News from the AOA's Blog

In what the agency calls “a key step in the national initiative to encourage adoption and effective use of EHRs by America’s health care providers,” the federal Office of the National Coordinator for Health Information Technology (ONC) last month designated its initial certification entities for electronic health records (EHRs).

The Certification Commission for Health Information Technology (CCHIT), Chicago, Ill.; the Drummond Group Inc. (DGI), Austin, Texas; and InfoGard Laboratories, Inc., of San Luis Obispo, Calif., as an ONC-Authorized Testing and Certification Body (ONC-ATCB), were named the first technology review bodies authorized to test and certify EHR systems for compliance with standards and certification criteria that were issued by the U.S. Department of Health & Human Services (HHS) earlier this year. Read the rest of this entry ?

The U.S. Department of Health & Human Services (HHS), Sept. 30, awarded nearly $49 million to help 48 states and the District of Columbia plan for the establishment of health insurance exchanges (HIEs).

A key part of health system reforms enacted under the Affordable Care Act earlier this year, health insurance exchanges will offer “new, competitive, consumer-centered private health insurance marketplaces” for individuals and small businesses, according to an HHS announcement. Read the rest of this entry ?

The U.S. Centers for Medicare & Medicaid Services (CMS) has released three new or updated “tip sheets” explaining eligibility requirements, maximum payments, and key date for the Medicare EHR Incentive Program.

Incentive payments totaling as much as $27 billion may be made under the Medicare & Medicaid Electronic Health Record (EHR) Incentive Programs beginning in 2011.

• Medicare EHR Incentive Programs, PQRI, and E-Prescribing Comparison (updated) outlines the opportunities available to Medicare-Eligible Professionals for incentive payments under Medicare initiatives. This fact sheet provides information on eligibility, timeframes, and maximum payments for each program.
• Flow Chart – Determine Eligibility for Medicare and Medicaid EHR Incentive Programs (updated) provides a handy flow chart practitioners can use to determine if they are eligible to participate in the Medicare or Medicaid EHR Incentive Programs
• Medicare EHR Incentive Payments for Eligible Professionals outlines the types of individual practitioners who can participate in the Medicare EHR Incentive Program. This easy tip sheet provides information about incentive payment amounts and describes how payments are calculated for fee for service (FFS) and Medicare Advantage providers. It also describes payment adjustments beginning in 2015 for eligible professionals who are not meaningful users of certified EHR technology.

All three tip sheets are accessible on the CMS Web site EHR Incentive Programs page (www.cms.gov/EHRIncentivePrograms).

Select the “Medicare Eligible Professional” tab on the left, and then scroll to “Downloads.”

The U.S. Centers for Medicare & Medicaid Services announced a simplified Medicare enrollment process for health care practitioners who do not themselves bill Medicare for products or services but wish to enroll in the government health plan solely for the purpose of ordering or referring items or services for Medicare beneficiaries.

Since July 6, 2010, Medicare Part B suppliers have been required to include, on any claim, the legal name and National Provider Identifier (NPI) of the physician or non-physician practitioner who ordered or referred the billed items or services for the beneficiary.

This effectively means that Medicare will reimburse claims from providers and suppliers who have furnished, ordered, or referred items or services to Medicare beneficiaries only when the ordering/ referring provider identified in the claims is enrolled in Medicare and has an enrollment record – with NPI – in health plan’s Provider Enrollment, Chain and Ownership System (PECOS) at the time of the service. Read the rest of this entry ?

 Need to know the Medicare basics? The Medicare Learning Network (MLN) offers a series of Web-based training (WBT) courses to teach health care professionals the fundamentals of the Medicare program.

The first course in the series, the “World of Medicare,” offers a basic introduction to Medicare.

The second course in the series “Your Office in the World of Medicare” focuses on Medicare knowledge required by health care professionals and their office personnel.

Both are available from the CMS Web site MLN page (www.cms.gov/MLNproducts) by scrolling to the bottom of the page and selecting Web based Training Modules from the Related Links Inside CMS section.