CMS softens proposal to require EHRs for payment of chronic care management

The Centers for Medicare & Medicaid Services has relaxed--slightly--its proposal of requiring physicians to use electronic health records to be reimbursed for chronic care management (CCM). It won't drop the requirement but will allow practices to use either 2014 or 2011 certified systems.

The final rule, released Oct. 31, and scheduled to be published in the Federal Register Nov. 13, adds the EHR requirement as a new scope of service for physicians providing CCM. The proposed rule would have required use of 2014 certified technology only; CMS softened its stance in response to comments that many physicians have not yet adopted 2014 certified EHR technology.

The agency reiterated its stance about adopting EHRs in its rule. 

"We continue to believe that it is necessary to require the use of EHR Technology that has been certified under the ONC Health IT Certification Program as requisite for receiving separate payment for CCM services, to ensure that practitioners have adequate capabilities to allow members of the interdisciplinary care team to have timely access to the most updated information informing the care plan," the agency states.

The rule also requires that the care plan provided to the patient be documented in the EHR and that clinicians' electronically capture care plan information and make it available to other team members furnishing CCM. In addition, it adds seven new telemedicine billing codes to the 2015 Medicare physician fee schedule, including those for annual wellness visits, psychotherapy and prolonged office visits; all were included as part of CMS' proposal for expanded coverage, published in July. 

CMS also is increasing Medicare payments to telehealth originating sites by 0.8 percent next year.

The rule additionally softens several requirements of the Meaningful Use incentive program itself. For example, eligible professionals no longer have to ensure that their certified EHR product has been recertified and the reporting obligations on comprehensive primary care initiative practice sites has been reduced. 

Comments on the final 2015 fee schedule are due Dec. 30.

The payment rule is the latest in a series of CMS rules that affect or require EHRs but are not directly related to the Meaningful Use program. Stakeholders had expressed concern about the EHR provisions in the physician payment rule.

To learn more:
- read the rule (.pdf)
- check out the fact sheet

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