Below is a video of my presentation at the AAMA 58th Annual Conference in St. Louis, in which I discussed order entry into the computerized provider order entry (CPOE) system and answered questions about the Centers for Medicare and Medicaid (CMS) Stage 2 Meaningful Use requirements.
The video can also be accessed through the AAMA YouTube channel: https://www.youtube.com/watch?v=Hz4avFT3XZE
The Medicare Electronic Health Record (EHR) Incentive Program and the Medicaid EHR Incentive Program are two similar, but different, federal initiatives. Questions have arisen about which health care providers are eligible to participate in the Medicare Program, the Medicaid Program, or both.
Medicare-only eligible professionals (EPs) are optometrists, podiatrists, and chiropractors. Medicaid-only EPs are nurse practitioners, nurse midwives, and physician assistants—when working at a federally qualified health center (FQHC) or rural health clinic (RHC) that is led by a physician assistant. In some circumstances, physicians, osteopaths, and dentists could be eligible for both the Medicare and Medicaid Incentive Programs.
The Centers for Medicare and Medicaid Services (CMS) recently issued an important clarification regarding meaningful use order entry. See the following quote from a report by the American Academy of Ophthalmologists:
EHR Meaningful Use Update: CMS Comes Out Against Scribes
Despite Academy efforts, the Centers for Medicare & Medicaid Services clarified this week that medical scribes − even those who are certified − are not permitted to enter electronic medication, laboratory, or radiology orders into electronic health record systems. The Academy believes that changes to the criteria for satisfying the EHR Meaningful Use Program’s Computerized Provider Order Entry measure lacked clarity regarding appropriate personnel who may perform this task.
In communication to the Academy, CMS explained that it is not permitting scribes to enter medical data under the CPOE measure. Medical staff entering orders into EHRs for purposes of satisfying the CPOE measure must be, at minimum, a certified medical assistant or equivalent, which includes certified ophthalmic technicians, certified ophthalmic technologists, and certified ophthalmic assistants.
Questions have arisen about the 60-month-after-graduation requirement for the CMA (AAMA) Certification Examination, and eligibility to recertify by retesting.
- Individuals who have graduated from a medical assisting program accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) or the Accrediting Bureau of Health Education Schools (ABHES) on or after January 1, 2010, must take and pass the CMA (AAMA) Certification Examination within 60 months after the date of graduation. Individuals who graduated before January 1, 2010, are not subject to the 60-month requirement. In other words, according to current policy of the Certifying Board of the AAMA, an individual who graduated from a CAAHEP or ABHES accredited medical assisting program prior to January 1, 2010, is not subject to any time limit for taking and passing the CMA (AAMA) Certification Examination and being awarded the CMA (AAMA) credential.
- Prior to the June, 1998 administration of the CMA (AAMA) Certification Examination, there were eligibility pathways other than graduation from a CAAHEP or ABHES accredited medical assisting program. Generally, those who became CMAs (AAMA) prior to June of 1998 and were not graduates of an accredited program are eligible to recertify by continuing education or retesting. Such individuals are not forbidden from recertifying by retesting because they did not graduate from a CAAHEP or ABHES accredited program.
As the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs continue to be implemented and enforced, questions arise about how certain objectives for meaningful use affect reimbursement. The short answer to these questions is that all objectives are critical. Failure to meet even one objective for meaningful use can result in not only a payment forfeiture, but also retroactive recoupment of previous payments, as well. Thus, it is incumbent on all health care providers to ensure that proper steps are being taken to comply with all meaningful use objectives. The text and video of Mr. Anthony’s statement on this matter follows:
“That’s correct. If [a practice] is not meeting all of the objectives for meaningful use for a program year, then that payment would be forfeit. … As we move forward, of course, every year is going to be a deciding year for payment adjustments—so potentially, if an audit comes through and you forfeit a payment, you may not only be forfeiting the payment, but you would also be subject retroactively to payment adjustments, as well.”