Health Information Technology
The American Recovery and Reinvestment Act of 2009, through the Health Information Technology for Economic and Clinical Health Act (HITECH Act) created incentives under the Medicare Fee-for-Service, Medicare Advantage and Medicaid programs for certain professionals (so-called eligible professionals) and certain hospitals to adopt and demonstrate meaningful use of certified electronic health record (EHR) technology. The objective of the HITECH Act has been to promote the adoption and “meaningful use” of interoperable health information technology (HIT) and “Qualified EHRs” through a combination of incentive payments and penalties.
As implemented, this federal EHR incentive program involves two distinct features, each of which is governed and overseen by a different agency. Specifically, the Centers for Medicare and Medicaid Services (CMS) oversees the establishment of meaningful use criteria for eligible professionals and hospitals, while the Office of the National Coordinator (ONC) for Health Information Technology oversees the establishment of certification criteria for the underlying technology.
Key rules and regulations related to HIT issued to date include the following:
- ONC Health Information Technology: Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, 2014 Edition; Revisions to the Permanent Certification Program for Health Information Technology; Final Rule (September 4, 2012). This rule finalizes standards, implementation specifications and certification criteria that EHR technology must satisfy to support (and to achieve) meaningful use during Stage 2. The rule also alters the definition of certified EHR technology through the introduction of a Base EHR component, which is defined as a fundamental set of EHR capabilities that all providers would need to implement or be able to access.
- Medicare and Medicaid Programs; Electronic Health Record Incentive Program—Stage 2; Final Rule (September 4, 2012). This rule finalizes criteria that eligible professionals and eligible hospitals must meet in order to qualify for incentive payments during Stage 2. It also establishes modifications to Stage 1 criteria including changes to the program timeline and rules for downward payment adjustments for providers failing to become meaningful users.
- ONC Establishment of the Permanent Certification Program for Health Information Technology; Final Rule (January 7, 2011). This final rule establishes the Permanent Certification Program for Health Information Technology. The permanent certification program will eventually replace the temporary certification program. The temporary certification program will continue to be in effect until it sunsets.
- Medicare and Medicaid Programs; Electronic Health Record Incentive Program; Final Rule (July 28, 2010). This rule finalizes criteria for determining program eligibility, incentive payment amounts and allocations, and the Stage 1 meaningful use criteria. This final rule defines the minimum requirements that providers must meet through their use of certified EHR technology in order to qualify for the payments in Stage 1.
- ONC Health Information Technology Initial Set of Standards; Final Rule (July 28, 2010). This rule identifies the standards and certification criteria for the certification of EHR technology, so that eligible professionals and hospitals may be assured that the systems they adopt are capable of performing the required functions.
- ONC Establishment of the Temporary Certification Body; Final Rule (June 24, 2010). This final rule establishes a temporary certification program for health information technology to enable organizations to become authorized by the National Coordinator to test and certify EHR technology. The final rule sets forth the process the National Coordinator will utilize to authorize organizations (ONC-Authorized Testing and Certification Bodies (ONC-ATCBs)) to test and certify Complete EHRs and/or EHR Modules.