Serious Planning for MU Stage 2

Ask Joy: This Week – Serious Planning for MU Stage 2

Did you miss it? The action plan we outlined for Meaningful Use Stage 2 in last week’s Learning Lunch? In the hour-long presentation, sponsored by Medical Mastermind, we outlined the important CMS deadlines to keep close-at-hand for 2014, we gave a snapshot of the biggest changes providers are facing as they transition from Stage 1 to Stage 2, we talked about health information exchanges, patient engagement, clinical quality measures, and seriously, so much more.

Listeners sent in their questions real-time for on-air answers, and here, lucky reader, is a sampling of some of my favorites. Ready? OK, here we go.

Is it true that any attestation, regardless of stage, must use a 2014 certified EHR before even starting their 90 day reporting period?

It’s true. All attestations in 2014, whether they comprise of Stage 1 or Stage 2 data, must be submitted using EHR certified to the 2014 Edition standards set by CMS. clarifies the definition of certified EHR technology (CEHRT) by year. They state, “for EHR reporting periods during or after FY/CY 2014, eligible providers will need to have EHR technology certified to the 2014 Edition EHR certification criteria that meets a required base amount of functionality and then any other functionality they need to achieve meaningful use. EHR technology certified to the 2014 Edition EHR certification criteria will be able to support an EP’s attempt to achieve either MU Stage 1 or Stage 2.”

This is one of the main reasons why it’s important to know where your vendor stands. Even those attesting Stage 1 need to attest from a 2014 Edition EHR. This is also one of the main reasons that the reporting period is 90 days in 2014. Most likely, if your vendor is not already 2014 certified, they may get certified in the early part of the year, allowing  their EPs to start their reporting periods in the second or third quarter of next year. Not sure if your EHR vendor is 2014 certified?  Here’s the site where you can look them up.

Is everyone, regardless of stage, required to have a functioning portal in 2014?

Patient portal IS a requirement in 2014, for both Stage 1 and Stage 2. A personal health record (PHR) may be used instead of a patient portal, but it will still need a patient portal certification for the View, Download / Transmit requirement.

If a provider doesn’t meet  the 30% patient volume for Medicaid, does he still get penalized?

Actually, there are no payment adjustments or penalties for Medicaid providers who fail to demonstrate meaningful use (Check out slide #20 of the participation guide). However, Medicaid eligible professionals who also treat Medicare patients will have a payment adjustment to Medicare reimbursements in 2015 if they do not successfully demonstrate meaningful use for 2013.

The eligibility requirements are that Medicaid EPs have a minimum of 30% Medicaid patient volume (20% minimum for pediatricians) to be eligible for the incentive. If the EP doesn’t meet these minimum requirements, they are not eligible for the incentive. Not sure if you meet the requirements?  Here’s a guide for how to calculate your patient volume.

For Stage 2, can the secure messaging communications be a short list of options that the doctor provides to patients, letting them know what types of questions can be answered in an email, and preventing the patient from asking tons of questions? 

The secure messaging requirement is for the patient to send a message to the provider and not otherwise. CMS provided some guidance on what the messaging should be about. states: “secure messaging can be used to promote care coordination between visits, handle routine health issues, address patient questions and concerns, monitor patient conditions, and help patients better understand their conditions. Secure messaging can be convenient for handling routine nonclinical tasks such as medication refills and referrals and evidence from a number of practices indicates that offering secure messaging contributes to patient satisfaction with care.”

For CPOE, is the 100 or fewer exclusion a combination of all three types of orders (medication, lab & radiology) or does it apply to each individually? 

This is a great question. The CPOE objective exclusion states that “you can be excluded from this objective if you write fewer than 100 medication, radiology, or lab orders during the reporting period.” So, it’s an individual exclusion, not 100 together.

However, if anyone out there has more detailed information about this, I implore you to send it my way.

About the Author: Joy Rios has worked directly with multiple EHRs to develop training programs for both trainers and practice staff. She has successfully attested to Meaningful Use for multiple ambulatory practices in both Medicare and Medicaid. She also authored the Certified Professional Meaningful Use course for Joy holds an MBA with a focus in sustainability. She is Health IT certified with a specialty in Workflow Redesign, holds HIPAA security certification, and is a great resource for information regarding government incentive programs.Ask Joy is a regular column on 4Medapproved HIT Answers.