HHS seeks physician comments on meaningful use rules

The federal health IT office is opening up stage 2 regulations about EMRs to public scrutiny and wants both positive and negative input.

By — Posted March 8, 2012

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Steven Posnack likens the rule-making process and importance of public comments to the TV show "American Idol."

"Every once in a while, the fan favorite is voted off because everyone thought they were safe and so they don't vote for them," said Posnack, director of federal policy for the Office of the National Coordinator for Health Information Technology.

In the rule-making world, he said, good policy can be eliminated because people don't express their satisfaction with what they like. This is why the Dept. of Health and Human Services' Centers for Medicare & Medicaid Services and the ONC hope people in the health information technology world -- including physicians -- will take the time to read the proposed stage 2 meaningful use rules and express their opinions, both good and bad.

The public has 60 days from the date of the rules' publication in the Federal Register on March 7 to submit comments. The ONC and CMS are soliciting public feedback that includes both likes and dislikes. That will help formulate the final stage 2 regulations, which are expected to be released in the summer.

The proposed rules were unveiled before official publication during the annual Healthcare Information and Management Systems Society meeting in Las Vegas in February.

There are two sets of rules. One is the "Medicare and Medicaid Electronic Health Record Incentive Program-Stage 2" from CMS that details how physicians are to use their electronic medical records systems. The other is the "Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, 2014 Edition" from the ONC. That rule explains certification criteria for the systems used to meet meaningful use.

Comments to the proposed rules can be submitted one of four ways: electronically, regular mail, express mail or hand-delivered in person. Posnack said the preferred method is electronic. Commenters can visit the Federal Register website and search under the name of each set of rules (link). Next to each title is a link that goes to a comment page where free text can be entered and supporting documents can be attached.

The proposed CMS rules include an extension to the attestation period of stage 1 through 2013, a change the government says was made due to the comments asking for more time.

The stage 2 rules made many of the menu (optional) objectives from stage 1 mandatory for stage 2 and increased the reporting thresholds for core (mandatory) stage 1 objectives. The proposed rules offer flexibility by including quality reporting requirements specific to certain specialties. They contain more scope-of-practice exemptions for specialists.

"What you do agree with really makes a significant impact, more so than the things you may disagree with because ... it's hard for us to tell when we have silence for what we thought was a pretty great proposal," Posnack said.

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How to submit comments on meaningful use

The Dept. of Health and Humans Services' Centers for Medicare & Medicaid Services and the Office of the National Coordinator for Health Information Technology prefer that comments on the proposed meaningful use stage 2 requirements be made online (link). But the public can submit comments in three other ways:

Regular mail: Comments can be sent to Centers for Medicare & Medicaid Services, Dept. of Health and Human Services, Attention: CMS-0044-P, P.O. Box 8013, Baltimore, MD 21244-8013.

Express mail: Centers for Medicare & Medicaid Services, Dept. of Health and Human Services, Attention: CMS-0044-P, Mail Stop C4-26-05, 7500 Security Blvd., Baltimore, MD 21244-1850.

Hand delivery or courier: In Washington, deliveries can be made to Centers for Medicare & Medicaid Services, Dept. of Health and Human Services, Room 445-G, Hubert H. Humphrey Building, 200 Independence Ave., SW, Washington, DC 20201. In Baltimore, deliveries can be made to Centers for Medicare & Medicaid Services, Dept. of Health and Human Services, 7500 Security Blvd., Baltimore, MD 21244-1850.

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