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Proposed Stage 2 requirements raise the bar for providers - Modern Healthcare
Proposed
Stage 2 requirements raise the bar for providers
Posted:
February 23, 2012 - 5:15 pm ET
The
proposed Stage 2 meaningful-use requirements raise the bar
for hospitals and eligible professionals on the use of computerized physician
order entry, electronic prescribing and electronic recording of several
patient-health measures, according to CMS officials.
Related Articles
Four health information technology and policy officials with the
CMS previewed the Stage 2 measures in a presentation at the Healthcare
Information and Management Systems Society's 2012 Conference and Exhibition in Las Vegas
Under the proposed Stage 2 standards, hospitals as well as eligible professionals—the latter category includes physicians not employed by hospitals—would have to use CPOE for more than 60% of medication, laboratory and radiology orders, double the share required under the Stage 1 standards.
The CPOE requirement is one of more than a dozen core objectives that hospitals and EPs would have to meet as part of demonstrating their meaningful use of electronic health-record systems, which would make them eligible to receive federal health IT incentive payments.
Other core objectives for both hospitals and EPs include the use of electronic prescribing for more than 50% of prescriptions issued, the recording of demographic data for more than 50% of patients, recording of vital signs in more than 80% of patient encounters and recording smoking status for more than 80% of patients.
In an effort to promote electronic engagement with patients, Stage 2 would require that more than 50% of patients be provided online access to their health information and demonstrate that more than 10% had actually accessed that information.
Among the proposed menu objectives for EPs are electronic recording of family health history for more than 20% of patients, successful ongoing transmission of syndromic surveillance data, successful ongoing transmission of cancer case information and successful ongoing transmission of data to a specialized cancer registry. For hospitals, menu objectives include electronic recording of advance directives for more than 50% of patients and the use of electronic prescribing for more than 50% of discharge prescriptions.
Under the proposed Stage 2 standards, hospitals as well as eligible professionals—the latter category includes physicians not employed by hospitals—would have to use CPOE for more than 60% of medication, laboratory and radiology orders, double the share required under the Stage 1 standards.
The CPOE requirement is one of more than a dozen core objectives that hospitals and EPs would have to meet as part of demonstrating their meaningful use of electronic health-record systems, which would make them eligible to receive federal health IT incentive payments.
Other core objectives for both hospitals and EPs include the use of electronic prescribing for more than 50% of prescriptions issued, the recording of demographic data for more than 50% of patients, recording of vital signs in more than 80% of patient encounters and recording smoking status for more than 80% of patients.
In an effort to promote electronic engagement with patients, Stage 2 would require that more than 50% of patients be provided online access to their health information and demonstrate that more than 10% had actually accessed that information.
Among the proposed menu objectives for EPs are electronic recording of family health history for more than 20% of patients, successful ongoing transmission of syndromic surveillance data, successful ongoing transmission of cancer case information and successful ongoing transmission of data to a specialized cancer registry. For hospitals, menu objectives include electronic recording of advance directives for more than 50% of patients and the use of electronic prescribing for more than 50% of discharge prescriptions.
Supreme Court punts on right to challenge Medicaid cuts - The Hill
Supreme
Court punts on right to challenge Medicaid cuts
By Julian Pecquet - 02/22/12 03:17 PM ET
The
Supreme Court on Wednesday declined to decide whether
Plaintiffs
had argued that the state violated the federal Medicaid statute by approving
deep cuts that would hurt patients' access to care, and the 9th Circuit Court
of Appeals recognized their right to seek redress. The question before the
high court was whether the cuts could be struck down under the Supremacy
Clause of the Constitution, which declares that federal statutes trump state
law when the two are at odds.
The
justices however ruled 5-4 that because the federal
Medicaid agency has signed off on the cuts since the suits were first filed,
the lower court should reexamine the case "in light of the changed
circumstances."
The
four conservatives on the High Court dissented, arguing those changed circumstances
were irrelevant.
The
Medicaid law doesn't allow providers or beneficiaries to sue to prevent cuts,
Chief Justice John Roberts wrote in dissent, and the plaintiffs can't count
on the Supremacy Clause to circumvent that obstacle.
"To
decide this case, it is enough to conclude that the Supremacy Clause does not
provide a cause of action to enforce the requirements [of the Medicaid
statute] when Congress, in establishing those requirements, elected not to
provide such a cause of action in the statute itself," he wrote.
In
its majority opinion, the high court does not take a stance on the Supremacy
Clause but strongly urges the plaintiffs and the lower court to abandon that
line of argument. Instead, the justices write, the cuts are ripe for a
challenge under the Administrative Procedure Act now that federal regulators
have signed off on them.
"Respondents'
basic challenge now presents the kind of legal question that ordinarily calls
for APA review," Justice Stephen Breyer wrote for the majority.
"The Medicaid Act commits to the federal agency the power to administer
a federal program. And here the agency has acted under this grant of
authority."
Gov. Jerry Brown (D-Calif.) had sought
permission to cut provider payment rates by 10 percent in order to cut the
state's deficit by hundreds of millions of dollars. The Centers for Medicare
and Medicaid Services approved some of
those cuts late last year.
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