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CMS and AMA Announce Efforts to Help Providers Get Ready For ICD-10

With less than three months remaining until the nation switches from ICD-9 to ICD-10 coding for medical diagnoses and inpatient hospital procedures, The Centers for Medicare & Medicaid Services (CMS) and the American Medical Association (AMA) are announcing efforts to continue to help physicians get ready ahead of the October 1 deadline.  In response to requests from the provider community, CMS is releasing additional guidance that will allow for flexibility in the claims auditing and quality reporting process as the medical community gains experience using the new ICD- 10 code set.

Recognizing that health care providers need help with the transition, CMS and AMA are working to make sure physicians and other providers are ready ahead of the transition to ICD-10 that will happen on October 1.  Reaching out to health care providers all across the country, CMS and AMA will in parallel be educating providers through webinars, on-site training, educational articles and national provider calls to help physicians and other health care providers learn about the updated codes and prepare for the transition.

“As we work to modernize our nation’s health care infrastructure, the coming implementation of ICD-10 will set the stage for better identification of illness and earlier warning signs of epidemics, such as Ebola or flu pandemics.” said Andy Slavitt, Acting Administrator of the Centers for Medicare and Medicaid Services. “With easy to use tools, a new ICD-10 Ombudsman, and added flexibility in our claims audit and quality reporting process, CMS is committed to working with the physician community to work through this transition.”

“ICD 10 implementation is set to begin on October 1, and it is imperative that physician practices take steps beforehand to be ready,” said AMA President Steven J. Stack, MD.  “We appreciate that CMS is adopting policies to ease the transition to ICD-10 in response to   physicians’ concerns that inadvertent coding errors or system glitches during the transition to ICD-10 may result in audits, claims denials, and penalties under various Medicare reporting programs.  The actions CMS is initiating today can help to mitigate potential problems.  We will continue to work with the administration in the weeks and months ahead to make sure the transition is as smooth as possible.”

The International Classification of Diseases, or ICD, is used to standardize codes for medical conditions and procedures. The medical codes America uses for diagnosis and billing have not been updated in more than 35 years and contain outdated, obsolete terms.

The use of ICD-10 should advance public health research and emergency response through detection of disease outbreaks and adverse drug events, as well as support innovative payment models that drive quality of care.

CMS’ free help includes the “Road to 10” aimed specifically at smaller physician practices with primers for clinical documentation, clinical scenarios, and other specialty-specific resources to help with implementation. CMS has also released provider training videos that offer helpful ICD-10 implementation tips.

The AMA also has a broad range of materials available to help physicians prepare for theOctober 1 deadline.  To learn more and stay apprised on developments, visit AMA Wire.

CMS also detailed its operating plans for the ICD-10 implementation. Upcoming milestones include:

  • Setting up an ICD-10 communications and coordination center, learning from best practices of other large technology implementations that will be in place to identify and resolve issues arising from the ICD-10 transition.
  • Sending a letter in July to all Medicare fee-for-service providers encouraging ICD-10 readiness and notifying them of these flexibilities.
  • Completing the final window of Medicare end-to-end testing for providers this July.
  • Offering ongoing Medicare acknowledgement testing for providers through September 30th.
  • Providing additional in-person training through the “Road to 10” for small physician practices.
  • Hosting an MLN Connects National Provider Call on August 27th.

In accordance with the coming transition, the Medicare claims processing systems will not have the capability to accept ICD-9 codes for dates of services after September 30, 2015, nor will they be able to accept claims for both ICD-9 and ICD-10 codes.

Also, at the request of the AMA, CMS will name a CMS ICD-10 Ombudsman to triage and answer questions about the submission of claims. The ICD-10 Ombudsman will be located at CMS’s ICD-10 Coordination Center.

July 6, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Healthcare Leaders Praise Reintroduction of the Flex-IT Act

Strong, Bipartisan Support for Increasing Meaningful Use Flexibility

ANN ARBOR, MI, January 12, 2015 – Healthcare leaders praised the reintroduction of the Flexibility in Health IT Reporting (Flex-IT) Act of 2015, a bipartisan bill granting the nation’s healthcare providers additional flexibility in meeting Meaningful Use (MU) requirements through a shortened reporting period in 2015. Swift action by Congress is needed to help providers already in the 2015 reporting year for Meaningful Use, several healthcare organizations said today.

Officials from the American Academy of Family Physicians (AAFP), American Hospital Association (AHA), American Medical Association (AMA), College of Healthcare Information Management Executives (CHIME), Healthcare Information Management Systems Society (HIMSS) and Medical Group Management Association (MGMA) applaud the leadership shown by bill sponsor Representative Renee Ellmers (R-NC-02) and a bipartisan list of original cosponsors, including Marsha Blackburn (R-TN-07), Ron Kind (D-WI-03), Glenn Thompson (R-PA-05) and David Scott (D-GA-13).

“We commend the leadership demonstrated by a bipartisan group of House Members on this critically important issue,” said CHIME President and CEO Russell P. Branzell, FCHIME, CHCIO. “With such across-the-isle support, Congress has underscored how fundamental this program is to the future of healthcare in the U.S.

“While CHIME remains committed to the success of Meaningful Use, and to making sure improved patient care is the program’s lasting legacy, we believe significant changes are needed to address increased dissatisfaction with EHRs and growing disenchantment with the program,” Branzell added. “This bill, if passed, would begin that much-needed course correction.”

The Flex-IT Act was introduced in September 2014, following a national joint call to action last year. The new Flex-IT Act of 2015 would adjust the Meaningful Use reporting timeline, giving providers the option to choose any three-month quarter for EHR reporting in 2015.

“America’s hospitals are strongly committed to the adoption of EHRs, because of their potential to increase the quality of care and reduce costs for patients,” said Rick Pollack, Executive Vice President of the American Hospital Association. “The health care field is faced with many major challenges and changes, all hitting at the same time. We need to be practical and responsible in terms of implementation timetables. That’s why hospitals need flexibility. This legislation is a positive first step toward ensuring the program is a success, and America’s hospitals look forward to working to achieve its passage.”

“Our nation needs a more efficient, cost-effective and patient-centered healthcare system. HIMSS applauds the efforts taken by these Congressional leaders and fully supports the Flexibility in Health IT Reporting (Flex-IT) Act of 2015 as essential to giving providers and hospitals a realistic chance to meet the 2015 Meaningful Use requirements,” said Carla Smith, MA, CNM, FHIMSS, Executive Vice President, HIMSS North America

According to the latest data available from the Centers for Medicaid & Medicare Services (CMS), more than one-third of hospitals expected to demonstrate Stage 2 Meaningful Use in 2014 had to file for a hardship exception or meet Stage 1 requirements again. In 2015, CMS data indicate more than 3,900 hospitals and 260,000 physicians will have to meet Stage 2 requirements. However, CHIME estimates that more than half of these EHs will likely seek further hardship exceptions or face penalties in 2015. And with CMS estimating that more than 257,000 EPs will receive penalties in 2015, the likelihood of robust physician participation is doubtful.

“We greatly appreciate the willingness of this bipartisan group of legislators to address this critical issue,” stated Anders Gilberg, Senior Vice President, Government Affairs, for the Medical Group Management Association. “Stage 2 of Meaningful Use has proven extremely challenging and, absent this reporting flexibility, a significant number of physicians will be unable to participate in the program and unfairly penalized. Passage of the Flex-IT Act is a critical step to allow physician practices to continue down the pathway of effective adoption and use of EHR technology,” added Gilberg.

“We are pleased with renewed efforts to provide greater flexibility in the Meaningful Use program and hope that this is the first of several steps to make the program work better for physicians and other providers so that the full potential of these technologies to improve care and value can be realized,” said American Medical Association President-Elect Steven J. Stack, MD.

In October 2014, the AMA unveiled their Meaningful Use blueprint, outlining several recommendations meant to improve participation in the EHR Incentive program. Among the high-level recommendations, AMA officials urged that policymakers adopt a more flexible approach for meeting Meaningful Use to allow more physicians to successfully participate; better aligning quality measure requirements including reducing the reporting burden on physicians and helping relieve them from overlapping penalties; and restructure EHR certification to focus on key areas like interoperability.

“As some of the earliest adopters of certified electronic health records technology, family physicians have demonstrated their belief that interoperable EHR – like primary care itself – is an essential component of a higher-quality, lower-cost health system,” said Robert Wergin, MD, president of the American Academy of Family Physicians. “However, as family medicine continues to do its part in building the EHR infrastructure – a massive undertaking – CMS should not set benchmarks so high that it discourages participation in the program. We applaud Reps. Ellmers and Kind for introducing the Flexibility in Health IT Reporting Act, which will allow eligible physicians to achieve Meaningful Use of EHR by reporting for a three-month period in 2015. The American Academy of Family Physicians believes this flexibility will help physicians stay on track in building an EHR system that works.”

About CHIME
The College of Healthcare Information Management Executives (CHIME) is an executive organization dedicated to serving chief information officers and other senior healthcare IT leaders. With more than 1,400 CIO members and over 140 healthcare IT vendors and professional services firms, CHIME provides a highly interactive, trusted environment enabling senior professional and industry leaders to collaborate; exchange best practices; address professional development needs; and advocate the effective use of information management to improve the health and healthcare in the communities they serve. For more information, please visit www.chimecentral.org.

January 12, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Disappointing Meaningful Use Data Prompts Industry Leaders to Urge HHS to Take Immediate Action

WASHINGTON, DC November 4, 2014 –  Healthcare leaders from across the nation today renewed calls for the Centers for Medicaid and Medicare Services (CMS) to shorten the Meaningful Use (MU) reporting period in 2015 and provide more program flexibility, citing concerns with lower-than-expected Medicare numbers and continued reports detailing nationwide difficulty in meeting Federal guidelines for electronic health records (EHR) requirements.

According to newly released CMS numbers, less than 17 percent of the nation’s hospitals have demonstrated Stage 2 capabilities. Further, less than 38 percent of eligible hospitals (EHs) and critical access hospitals (CAHs) have met either Stage of Meaningful Use in 2014, highlighting the difficulty of program requirements and foretelling continued struggles in 2015.  And while eligible professionals (EPs) have until the end of February to report their progress, only 2 percent have demonstrated Stage 2 capabilities thus far.

Officials from the American Medical Association (AMA), College of Healthcare Information Management Executives (CHIME), Healthcare Information and Management Systems Society (HIMSS) and Medical Group Management Association (MGMA) called the results disappointing, yet predictable.

“Meaningful Use participation data released today have validated the concerns of providers and IT leaders.  These numbers continue to underscore the need for a sensible glide-path in 2015,” said CHIME President and CEO Russell P. Branzell, FCHIME, CHCIO.  “Providers have struggled mightily in 2014, in many instances for reasons beyond their control.  If nothing is done to help them get back on track in 2015, we will continue to see growing dissatisfaction with EHRs and disenchantment with Meaningful Use.”

CMS data required by Congress indicate that more than 3,900 hospitals must meet Stage 2 measures and objectives in 2015 and more than 260,000 eligible professionals (EPs) will need to be similarly positioned by January 1, 2015.  Given the low attestation data for 2014 and the tremendous number of providers required, but likely unable to fulfill, Stage 2 for a full 365-days in 2015, healthcare leaders have pressed for a shortened reporting period in 2015, mirroring the policy of 2014.

“The low number of EP attestations to date is clear evidence that physician practices and their vendor partners have faced significant challenges in meeting the more onerous Stage 2 requirements of meaningful use,” said Anders M. Gilberg, Senior Vice President, government affairs, MGMA. “Shortening the reporting period in 2015 is a much needed change if the program is to remain viable and is a critical step if the nation is to continue making progress toward the goal of interoperability.”

“We’re focused on transforming health and healthcare,” said Carla Smith, MA, CNM, FHIMSS, Executive Vice President of HIMSS.  “Meaningful Use Stage 2 and 2014 certified EHR technology are important drivers toward that outcome.  If CMS continues to require a full-year of Meaningful Use reporting for 2015, we anticipate that large segments of providers will no longer be able to participate in the program-which hinders our nation’s ability to improve the quality, safety, cost-effectiveness, and access to care.”

A coalition of national provider groups have repeatedly told CMS that a shortened reporting period will have a dramatically positive effect on program participation and policy outcomes sought in 2015.  Additionally, allowing flexibility in how providers meet the Stage 2 requirements, particularly related to Transitions of Care and View, Download, Transmit measures would also improve program participation.

“In addition to a shortened reporting period, CMS must end its one-size-fits all approach to achieve the goals of the Meaningful Use program, which are to create a secure and interoperable infrastructure,” said AMA President Elect Steven J. Stack, MD. “The AMA recently released a blueprint to outline ways to improve the Meaningful Use program, as well as a framework outlining eight priorities for more usable EHRs. We believe the stringent pass fail requirements for meeting Meaningful Use, combined with a tsunami of other overlapping regulations, are keeping physicians from participating in the Meaningful Use program.”

In response to a CMS final rule issued in September, provider groups sent a letter to Health and Human Service Secretary Burwell saying additional time would help hundreds of thousands of providers meet Stage 2 requirements in an effective and safe manner.  Further, the group of nearly twenty national provider organizations said a shortened reporting period and flexibility on the Transitions of Care and View, Download, Transmit measures would serve as positive incentive for those who must seek alternative paths to MU in 2014 to continue their work in 2015.

“The agency’s decision to require a full-year of reporting using 2014 Edition certified EHR technology (CEHRT) in 2015 puts many eligible hospitals and physicians at risk of not meeting Meaningful Use next year and hinders the forward trajectory of the program,” the letter states.

November 4, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.