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DEPARTMENT OF HEALTH AND HUMAN SERVICESCenters for Medicare & Medicaid Services42 CFR Parts 412, 413, 422, and 495CMS-0033-FRIN 0938-AP78Medicare and Medicaid Programs; Electronic Health Record Incentive ProgramAGENCY:
Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION:
Final rule.
SUMMARY:
This final rule implements the provisions of the American Recovery andReinvestment Act of 2009 (ARRA) (Pub. L. 111-5)
that provide incentive payments to eligibleprofessionals (EPs), eligible hospitals and critical access hospitals (CAHs) participating inMedicare and Medicaid programs that adopt and successfully demonstrate meaningful use of certified electronic health record (EHR) technology. This final rule specifies—the initial criteriaEPs, eligible hospitals, and CAHs must meet in order to qualify for an incentive payment;calculation of the incentive payment amounts; payment adjustments under Medicare for coveredprofessional services and inpatient hospital services provided by EPs, eligible hospitals andCAHs failing to demonstrate meaningful use of certified EHR technology; and other programparticipation requirements. Also, the Office of the National Coordinator for Health InformationTechnology (ONC) will be issuing a closely related final rule that specifies the Secretary’sadoption of an initial set of standards, implementation, specifications, and certification criteriafor electronic health records. ONC has also issued a separate final rule on the establishment of certification programs for health information technology.
CMS-0033-F 2
EFFECTIVE DATE
: These regulations are effective on[[iinnsseerrtt6600ddaayyssaaf f tteerrtthheeddaatteeoof f ppuubblliiccaattiioonniinntthhee
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FOR FURTHER INFORMATION CONTACT:
Elizabeth Holland, (410) 786-1309, EHR incentive program issues.Edward Gendron, (410) 786-1064, Medicaid incentive payment issues.Jim Hart, (410) 786-9520, Medicare fee for service payment issues.Bob Kuhl or Susan Burris, (410) 786-5594, Medicare CAH payment and charity care issues.Frank Szeflinski, (303) 844-7119, Medicare Advantage issues.
SUPPLEMENTARY INFORMATION:
Acronyms
ARRA American Recovery and Reinvestment Act of 2009AAC Average Allowable Cost (of certified EHR technology)AIU Adopt, Implement, Upgrade (certified EHR technology)CAH Critical Access HospitalCAHPS Consumer Assessment of Healthcare Providers and SystemsCCN CMS Certification NumberCFR Code of Federal RegulationsCHIP Children’s Health Insurance ProgramCHIPRA Children's Health Insurance Program Reauthorization Act of 2009CMS Centers for Medicare & Medicaid ServicesCPOE Computerized Physician Order EntryCY Calendar YearEHR Electronic Health Record
CMS-0033-F 3EP Eligible ProfessionalEPO Exclusive Provider OrganizationFACA Federal Advisory Committee ActFFP Federal Financial ParticipationFFY Federal Fiscal YearFFS Fee-For-ServiceFQHC Federally Qualified Health CenterFTE Full-Time EquivalentFY Fiscal YearHEDIS Healthcare Effectiveness Data and Information SetHHS Department of Health and Human ServicesHIE Health Information ExchangeHIT Health Information TechnologyHIPAA Health Insurance Portability and Accountability Act of 1996HITECH Health Information Technology for Economic and Clinical Health ActHMO Health Maintenance OrganizationHOS Health Outcomes SurveyHPSA Health Professional Shortage AreaHRSA Health Resource and Services AdministrationIAPD Implementation Advance Planning DocumentICR Information Collection RequirementIHS Indian Health ServiceIPA Independent Practice Association
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