Medicare Compliance & Reimbursement

Tip: It might be time to upgrade your CEHRT, CMS guidance suggests.

Rollbacks and reversals have marked the Medicare landscape over the last year. Therefore, it should come as no surprise that a newly-released initiative from CMS reexamines data sharing, EHR mandates, and information blocking. The patient-first programs promise to change Medicare clinicians' burdens - but not necessarily reduce them.

Context: Last October, President Trump urged his administration to put patients first and reorganize federal healthcare requirements and protocols with the "Executive Order to Promote Healthcare Choice and Competition Across the United States." Since the Presidential Order's release, HHS, CMS, and other federal health programs have rolled back Quality Payment Program (QPP) Year 2 requirements, cut down on providers' administrative duties under "Patients Over Paperwork," and eased up on Certified EHR Technology (CEHRT) mandates.

Read the Executive Order at: www.whitehouse.gov/presidential-actions/presidential-executive-order-promoting-healthcare-choice-competition-across-united-states/.

Give Patients Their Data, CMS Warns

According to a recent announcement from CMS, the deregulation train is just getting started. The feds want patients, not physicians, to control healthcare data and make it available for patients to carry with them wherever they go.

"The government-wide MyHealthEData initiative" hopes to "empower patients," and "help to break down the barriers that prevent patients from having electronic access and true control of their own health records fromthe device or application of their choice," said a CMS press release on the new program. The initiative puts cost, quality, and competition on the front burner, giving patients control of their histories and health information. The program allows patients to determine where they want to take their records, and who they want to give their business to, the agency suggests in the release.

Nuts and bolts: CMS introduced a new "universal digital format" for Medicare patients to access their data called "Blue Button 2.0" at the Healthcare Information and Management Systems Society (HIMSS) Annual Conference in Las Vegas. The program will promote application designs and technology from more than 100 health IT organizations. CMS also discussed other significant changes ahead for EHRs, interoperability, coding, and more. (See story, p.45)

Remember: The Blue Button program is not new, but is actually a revamp of a program that began in 2010, which gave patients their health data in a downloadable PDF file, CMS guidance reminded. Blue Button 2.0, however, will allow patients to utilize the program "on applications designed to help them manage their health, or share it with their doctors to improve clinical decision-making," a CMS fact sheet on the platform said. The upgrade will include up to four years of beneficiaries' Medicare Parts A, B, and D details, including prescriptions and treatments.

"CMS serves more than 130 million beneficiaries through our programs, which means we are uniquely positioned to transform how important healthcare data is shared between patients and their doctors," said Seema Verma, CMS Administrator, during a speech at HIMSS. She also encouraged private payers to endorse and embrace these federal initiatives, ensuring their patients have easy access to health information and utilize Medicare's Blue Button 2.0 and data-sharing applications, too.

AMA Offers Assistance and Praise on HIT Revamps

Physician and hospital groups have pushed repeatedly for change as the paperwork required to care effectively for patients has increased exponentially in recent years, bogging down providers and taking time away from the actual care of patients. One group was particularly encouraged by the newly announced initiatives and offered assistance.

"We look forward to working with the administration in fleshing out the details to ensure that physicians get to spend more time caring for their patients and less time on administrative tasks," said David O. Barbe, MD, president of the American Medical Association (AMA) in a recent release. "There is room for improvement, and we are excited that Administrator Verma agrees."

Endnote: No definite deadlines were set regarding the implementation of these CMS initiatives. However, if last year's plethora of deregulation efforts and changes are any indication, these new programs will be on the books sooner rather than later. Medicare Reimbursement and Compliance will continue to report on the changes as they are implemented and required.

Resource: To review the CMS release on the MyHealthEData initiative and Medicare's Blue Button 2.0, visit www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2018-Press-releases-items/2018-03-06.html.