ACEP4U: Electronic Health Records (EHR)

AUGUST 2020

Appropriate Use Criteria Program: Due to the COVID-19 public health emergency, CMS has delayed the full implementation of the AUC Program until at least the start of calendar year (CY) 2022. The educational period (where compliance is encouraged but not required) which was supposed to run through the end of CY 2020 has been extended through the end of CY 2021.

AUGUST 2019

Appropriate Use Criteria Program: Now that we have this clarification to the exemption, we need you to spread the word to your hospital administrators. Here is a sample letter you can personalize to let your hospital administrators know about the emergency medical condition exemption and ask them to help make sure the exemption is properly implemented in your ED. 

JULY 2019

Promoting Interoperability Category of MIPS: CMS released the Calendar Year (CY) 2020 Physician Fee Schedule and Quality Payment Program Proposed Rule, which includes a proposal to exempt groups from the Promoting Interoperability category of MIPS if 75 percent of the individuals in the group meet the definition of hospital-based. ACEP’s full summary of the Proposed Rule can be found here.

Appropriate Use Criteria Program: CMS posted instructions about how to claim the emergency medical conditions exemption. The guidance instructs clinicians to use modifier “MA” on the same line as the CPT code for the advanced diagnostic imaging service in cases where the service is “being rendered to a patient with a suspected or confirmed emergency medical condition.”

JUNE 2019

CMS issued a call for ideas for reducing provider burden as part of its Patients Over Paperwork initiative. ACEP submitted ideas specific to EM, and we asked our members to send their suggestions to Jeffrey Davis, ACEP's Director of Regulatory Affairs, at jdavis@acep.org. 

EHRs and Data Sharing: We submitted detailed comments on both CMS and ONC interoperability and data blocking proposed rules.

Like other provider groups, we support the goal of improving access to data but are very concerned about the additional pressure being placed on providers to invest in data sharing technology and the speed at which providers would be required to implement these new technologies. Given the magnitude of changes in these rules, we believe that CMS and ONC should publish interim final rules rather than final rules to allow additional opportunity for stakeholder comment. We also recommend that CMS and ONC delay any disincentives and/or penalties until two years after implementation of the rule to allow all stakeholders to have time to address any unforeseen challenges.

EHRs & Data Sharing: ACMS and ONC released two rules related to interoperability and data blocking. These rules are required in part by the 21st Century Cures Act. Read our summary of both rules.

EHR Burden: We responded to the Office of the National Coordinator for Health Information Technology’s (ONC’s) draft strategy on ways to reduce burden for providers using health information technology (IT) and EHRs. In general, ACEP supported the main recommendations included in the draft strategy and appreciated the efforts the Administration has already taken to reduce provider burden and to improve the usability and exchange of information. We also described ways that CMS can further reduce provider reporting burden under MIPS. Lastly, we expressed our disappointment that the draft strategy does not at all address the effectiveness of qualified clinical data registries (QCDRs) or what the Administration can do to continue to encourage these as a way of reporting quality measures.

Promoting Interoperability Category of MIPS: We sent out an action alert recommending that physicians apply for a hardship exception to the Promoting Interoperability of MIPS. If granted the exemption, the 25 percent PI allocation is usually redistributed to the Quality category, giving physicians more control over meeting the necessary requirements so they can avoid negative impacts on revenue. 

Appropriate Use Criteria Program: In response to ACEP’s comments,
CMS clarified in the final Medicare physician regulation that the AUC exemption for emergency medical conditions includes cases where an emergency medical condition is suspected, but not yet confirmed. Examples include severe allergic reactions and pain. 

Appropriate Use Criteria Program: ACEP met with the Office of Management and Budget, the final decision-maker for regulatory policies, on our concerns related to the exemption for emergency medical conditions. 

PI Category of MIPS: We strongly advocated for a change to the “all-or-nothing” MIPS exemption for hospital-based individual physicians in our official response to a major Medicare proposed regulation impacting physician payments.

AUC Program: ACEP implored CMS to clarify the exemption for emergency medical conditions in our response to this same regulation.