Recent News

New AOA Resource To Assist Physicians In EMR Vendor Contracting

A new annotated online resource, Negotiating EMR Contracts, is available for osteopathic physicians to assist them in understanding and negotiating an HIT-EMR contract. This resource is timely as we approach 2012, the last year to receive the greatest share of the CMS EMR Medicare incentive. Staff worked closely with an attorney who has extensive expertise in healthcare regulation. The article interprets and translates the EMR license agreement 'legalize' into understandable layman language and flags the terms and conditions that physicians should pay close attention to. Also included is a list of Frequently Asked Questions.

CMS Medicare and Medicaid EHR Incentive Programs Milestone Timeline

Eligible Professional (EP) Health Information Technology (HIT) Planner

CMS' Office of E-Health Standards and Services Announces 90-Day Period of Enforcement Discretion for Compliance with New HIPAA Transaction Standards

Electronic Submission of Medical Documentation (esMD) Pilot Project

CMS is working to lessen the burden on physicians by giving them a new way to submit medical documentation- through their Electronic Submission of Medical Documentation (esMD) Pilot Project in response to claims review requests.

CMS employs claim review contractors to find improper payments by selecting a small sample of claims, requesting the necessary medical documentation from the provider, and reviewing claims against the documentation provided to determine if the provider complied with Medicare program rules. This is a time-consuming and cumbersome task for both reviewers and providers. Most medical documentation is currently received by mail or fax.

Under the esMD Pilot Project, physicians that want to electronically submit documentation must either build their own gateway or procure gateway services from a Health Information Handler (HIH). Examples of HIHs include: a health information exchange (HIE), a Regional Health Information Organization (RHIO), an E HR Vendor, a Claim Clearinghouse, or a Health Internet Service Provider (HISP). Health Information Handlers that are participating in this program are required to attend bi-weekly calls with CMS, build a gateway that is compatible with the CONNECT portal, test their system with the CMS gateway contractor, and recruit providers to join this project. CMS anticipates that many providers will obtain services for their own gateway by entering into an agreement with a HIH.

The esMD program is voluntary. For providers that wish to send information electronically, they must access a CONNECT compatible gateway. The esMD project will allow for submission of files in a PDF format. Providers who have paper records and wish to participate in the esMD program may do so as long as there is a way to scan paper records into a PDF file.

Note: The Office of the National Coordinator for HIT (ONC) is working with CMS on this project. The formal launch of the first phase of the project will occur at the Standards and Interoperability Framework Face to Face Meeting on October 18. It is anticipated that Phase 2 of the esMD project will launch in October 2012. During the second phase, CMS claim reviewers will electronically send documentation requests to providers when their claims are selected for review.

Additional information is at www.cms.gov/esMD

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