HIPAA-HITECH Overview

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HIPAA / HITECH / Security Rule / Meaningful Use  – What does it all mean?

Businesses all over the world are going digital. One of the few industries that is being left behind in the digital age is the medical services industry.  Concerns of Electronic Patient Health Information protection, and the lack of resources to implement secure information systems are a few of the underlying reasons for the lack of progress. Seeing that providers needed  incentive and guidance to trade in their old paper charts for electronic health records (EHRs), the US Government passed the HITECH act as part of the American Recovery and Reinvestment Act.

The HITECH Act promotes the conversion of medical paper files to EHRs, lays out testing requirements for information systems to ensure compliance, provides funding support to eligible professionals through the use of incentive payments, and clarifies privacy rules in the final Omnibus Rule. The Omnibus Rule simply bolsters privacy already required by the HIPAA act by taking into account new security and privacy concerns brought about by the digital age.

 So how do you receive money to go digital? By becoming a Meaningful User!

What is a Meaningful User?

Simply put, an eligible provider is a meaningful user if they use Electronic Health Records (EHRs) in a meaningful way.  The Centers for Medicare & Medicaid Services (CMS) Incentive Programs lays out a set of standards that defines the “meaningful way”.  An eligible provider is any medical provider who receives Medicare and/or Medicaid reimbursements.

How do I become a Meaningful User?

To become a meaningful user and earn incentive payments, you must meet and attest to meeting specific criteria defined by the Centers for Medicare & Medicaid Services (CMS) Incentive Program.

What if I choose not to participate?

Choosing not to participate in the Meaningful Use process doesn’t just mean that you won’t benefit from the incentive program dollars; it means that eventually you will begin to be penalized for non-compliance. Medicare and Medicaid reimbursements will be reduced more and more for each year that the Practice is not a Meaningful User of EHR. Beginning in 2015, Medicare eligible professionals who do not successfully demonstrate meaningful use will be subject to a payment adjustment. The payment reduction starts at 1% and increases each year that a Medicare eligible professional does not demonstrate meaningful use, to a maximum of 5%.

How do I avoid Penalties?

To avoid reduction in Medicare and/or Medicaid reimbursements, known as penalties, each eligible provider must demonstrate meaningful use prior to the 2015 calendar. You may demonstrate meaningful use under either Medicare or Medicaid.

EPs who first demonstrate meaningful use in 2014 must demonstrate meaningful use for a 90-day reporting period in 2014 to avoid payment adjustments in 2015. This reporting period must occur in the first 9 months of calendar year 2014, and EPs must attest to meaningful use no later than October 1, 2014, in order to avoid the payment adjustments.

See CMS’ Payment Adjustments & Hardship Exceptions Tipsheet for Eligible Professionals for additional payment adjustment information.

How do I Attest for Meaningful Use?

To be eligible to attest for meaningful use and submit for the insensitive payments, eligible providers must ensure that they are meeting the meaningful use requirements. The next step is to register and attesting in the Medicare & Medicaid EHR Incentive Program Registration and Attestation System.