7 health IT changes in latest Medicare program proposal

CMS made a series of changes that will affect the use of health IT in its latest Medicare Physician Fee Schedule and Quality Payment Program proposal released July 12.

Changes are aimed at getting physicians to focus on clinically meaningful information rather than data needed strictly for billing purposes. CMS' goal is to increase the time physicians spend with their patients face-to-face.

"Today's proposals deliver on the pledge to put patients over paperwork by enabling doctors to spend more time with their patients," CMS Administrator Seema Verma said. "Physicians tell us they continue to struggle with excessive regulatory requirements and unnecessary paperwork that steal time from patient care. This administration has listened and is taking action."

Here are seven health IT-related changes proposed in the fee schedule and QPP rules:

Changes to documentation:

1. CMS is proposing the following changes:

  • Allowing practitioners to choose to document office or outpatient evaluation and management visits using medical decision-making instead of applying current documentation guidelines;
  • Expanding current options by allowing practitioners to use time as the governing factor in selecting visit level and documenting the visit, regardless of whether counseling or care coordination dominate the visit;
  • Expanding current options regarding the documentation of history and exam to allow practitioners to focus their documentation on what has changed since the last visit or on pertinent items that have not changed, rather than redocumenting information, provided they review and update the previous information; and
  • Allowing practitioners to simply review and verify certain information in the medical record that is entered by ancillary staff or the beneficiary, rather than re-entering it.

Changes to the Merit-based Incentive Payment System:

2. Under year three of MIPS, the agency is considering removing low-value, low-priority process measure reporting to focus on patient outcomes and improve interoperability.

3. CMS also seeks to overhaul MIPS' "Promoting Interoperability" performance category and instead, roll this performance category under the new Promoting Interoperability program to support greater EHR data sharing capabilities and patient access to their health information.

Changes to EHR and virtual care technology:

4. Providers would be required to upgrade to the 2015 edition certified EHR technology beginning in 2019.

5. Under the changes, providers would be able to bill Medicare for short virtual check-ins that would help patients manage chronic diseases or avoid preventable hospital readmissions. Clinicians would no longer need to establish a prior in-person relationship with the beneficiary.

6. The proposed rule would ensure providers are  paid separately for the "brief communication technology-based service" when they check in with beneficiaries via telephone or other telecommunications during evaluations on whether the patient should be seen in-office or not.

7. Practitioners would  be paid for reviewing photos or videos submitted by patients to assess whether a visit is needed.

Comments on the proposed rule are due Sept. 10.

To learn more about CMS' proposed rule changes, click here for a detailed fact sheet.

To access the complete proposal, click here.

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