CMS Final Rule on Hospital Meaningful Use and Quality Reporting

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The Centers for Medicare & Medicaid Services’ final rule updating the hospital outpatient prospective payment system (OPPS) and payment rates contains a specific provision designed to make meeting Meaningful Use easier.  The rule finalizes the launch of a pilot program that would allow for the electronic reporting of clinical quality measures (CQMs) under the electronic health record incentive program.

The final rule with comment period, released Nov. 1, will allow eligible and critical access hospitals to report CQMs electronically to meet that core objective for Meaningful Use of their EHR systems, instead of having to calculate the CQM results and attesting to them.  If a hospital reported the CQMs electronically, CMS would calculate the results for them.  If, based on CMS’ calculations, a hospital doesn’t meet the CQMs, it still would have the opportunity to measure them itself and attest to the results.

Comments on the final rule will be accepted through January 3, 2012.

If the hospital successfully reports the CQMs electronically, it would meet that core objective, but still would need to meet and attest to the other core and menu set objectives required under the EHR program.

The pilot program would help hospitals test the interoperability and functionality of their certified EHR systems and help advance EHR reporting, according to the rule.  Participation in the pilot would be voluntary.

CMS reported in the final rule that it had received a lot of industry support for the pilot, which it had suggested in its proposed OPPS rule released July 18.  The agency acknowledged that it anticipated only those hospitals that are the most ready to transmit this information electronically would participate in the pilot, but encouraged hospitals to participate for the “valuable learning process.”  CMS also indicated that it would provide education, outreach and testing of the reporting pilot.

According to a summary by CMS, the final rule also updates the revised Medicare ambulatory surgical center (ASC) payment system to implement applicable statutory requirements and changes arising from their continuing experience with this system. These changes are applicable to services furnished on or after January 1, 2012.

CMS is also revising the requirements for the Hospital Outpatient Quality Reporting (OQR) Program, adding new requirements for ASC Quality Reporting System, and making additional changes to provisions of the Hospital Inpatient Value-Based Purchasing (VBP) Program.

Finally, CMS announced changes to the rules governing the whole hospital and rural provider exceptions to the physician self-referral prohibition for expansion of facility capacity and changes to provider agreement regulations on patient notification requirements.

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