The Centers for Medicare and Medicaid Services has to make sure that changes it makes to the final version of the proposed meaningful use rule mesh with other rules for standards and certification, as well as the recently published proposal for a certification process.
"There really is a dance among the regulations," said Tony Trenkle, CMS director of ehealth and standards, at a meeting March 17 of the Health IT Policy Committee, which advises the Health and Human Services Department, and CMS has to keep this interplay in mind as it considers what to incorporate into the meaningful use rule.
"The more complexity you build into this process, the more difficult it becomes to launch the program quickly," he said.
The combination of meaningful use and the other rules and regulation is important because they lay out the requirements that healthcare providers must accomplish to document meaningful use to qualify for incentives, the functions that electronic health records must be capable of to support meaningful use and the process for an organization to validate the capability of an EHR
CMS will start paying out billions of dollars in incentives in 2011 under the HITECH Act to healthcare providers who become meaningful users of certified electronic health record systems, based on the requirements in these regulations.
CMS identified common themes among the more than 2,000 comments it received about the proposed meaningful use rule "once we waded through the "˜government is evil' ones," Trenkle said. The agency has sifted through about half of the comments and expects to have a bead on the rest within two weeks.
CMS closed its comment period March 15.
One of the most prevalent themes in the comments was for providing flexibility in meeting the requirements. Individuals and organizations, including the policy committee, urged that physicians and hospitals be required to accomplish a certain percentage of the measures or set some measures as core, and others as optional, to be able to qualify for incentives.
Translating that into what's needed overall to meet the 2011 operational date is a good example of why you need to consider the interplay between the various regulations, Trenkle.
For the Interim Final Rule on standards and certification criteria, the Office of the National Coordinator is mulling over about 300 "relevant" comments out of total of 700, said Steve Posnack, ONC policy analyst. ONC and CMS have coordinated on their related regulations.
If ONC tweaks objectives in the certification criteria, "we will be doing the one-two step with CMS," he said. Likewise, when policy decisions are made related to meaningful use, ONC will "try to reflect them in the standards that we have adopted," he said.
However, if CMS introduces flexibility in meaningful use objectives and measures, "that may not be something that we can reflect in certification because the technology still needs to be able to support the different and flexible uses," Posnack said.
