Under a new proposed rule, federally qualified health centers and rural clinics must use electronic health recordscertified to the 2014 Edition meaningful use requirements at a minimumbeginning in January to receive higher reimbursement for managing Medicare patients with two or more chronic conditions during calendar year 2016.
Certified health IT must be used for the recording of demographic information, health-related problems, medications and medication allergies, a clinical summary record, and other scope of service requirements that reference a health or medical record, the Centers for Medicare and Medicaid Services states in the rule setting the Part B physician fee schedule.
What the higher payment would be and related issues arent specified in the rule, but CMS asks for suggestions during the comment period. This is the first physician fee schedule rule since the Sustainable Growth Rate formula was repealed.
CMS is proposing minimum levels of EHR capabilitywhat it calls CCM certified technologyto support data sharing that would enhance coordination of care with other practitioners as patients with multiple conditions often have multiple physicians.
Other EHR requirements for FQHCs and rural health clinics include making care plan information available on a 24/7 basis to all practitioners within the RHC or FQHC whose time counts towards the time requirement for the practice to bill for CCM services; and share care plan information electronically (other than fax) as appropriate with other practitioners, providers and caregivers, according to the proposed rule.
Further, CMS proposes that communication to and from home and community based providers regarding the patients psychosocial needs and functional defects must be documented in the patients medical record using CCM-certified technology.
Another new requirement: rural health clinics previously need to submit HCPCS codes only for preventive services. Now, CMS proposes they submit HCPCS codes for all services furnished. Doing so would be consistent with electronic health transactions requirements and would provide useful information on RHC patient characteristics, such as level of acuity and frequency of services furnished, and the types of services being furnished by RHCs, according to the rule. This information also would allow greater oversight of the program and inform policy decisions.
The proposed rule is available here.
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