The Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs Final Rule, CFR 42 Parts 412, 413, 422 et al., (Final Rule) provides guidance and requirements for a Medicaid appeals process, but does not provide an appeals process for the Medicare EHR Incentive Program. CMS is currently implementing an appeals process for the EHR Incentive Program which will include requirements for appealing eligibility, meaningful use and incentive payment determinations under the Medicare EHR incentive program. Originally, eligible hospitals or representatives filing an eligibility appeal on behalf of eligible hospitals could file an appeal no later than December 30, 2011 for the 2011 EHR Incentive Program reporting period. However, CMS has extended the filing deadline to January 30, 2012.

Eligible hospitals may reach the appeals support contractor or the Office of Clinical Standards and Quality (OCSQ) Appeals Support Center either by email at OCSQAppeals@provider-resources.com or the toll free number at 1-855-796-1515. The OCSQ Appeals Support Center is available between the hours of 9 a.m. and 5 p.m. EST Monday through Friday.

View more information.

January 26, 2012 — A new online toolkit will serve as a pilot program for providing health information technology (HIT) resources to rural health care providers. The toolkit, developed by the Rural Assistance Center (RAC) and the National Rural Health Resource Center (The Center) is designed to help rural providers find resources for HIT, electronic health records (EHR), meaningful use and related topics. Funding for the toolkit, available at http://www.raconline.org/hit/, is provided by the federal Office of Rural Health Policy (ORHP).

“HIT is critically important for rural communities and this toolkit is one way to help rural health care providers get projects up and running,” explains Kristine Sande, RAC program director. “While rural communities have seen many advances and innovation in using EHRs and HIT networks, they still face a number of challenges.”

This toolkit was developed as a result of the President’s Rural Health Initiative, which identifies HIT as a priority. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius established the Rural HIT Taskforce to address challenges rural communities face in adopting HIT and achieving meaningful use. The taskforce offers ways to meet those challenges and show rural communities how to coordinate federal resources. The taskforce is co-chaired by HRSA Administrator Dr. Mary Wakefield and National Coordinator for HIT Dr. Farzad Mostashari.

Using the toolkit, rural communities will be able to:

• Address challenges in finding capital funding
• Provide support to community colleges to enhance training programs
• Stay informed about legislation affecting EHRs
• Leverage multiple federal resources for project development

Toolkit resources provide guidance in the planning, setup, implementation and operation of an HIT infrastructure. Additional information also shows where to find training programs, funding support and management expertise. Resources are broken down by category and topic for easier access, and can be sorted for more specific results.

Terry Hill, executive director of the National Rural Health Resource Center, emphasizes, “A lot of rural providers need guidance on putting an HIT system in place. This toolkit gives them a starting point and can help them get through the entire implementation process.”

For more information
Kristine Sande, RAC Program Director
701.777.6466

About the Rural Assistance Center
The Rural Assistance Center (RAC) helps rural communities and agencies learn about programs, funding and research beneficial to rural residents. Located at the Center for Rural Health at the University of North Dakota School of Medicine and Health Sciences, RAC provides information and technical assistance through its call center and online resource library, www.raconline.org.

About the National Rural Health Resource Center
The Center is a nonprofit organization dedicated to sustaining and improving health care in rural communities by providing technical assistance, information, tools and resources. It also serves as a national rural health knowledge center and strives to build state and local healthcare capacity.

Meaningful Use and “Million Hearts”: Their Potential for Impacting & Improving Cardiovascular Disease & Stroke Through Quality Measures Advanced Webinar Series

Columbia, MO—Improving health outcomes is what health care is all about, and with that in mind, our next advanced Missouri Health Information Technology (MO HIT) Assistance Center Webinar will focus on the “Meaningful Use and Million Hearts.” 

Our advanced Webinar for February will show how meaningful use of electronic health records and “Million Hearts” will use quality measurement to impact cardiovascular disease (CVD) and stroke.  Penelope Solis, JD, Healthcare Quality Manager of the American Heart Association, will deliver this Webinar.  Her presentation will recap the measures currently included in stage one of meaningful use and the current proposals for stages two and three as they relate to clinical quality measures.  Solis will also discuss the role of, and barriers identified by, the Health and Human Services Health Information Technology Policy Committee. Providers will also learn the ways “Million Hearts” seeks to prevent 1 million heart attacks and strokes in five years and the potential points of intersection between meaningful use and “Million Hearts.”

Please join us at 11:30 a.m. on Wednesday, February 8^th for this one-hour presentation. This is a free session, but space is limited and you must preregister to attend. Please follow the link below to register for this presentation. https://www3.gotomeeting.com/register/330432086

This live Webinar presentation is eligible for American Osteopathic Association Category 2B Credit. Physicians may earn one CME credit for the same live Webinars. Full instructions for these credits will be provided during the presentation.

The Office of Continuing Education, School of Medicine, University of Missouri designates this live Internet educational activity for a maximum of one AMA PRA Category 1 Credit™. Physicians should only claim the credit commensurate with the extent of their participation in the activity.

The Office of Continuing Education, School of Medicine, University of Missouri is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. 

This presentation is eligible for American Osteopathic Association Category 2B Credit.  Please complete and submit the printed questionnaire to the American Osteopathic Association.

For information on the Medicaid and Medicare EHR incentive programs, EHR adoption, or how the MO HIT Assistance Center helps health care providers adopt and achieve meaningful use of certified EHRs, please visit the Missouri Health Information Technology Assistance Center Web site http://www.EHRhelp.missouri.edu, E-mail us EHRhelp@missouri.edu, or call us toll-free 1-877-882-9933.

The Flex Monitoring Team is pleased to announce the release of a new policy brief, part of a series of policy briefs identifying and assessing evidence-based patient safety and quality improvement interventions appropriate for use by state Flex Programs and CAHs.  

Evidenced-based Falls Prevention in Critical Access Hospitals 

Because falls are among the significant adverse events experienced in hospitals, falls prevention is a critical component of any patient safety strategy.  Partnership for Patients, a public-private partnership funded by the U.S. Department of Health and Human Services, includes as one of its nine areas of focus Injuries from Falls and Immobility which are a significant cause of hospital-acquired injury. Partnership for Patients estimates that 25% of fall injuries are preventable and the goal set for hospitals is to cut the number of preventable fall injuries in half while maintaining or increasing patients’ mobility by 2013.

This Policy Brief by the Flex Monitoring Team aligns with the goals of Partnership for Patients, and describes strategies applicable to Critical Access Hospitals and State Flex Programs.   

Key Findings:  

• Hospital falls are a serious patient safety problem, accounting for nearly 84% of all inpatient incidents. Most falls commonly occur as a result of medication related issues, toileting needs, and hospital environmental conditions.
• Effective falls interventions target both intrinsic (e.g. physiologic) and extrinsic (e.g. environmental) risk factors.
• Effective falls prevention teams are interdisciplinary and ideally include pharmacists, nurses, physical therapists, medical, and quality officers and are imbedded in a culture of patient safety.
• Education for and communication across all staff contributes to successful falls prevention programs.
• Reporting falls data to one of the national organizations allows for benchmarking.

For more information, contact Karen Pearson, karenp@usm.maine.edu at theUniversity of Southern Maine.   

The authors gratefully acknowledge the assistance of Angie Charlet, Illinois Critical Access Hospital Network; Katherine Jones, University of Nebraska Medical Center; Darlene Bainbridge, DD Bainbridge & Associates, Inc.; Kathy Wilcox, Montana Performance Improvement Network; Laura Gamble and the Fall Risk Committee, Providence Medical Center, Wayne, Nebraska; Trudy O’Bar, Katrina Taggett, and Tom Mockus, Maine Critical Access Hospitals; and Alexander Dragaski, Maine Quality Forum. We also extend our appreciation to our USM colleagues for their encouragement and support and our  thanks to colleagues at the University of Minnesota and staff at the federal Office of Rural Health Policy for their thoughtful review of this policy brief.

 Eliminating Central Line Infections and Spreading Success at High-Performing Hospitals

Commonwealth Fund
Silow-Carroll, Sharon; Jennifer N. Edwards

Synthesizes lessons in preventing central line-associated bloodstream infections, including the importance of evidence-based protocols, dedicated teams to oversee central line insertions, participation in collaboratives, and monitoring of infection rates.

Published: December 2011
Funder(s): Commonwealth Fund
Subject(s): Health; Health, Healthcare Access/Reform

The Department of Health and Human Services through the Office of Minority Health Think Cultural Health Program has a section of tools and resources that your organization may find useful in addressing some of the major challenges in providing cultural effective care.
If you are interested, please see the links below:

1. Think-Speak-Act Cultural Health: Part I
2. Think-Speak-Act Cultural Health: Part II
3. https://www.thinkculturalhealth.hhs.gov/

Thank you very much for your time,
Ioana Staiculescu
Research Specialist
Center for Health Policy

Please note the following correction in HRSA’s November/December Health IT and Quality Newsletter, “ICD-10 Update” section.

ICD-10 Update

CMS Announces Enforcement Discretion Period for HIPAA Version 5010

Correction: “The compliance deadline of January 1, 2012 remains unchanged for Version 5010. CMS announced a period of discretionary enforcement and described those terms in our messages. Grantees should continue to work in close collaboration with their partners to explore potential impacts and compliance strategies.”

CMS has announced a three-month enforcement discretion period during which it will not enforce against HIPAA covered entities that accept non-compliant HIPPA Version 5010, NCPDP 3.0 and NCPDP D.0 standards.  This enforcement discretion period ends March 31, 2012. HRSA encourages all grantees all grantees and safety net providers to continue to working towards meeting the January 1, 2012 standards’ deadline, as well as the October 1, 2013 ICD-10 code set deadline.

For more information, see HRSA’s “ICD-10 Conversion Website for Safety Net Providers”.

Questions should be directed to healthIT@hrsa.gov.

December 13, 2011

To:  Critical Access Hospitals, Rural Clinicians, State Offices of Rural Health

From:  The Office of Rural Health Policy, Health Resources and Services Administration, U.S. Department of Health and Human Services

RE:  National Health Service Corps Critical Access Hospital Pilot Program

The Health Resources and Services Administration has released its 2012 guidance for the National Health Service Corps (NHSC) Loan Repayment Program (LRP), which includes a pilot program that expands eligibility to Critical Access Hospitals (CAHs) and eligible clinicians working in CAHs:  primary care physicians; psychiatrists; nurse practitioners; certified nurse midwives; and physician assistants. The NHSC CAH Pilot Program was created as part of the White House Rural Council (http://www.whitehouse.gov/administration/eop/rural-council).

CAHs and interested clinicians should review the 2012 guidance.  CAHs that want to become service sites have to be in a Health Professional Shortage Area (HPSA) and meet other basic program requirements (http://nhsc.hrsa.gov/sites/becomenhscapprovedsite/index.html). Currently, approximately 64 percent of CAHs are located in HPSAs. Of these, 36 percent have HPSA scores of 14 or more.  

Once they are approved as service sites, their clinicians can apply for loan repayment. The NHSC will pay up to $60,000 for an initial 2 years of full‐time clinical practice to clinicians serving at an NHSC‐approved service site with a HPSA score of 14 or higher. Applicants working at NHSC‐approved service sites with HPSA scores of 13 or lower are eligible to receive up to $40,000 for an initial 2 years of full‐time clinical service.

The NHSC will pay up to $60,000 for an initial 4 years of half‐time clinical practice to clinicians serving at an NHSC‐approved service site with a HPSA score of 14 or higher. Applicants working at NHSC‐approved service sites with HPSA scores of 13 or lower are eligible to receive up to $40,000 for an initial 4 years of half‐time clinical service.

Allowing CAHs to be eligible for loan repayment will enhance health care access and flexibility. Most providers working for these hospitals staff clinical settings across the CAH, ranging from outpatient clinics, skilled nursing care and emergency services, as well as providing limited inpatient hospital services.

Please help us get the word out about this program to CAHs and interested clinicians so they can take advantage of this opportunity.

The Office of Rural Health Policy (ORHP) and the NHSC have conducted Webinars related to this change (http://nhsc.hrsa.gov/downloads/criticalaccesspresentation.pdf). The NHSC has a contact available to answer questions: Lindsey Toohey (ltoohey@hrsa.gov). Additional contacts include your State Offices of Rural Health. You may also Contact your State PCO for assistance, or your ORHP project officer or regional liaison.

For additional program details, please see the 2012 NHSC Loan Repayment Program At-A-Glance Fact Sheet , the NHSC Loan Repayment Program Announcement Flyer and the complete Application and Program Guidance.

ORHP believes there will be significant interest among CAHs in becoming NHSC service sites to help address the ongoing access challenges these facilities face. The flexibility for loan repayors to divide service time between inpatient and outpatient care will be attractive to program applicants.