The regulation and legislation governing IT in healthcare continues to expand in 2015. (This is not really news to anyone in the healthcare field!) The ever-evolving landscape of federal regulation -including PPACA and the HITECH Act-means providers must adapt their infrastructure. But aside from simply responding to mandates, HIT (Healthcare Information Technology) also presents opportunities in 2015 for providing better and more accurate information as well as more efficient services and achieving better control of costs. In this post, we’ll take a look at a couple of the top issues in IT healthcare legislation affecting providers this year.
The Federal Government defines ‘meaningful use’ as:
using certified electronic health record (EHR) technology to: Improve quality, safety, efficiency, and reduce health disparities. Engage patients and family. Improve care coordination, and population and public health.
Meaningful use has been pushed forward by The Health Information Technology for Economic and Clinical Health (HITECH) Act, which was established as part of the American Recovery and Reinvestment Act of 2009. It was designed to advance the adoption and meaningful use of health information technology.
HITECH established Medicare and Medicaid EHR Incentive Programs for participating professionals and hospitals. Those providers who do not demonstrate meaningful use by 2015 will become subject to a payment adjustment that starts at 1% the first year and increases each subsequent year that compliance is not demonstrated. The maximum penalty is 5%. Providers will have to be prepared to respond to Meaningful Use Audits.
The HITECH Act also widens the scope of privacy and security protections available under HIPAA; it increases the potential legal liability for non-compliance; and it provides for more enforcement. Under HITECH, mandatory penalties will be imposed for “willful neglect.”
Additionally, Subtitle D of the HITECH Act deals with the privacy and security of electronic protected health information (ePHI), increasing the enforcement of HIPAA rules and also increasing potential civil and criminal liability for violations.
In 2014, the Centers for Medicare and Medicaid Services (CMS) announced Oct. 1 2015 as the date ICD-10 compliance will become mandatory. ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification is the tenth revision of the coding system established by the World Health Organization and will replace ICD-9-CM Volumes 1 and 2 for reporting diagnoses in all clinical settings. Conversion to ICD-10 is mandatory for providers–it is a HIPAA code set requirement. Healthcare payers are also covered by HIPAA and so must also convert to ICD-10 as well. [ICD-1o-PCS is the procedure code set that will replace ICD-9-CM Volume 3 for reporting hospital inpatient procedures. ICD-10-PCS will not replace CPT® HCPCS for services and procedures in outpatient settings.]
It’s important to note that ICD-10 compliance applies not only to HIPAA electronic transactions but also to to manual transactions such as phone, fax or paper. After October 1, any transactions using ICD-9 coding will not be processed. In order to maintain the continuity of your practice and avoid cash flow hiccups, it’s important to start planning and implementing the move to ICD-10 now.
If you have questions or concerns about your organization’s healthcare technology, please reach out to us at 512 876 5984.
