A number of radiologists and other physicians working with electronic health records have struggled to meet the rigid requirements established under Meaningful Use by the U.S. Centers for Medicare and Medicaid Services. Recently, the Office of the National Coordinator for Health IT released rulings meant to ease attestation but was met with considerable resistance from the health care community.
FierceEMR reported that on Sept. 10, 2014, the ONC chose not to adopt the 2015 version of the EHR certification criteria that was developed to assist providers with Meaningful Use. The agency issued a final rule, however, that makes the 2014 edition more flexible and includes some components that had been proposed in the voluntary 2015 edition. The ruling is set to be published in the Federal Register on Sept. 11, 2014.
"[U]pon consideration of public comment, further reflection of ONC goals and timelines, and a desire to adhere to the administration's principles … we have not adopted the Proposed Voluntary Edition," read the ruling, quoted by FierceEMR.
The ONC will adopt a smaller group of its original proposals as optional 2014 Edition EHR certification criteria, which will also be referred to as the "2014 Edition Release 2." The federal agency also made revisions to provide increased clarity and flexibility, as well as enhance health information exchange among practices.
In addition, the final ruling makes administrative improvements to the program, such as adopting updated standards for ONC-authorized certification bodies. EHR vendors do not have to update and recertify their products for the revisions. However, they are free to consider the added opportunities they might pursue with the increased flexibility.
Providing reimbursements for multiple interpretations
Meaningful Use was not the only federal issue recently reviewed by the health care industry. FierceMedicalImaging explained that the comment period for the 2015 Medicare Physician Fee Schedule ended on Sept. 5, 2014, and the topic of reimbursement reductions moved to the front of the discussion table.
Currently, secondary interpretations are only reimbursed by Medicare due to unusual circumstances. However, as the CMS pushes for expanded image sharing, radiologists are wondering how information exchange will be covered financially. The agency indicated that reimbursing payments would need to result in direct savings for Medicare. In response, the American College of Radiology claimed that not only would reimbursements for secondary interpretations reduce repeated studies, it would also limit patient exposure to harmful levels of radiation.
Last year, the Wall Street Journal reported that Medicare spent roughly $10 billion on medical imaging in 2010, with 10 to 20 percent of the expenses estimated to be for multiple unnecessary exams.
If the CMS agreed to cover all diagnostic imaging studies, the industry would experience a significant drop in redundant procedures that only drive up health care costs for all stakeholders. With the comment period now closed, the ball is in CMS' court to determine whether or not reimbursements for secondary interpretations would garner the Medicare savings needed to improve care quality and enhance clinical services.
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Ronny Bachrach
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