Medicaid managed care organization rule supports EHRs, health info exchange

The new proposed rule that updates the Centers for Medicare & Medicaid Services' Medicaid managed care organization (MCO) regulations supports both electronic health record systems and health information exchange.

The long-awaited rule, which was last updated in 2002, covers a lot of ground, as reported on by FierceHealthPayer.

CMS says health information technology is an important tool for care coordination objectives outlined in the rule. The rule encourages states to support the adoption of technology that enables interoperability across providers and supports seamless care coordination.

One way IT could be used would be to have states make incentive payments available for use of technology that supports interoperability by network providers that were not eligible for EHR incentive payments under the HITECH Act.

"The state would be permitted to use the health plan payments as a tool to incentivize providers to participate in particular initiatives that operate according to state-established and uniform conditions for participation and eligibility for additional payments," the rule reads.

In the rule, CMS also proposes:

  • Health entities should refer to the Office of the National Coordinator for Health IT's Interoperability Standards Advisory draft for best available standards for health IT exchange
  • To permit states and managed care plans to make beneficiary information available in electronic form
  • Addition of a definition of "readily accessible" to clarify parameters for the provision of electronic information

The proposed rule will be posted in the Federal Register on June 1. The deadline to submit comments is July 27.

To learn more:
- here's the proposed rule (.pdf)