Final MU rules are out but don’t forget, you’ve still got all of 2011 and 2012 to get paid

As you’re probably already aware, the final meaningful use rules were released by the government about 48 hours ago. Overall, I’m impressed with the transparency, quality, and timeliness of the final regulations. I think the “little guy” won one because the MU rules have mostly been reduced from the original requirements and the two additions are relatively easy. While I don’t think we should be doing any top-down initiative like MU, given that it’s the law, HHS, CMS, and NIST is doing as good a job as they can in writing the rules and attempting to make them understandable. I’m especially impressed with NIST’s draft test plans and directives which should ease the certification process for techies like me.

We’re still months away from any systems being certified for MU because NIST still has to update all of it draft test plans to match the final rules, the certifying bodies have yet to be selected, the certifying bodies haven’t prepared their test processes and plans, and the certification bodies haven’t finalized their certification requirements. My guess is that vendors will not be able to submit their products for final MU certification until September or October and that the first certified-versions of the products won’t be released until late this Fall.

Many readers have been e-mailing me about “what should I do now?” and my answer is simple:

  • Don’t be in a hurry to make an EMR/EHR decision because of incentive payments; even if you start in 2012 you’ll be eligible for full payments from Medicare ($44k over 5 years) and you can start as late as 2016 to get full payments from Medicaid ($66k over 5 years). If you’re making EHR/EMR decisions based on other business benefits and not incentive payments then you should continue that research and decision-making process.
  • Do be in a hurry to use technology that helps with office automation first (like document management, patient relationship management, etc.). General office automation technology won’t qualify you for incentive payments but it will help reduce your costs and you’ll run your business better. If you use the proper technology you save more in one year than you’ll get back from incentive payments in 5 years.
  • Make sure to get your MU and certification information from the most trustworthy place: the government’s website at http://www.cms.gov/EHRIncentivePrograms. It’s not that other sites (like mine) would deliberately mislead you but government regulations are so new that there are no experts on those rules so anyone saying they “know” what the government expects is probably not correct because even government officials don’t know all this stuff. Whatever you’re told, always try to bounce it off the government’s site and for those that give you advice have them source their knowledge from official guidance or regulations and prove to you that they’re correct. The government doesn’t hide regulations, it’s all public and transparent and anyone providing advice should be able to quote it appropriately.

Lastly, don’t forget that there some nice sites that are providing good free “EMR decision-making” guidance. Check them out.

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26 thoughts on “Final MU rules are out but don’t forget, you’ve still got all of 2011 and 2012 to get paid

  1. Re: “so anyone saying they “know” what the government expects is probably not correct because even government officials don’t know all this stuff.”

    Agreed! I tried to spend this week really diving into this rule, and feel that I only scratched the surface of all the changes and developments that have occurred. In fact, skimming through the comments and responses, I realized how little I had actually known about the original nprm!

    For those interested in different reactions to the rule, John Lynn over at EMR & EHR has created a list of links dealing with the various reactions to the final rule online. I've also taken my own stab at summarizing the rule, in video format. Personally, I'm very glad that some flexibility has been made available: while there's still a lot to do, this list of objectives looks far more manageable than the earlier rule.

  2. Shahid, few minor corrections. The max Medicaid amount is still $63,750 and it's for over 6 years… I know, so many numbers to remember :). I am doing my assessment of the final rule right now and it's very interesting and actually much better than I expected.

  3. Hi Shahid, great post here! Its great to see that many of the meaningful improvements are focused on improving patient care. For example, doctors will be expected to transmit more than 40% of their prescriptions electronically and providers must produce an electronic copy of a patient’s medical record within three business days to more than 50% of patients who request it.

    On your last note about selecting a good EMR product, please take a look at WireTap (www.wiretap.com), a new service (beta) focused on helping doctors rate and review medical products by allowing users to share their honest feedback on the EMR product they are using.

  4. Very interesting insight. As an IT provider we are often asked questions about EMR from our medical clients. You site is generally one of the first places I send them. You have your finger on the pulse, please keep up the excellent work.

  5. My guess is that vendors will not be able to submit their products for
    final MU certification until September or October and that the first
    certified-versions of the products won’t be released until late this
    Fall.

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