will be assessed beginning in 2015 for providers who have failed to adopt EHRs. For more information about the proposed rule or about meaningful use and the incentive program, please contact Hiscock & Barclay.

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