ARRA / HITECH Update & X12 5010 and ICD-10 Update

The American Recovery & Reinvestment Act (ARRA) signed in February by President Obama provided the largest influx of capital ever toward the adoption of healthcare IT in the US. However, many decisions surrounding how this funding will be distributed are still in the works. Since February, several clarifica¬tions required by the legislation have been issued, while others are still pending. Of these, perhaps the largest will be the final definition of “meaningful use” and the issuance of requirements EHRs must fulfill in order to be “certified.”

“Meaningful use” is a standard providers must meet in order to be a candidate for any type of funding under ARRA. The intent is to ensure that providers are not only implementing EHRs, but are using them consistently throughout the various processes of care delivery. We know that meaningful use will be monitored through multiple methods including mandatory report sub¬mission, audits, and provider attestation, but the controversy surrounding what meaningful use actually IS, is yet to be deter¬mined. In mid-July, the Healthcare IT Policy committee submit¬ted a revised recommendation of meaningful use to the Office of the National Coordinator (ONC) and HHS, who are the final decision-makers regarding the definition. Some key inclusions in the new recommendation broaden meaningful use to include workflows such as electronic claims submission, eligibility, and the ability to provide patients with an electronic version of their health record. Another positive change recommended is that 2011 meaningful use requirements would instead be treated as “year one” criteria, meaning that if a provider starts to use an EHR in 2012, they will be required to meet the 2011 require¬ment rather than the 2012 requirement, which would be more stringent.

SourceMedical is also closely following the progress of EHR certification requirements, which ARRA states must be published no later than December 31, 2009. There is strong speculation that CCHIT requirements may be a component of the govern¬ment requirements, but it is likely that requirements from other entities will also be included, and that there will be some changes to the CCHIT requirements if they are included. More recent speculation is that there may be multiple certification bodies formed, allowing EHR vendors to become certified by any of these organizations. This would address the criticism that CCHIT favors the largest of the large EHR vendors, and could also make the process of EHR certification more effective and time-efficient for the government and EHR vendors.

To ensure that our customers are in the best possible position, and to demonstrate our commitment to the broad adoption of EHRs in ASCs and Surgical Hospitals, SourceMedical is proac¬tively working toward CCHIT certification for our EHR solutions. We recently announced the Vision EHR Compliance Guarantee, which provides customers with peace of mind knowing that if Vision EHR fails to comply with the government requirements once in place, a refund will be issued. In addition, SourceMedical is offering new financing options that make it easier than ever for our customers to adopt an EHR without significant upfront costs. For more information on these exciting programs, please contact your Account Manager or our Sales Support team at 800-719-1409.

We strongly believe that healthcare technology can add to the quality and safety of patient care, and can create much-needed efficiencies within the healthcare system. We look forward to serving you and your staff on this important initiative. For more information, please visit the “Industry News” page of our website (www.sourcemed.net), or contact Lindsay McQueeney, Director of Product Management, at lindsay.mcqueeney@sourcemed.net.

X12 5010 and ICD-10 Update
On January 16, 2009 the Secretary of the Department of Health and Human Services (HHS) published the ruling adopting ASC X12 version 5010 as the next HIPAA standard for HIPAA cov¬ered transactions. This action impacts electronic claim file for¬mats including both institutional and professional claims as well as electronic remittance advice files. Some important dates in the implementation process are listed on the Centers for Medicare and Medicaid Services’ website.

•    Level I compliance must be met by 12/31/2010. Level I compliance is defined as, “that a covered entity can demonstrably create and receive compliant transactions, resulting from the compliance of all design/build activities and internal testing.”
•    Level II compliance must be met by 12/31/2011. Level II compliance is defined as, “that a covered entity has completed end-to-end testing with each of its trading partners, and is able to operate in production mode with the new versions of the standards.”

SourceMedical is in the process of analyzing the various changes that will be required to accommodate these mandates in our products. A few examples of some of the changes that will impact all healthcare IT systems include:

•    A pay-to-provider segment can now be used to direct payment to a lockbox or post office even if the billing provider is the same entity as the pay-to-provider
•    Addition of the present on admission field within the claim loop instead of an add-on segment
•    For anesthesia claims, units can no longer be used for billing, as the minutes are now required in the professional claim file
•    The addition of ICD-10 diagnosis and procedure codes
 
As we make changes to accommodate the 5010 file format, we will also be taking the upcoming ICD-10 code changes into consideration. The ICD-10 code must be implemented by October 1, 2013. For more information on this topic, please contact Angie Hicks, Product Manager, at angie.hicks@sourcemed.net.