Three EHR Vendors Meet Meaningful Use 2014 Standard, Creates Challenge for EPs Wishing to Achieve Stage 2

HITECH Act Meaningful Use Final Rule

On September 4, 2012, CMS published the HITECH Act final rule listing Stage 2 criteria for the ARRA HITECH Act of 2009, Meaningful Use of Electronic Health Records, that eligible professionals (EPs), hospitals, and critical access hospitals (CAHs) have to meet to continue to participation in Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs.

By June 13, 2013, only three vendors were ready for inpatient, and three for ambulatory on the CMS website that shows which EHR vendors have their product certified for Meaningful Use under the 2014 Standard.

This creates an issue for all Eligible Providers (EPs) who achieved meaningful use Stage 1.  Unless their EHR vendor meets the Stage 2 requirements, those EPs no longer qualify for Meaningful Use stimulus dollars.  Subseqently the ONC Certified Electronic Health Record Technology (CEHRT) vendors increased certification levels enabled more EPs and EHs to attest.

Today the ONCHPL web site provides information on certified vendor software in compliance with the HITECH Act.

These developments come in the same year that all HIPAA Covered Entities should be moving toward ICD-10.

The 2014 Edition Standards and Certification Criteria final rule for Meaningful Use

As provided or in 45 CFR Part 170 RIN 0991–AB82 – Health Information Technology: Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, 2014 Edition; Revisions to the Permanent Certification Program for Health Information Technology, the new Rule:

  • Introduces new privacy, security, interoperability, safety, portability, quality measures, and transitions of care standards.
  • Redefines the meaning of Certified EHR Technology (CEHRT) while aiming to permit greater innovation and reduced regulatory burden;
  • Adopts certification criteria for transitions of care that will ensure EHR technology supports standards-based electronic health information exchange
  • Requires test reports used for EHR technology certification be made publicly available and that EHR technology developers follow certain price transparency practices related to the types of costs (i.e., one-time, ongoing, or both) associated with EHR technology implementation for meaningful use; and
  • Makes available for the first time, “gap certification” for certain certification criteria, which will enable more efficient EHR technology certification.

Details of many provisions from the 2014 Edition Meaningful Use / HITECH Act Final Rule below:

III. Provisions of the Final Rule Affecting Standards, Implementation Specifications, and Certification Criteria

A. 2014 Edition EHR Certification Criteria

1. Certification Criteria Relationship to MU
2. Applicability
3. Scope of a Certification Criterion for Certification
4. Explanation and Revision of Terms Used in Certification Criteria
5. Consensus-Based Standards
6. Adopting Versions of Standards
7. Display of Vocabulary Standards
8. Common Data Elements in CertificationCriteria
9. New Certification Criteria
a. Ambulatory and Inpatient Setting
b. Ambulatory Setting
c. Inpatient Setting
10. Revised Certification Criteria
a. Ambulatory and Inpatient Setting
b. Ambulatory Setting
c. Inpatient Setting
11. Unchanged Certification Criteria
a. Refinements to Unchanged Certification Criteria
b. Unchanged Certification Criteria Without Refinements
12. Gap Certification
13. ‘‘Disability’’ Status

B. Redefining Certified EHR Technology and Related Terms

1. Certified EHR Technology (CEHRT) Definition
2. Base EHR Definition
3. Complete EHR Definition
4. Certifications Issued for Complete EHRs and EHR Modules
5. Adaptations of Certified Complete EHRs or Certified EHR Modules

IV. Provisions of the Final Rule Affecting the
Permanent Certification Program for HIT (‘‘ONC HIT Certification Program’’)

A. Program Name Change
B. ‘‘Minimum Standards’’ Code Sets
C. Revisions to EHR Module Certification Requirements
1. Privacy and Security Certification
2. Certification to Certain New Certification Criteria
D. ONC–ACB Reporting Requirements E. Continuation and Representation ofCertified Status
1. 2011 or 2014 Edition EHR Certification Criteria Compliant
2. Updating a Certification
3. Representation of Meeting the Base EHR definition
F. EHR Technology Price Transparency G. Certification and Certification Criteria for Other Health Care Settings

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Michael F. Arrigo

Michael is Managing Partner & CEO of No World Borders, a leading healthcare management and IT consulting firm. He serves as an expert witness in Federal and State Court and was recently ruled as an expert by a 9th Circuit Federal Judge. He serves as a patent expert witness on intellectual property disputes, both as a Technical Expert and a Damages expert. His vision for the firm is to continue acquisition of skills and technology that support the intersection of clinical data and administrative health data where the eligibility for medically necessary care is determined. He leads a team that provides litigation consulting as well as advisory regarding medical coding, medical billing, medical bill review and HIPAA Privacy and Security best practices for healthcare clients, Meaningful Use of Electronic Health Records. He advises legal teams as an expert witness in HIPAA Privacy and Security, medical coding and billing and usual and customary cost of care, the Affordable Care Act and benefits enrollment, white collar crime, False Claims Act, Anti-Kickback, Stark Law, physician compensation, Insurance bad faith, payor-provider disputes, ERISA plan-third-party administrator disputes, third-party liability, and the Medicare Secondary Payer Act (MSPA) MMSEA Section 111 reporting. He uses these skills in disputes regarding the valuation of pharmaceuticals and drug costs and in the review and audit of pain management and opioid prescribers under state Standards and the Controlled Substances Act. He consults to venture capital and private equity firms on mHealth, Cloud Computing in Healthcare, and Software as a Service. He advises ERISA self-insured employers on cost of care and regulations. Arrigo was recently retained by the U.S. Department of Justice (DOJ) regarding a significant false claims act investigation. He has provided opinions on over $1 billion in health care claims and due diligence on over $8 billion in healthcare mergers and acquisitions. Education: UC Irvine - Economics and Computer Science, University of Southern California - Business, studies at Stanford Medical School - Biomedical Informatics, studies at Harvard Medical School - Bioethics. Trained in over 10 medical specialties in medical billing and coding. Trained by U.S. Patent and Trademark Office (USPTO) and PTAB Judges on patent statutes, rules and case law (as a non-attorney to better advise clients on Technical and Damages aspects of patent construction and claims). Mr. Arrigo has been interviewed quoted in the Wall Street Journal, New York Times, and National Public Radio, Fortune, KNX 1070 Radio, Kaiser Health News, NBC Television News, The Capitol Forum and other media outlets. See and for more about the company.

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