June 18, 2010 - Advocacy Corner

Final Rule for Temporary Certification Program Released by ONC. The long-awaited final rule released today will officially be published in the Federal Register on June 24. As laid out in the 206-page rule, the temporary certification program establishes processes that organizations will need to follow in order to be authorized by the National Coordinator to test and certify EHR technology.

“By purchasing certified EHR technology, hospitals and eligible professionals will be able to make EHR purchasing decisions knowing that the technology will allow them to become meaningful users of electronic health records, qualify for the payment incentives, and begin to use EHRs in a way that will improve quality and efficiency in our health care system,” said David Blumenthal, M.D., M.P.P., national coordinator for health information technology. “We hope that all HIT stakeholders view this rule as the federal government’s commitment to reduce uncertainty in the health IT marketplace and advance the successful implementation of EHR incentive programs.”

In responding to the Temporary Certification Rule proposed rule in April, CHIME urged “positioning the temporary program as ‘provisional,’ meaning that it will lead logically into a permanent certification process.” Further, CHIME said ONC should “actively support the ONC-ATCBs (approved testing and certification bodies) in obtaining permanent status as ONC-ACBs (approved certification bodies). In addition, ONC should clearly state that products certified under the provisional program will be considered equal to those certified under the permanent program, with no automatic recertification required.”

CHIME will prepare an analysis of the Final Rule and provide this information as well as follow up education materials and opportunities for CHIME members. A Final Rule on the Permanent Certification Program is expected this fall. For more information about the temporary certification program and rule, please visit http://healthit.hhs.gov/certification.

Doc Fix Saga Continues. Efforts in the Senate continue to pass a legislative package that includes extended job benefits as well as deferring a physician Medicare pay cut for six months rather than the 19 months approved earlier by the House. Two Democrats--Sens. Ben Nelson (D-NB) and Joseph I. Lieberman (I-CT)---voted with Republicans to block the approximately $120 billion package. Sixty votes were needed to permit bringing the bill to the floor for a vote, but the bill received just 56. To make up for the loss of the two Democratic votes, the Democratic leadership believed they had secured the support of Senators Olympia Snowe (R-ME) and Scott Brown (R-MA), but the deal fell apart.

During the past month, Democratic leaders had reduced the overall price tag from $200 billion to $120 billion and reduced its impact on the deficit by two-thirds. The House narrowly approved the package May 28 and sent it to the Senate, which has endeavored to add $24 billion in aid to state governments, a top Obama priority aimed at preventing thousands of state layoffs and the 9.7 percent unemployment rate from rising even higher. Further negotiations were on tap for today as the leadership aims at a revamped strategy to pass a much needed jobs bill along with addressing the Medicare physician pay cut.

ONC Focuses on Adoption and Coordination in Meeting with CIOs. CHIME StateNet Coordinators and members of ALT on Wednesday during National Health IT Week met with ONC Deputy Coordinator Dr. Farzad Mostashari. Among issues under discussion was the use of a nationwide patient identifier, a priority issue identified in a StateNet survey as critical for patient matching and adoption, which Dr. Mostashari characterized as very unlikely. Some attendees, however, speculated that over time as information exchange advanced, patients and members of Congress could be more open to this step.

Regional Extension Centers (RECs) and the role played by hospitals in working with physician practices was also addressed by the ONC Deputy. CIOs described experiences in working with physician practices. Several examples were highlighted, including efforts by Self Regional Healthcare in Greenwood, SC. Self Regional, the leading referral hospital in the upstate area of South Carolina, developed a program that supports the purchase, adoption, and education of EMRs for physician practices. In working with a major EMR vendor, the “community model” developed under this initiative has substantially reduced the pricing and upfront capital requirement for physicians to adopt EMRs. Conversations with Dr. Mostashari on the RECs and other state level initiatives will continue as a means to leverage the CIO role to advance coordination and interoperability across states.

As follow up to CIO discussions on the above issues, the NHIN and other areas identified in the StateNet survey, CHIME will launch one or more workgroups this summer that will be open to both StateNet and ALT members. For further information, please contact Sharon Canner at CHIME.