SCGhealth Blog


Share your EMR Information- Prevention of Information Blocking Attestation

Monday, November 27, 2017

By Audrey Landers, Intern

Part of getting the highest score possible in the Advancing Care Information (ACI) category of the Merit-based Incentive Payment system (MIPS) is using your certified electronic medical record technology to exchange electronic health information. The Center for Medicare & Medicaid (CMS) understands that sometimes there may be circumstances that are beyond a MIPS eligible clinician’s control that may hinder their ability to do this, therefore you must show that you have acted in good faith to share health information when appropriate. CMS intends to focus on the individual clinician’s circumstances in order to determine whether a good faith effort was made.

All MIPS eligible clinicians will be required to attest to statements about the implementation and use of certified electronic medical record technology. If you are reporting as a group, every single MIPS eligible clinician must attest. If any member does not attest, the whole group will fail the meet the attestation requirement.

There are three statements that each MIPS eligible clinician must attest to:

Statement 1: I did not knowingly and willfully take action (such as to disable functionality) to limit or restrict the compatibility or interoperability of certified electronic medical record technology.

Statement one is mostly an umbrella statement, with the other two statements going into further detail. With this first statement, you must be ready to demonstrate that you have not knowingly restricted access to your certified electronic medical record technology.

Statement 2: I implemented technologies, standards, policies, practices, and agreements reasonably calculated to ensure, to the greatest extent practicable and permitted by law, that the certified electronic medical record technology was, at all relevant times:

  • Connected in accordance with applicable law

  • Compliant with all standards applicable to the exchange of information, including the standards, implementation specifications, and certification criteria in regulation

  • Implemented in a manner that allowed for timely access by patients to their electronic health information (including the ability to view, download, and transmit this information)

  • Implemented in a manner that allowed for the timely, secure, and trusted bidirectional exchange of structured electronic health information with other health care providers as defined by law

Statement two is about the interoperability of certified electronic medical record technology. Specifically, this statement confirms that you reasonably implement corresponding technologies, standards, practices, and policies as well as agreeing not to restrict appropriate access to your certified electronic medical record technology’s information. CMS does not expect individual clinicians to have a complete understanding of the technical details as long as a good faith effort is shown to comply with this statement.

Statement 3: I responded in good faith and in a timely manner to requests to retrieve or exchange electronic health information, including from patients, health care providers and other persons, regardless of the requestor’s affiliation or technology vendor.

Statement three focuses on the use of certified electronic medical record technology and the steps taken to exchange appropriate information in a timely manner. You may attest to statement three even if you have restricted information, as long as there was a good reason. For example, in the cases of certified electronic medical record technology maintenance or a security concern, functionality may be reasonably restricted in ways that are narrowly tailored to the situation and show a good faith effort to minimize the impact of loss of functionality for patients and other clinicians.

For more information about the prevention of information blocking attestation, please see CMS’ official fact sheet.


No More “Hardships” - How to Qualify for Reweighting of ACI Performance Category Under MIPS

Wednesday, October 25, 2017

By Brandy Dehaven, Intern

Previously, any eligible clinician without certified electronic medical technology (CEMRT) could receive reweighting of the Advancing Care Information (ACI) performance category, but as of October 1, 2017, clinicians will have to prove that their reasons for not having CEMRT are good enough to receive a hardship exception. This exception allows eligible clinicians that meet the hardship specifications to participate in the Quality Payment Program (QPP) and not receive a negative 4% payment adjustment. The deadline to apply for a hardship exception is March 31, 2018.

Who Qualifies?
Just because an eligible clinician does not have CEMRT, does not mean they qualify for the reweighting. There are specific reasons that will need to be cited by the eligible clinician to receive the reweighting. 

The reasons specified are:

  • insufficient internet connectivity

  • extreme and uncontrollable circumstances

  • lack of control over the availability of CEMRT

Eligible clinicians may also qualify for reweighting if classified as a special status Merit-based Incentive Payment System (MIPS)-eligible clinician. Special status clinicians in 2017 include hospital-based MIPS-eligible clinicians, physician assistants, nurse practitioners, clinical nurse specialists, certified RN anesthetists, and non-patient facing clinicians. 

What steps do eligible clinicians need to take?
Applications for reweighting can be completed and submitted online. In addition, the QPP service center is offering eligible clinicians an opportunity to submit an application verbally. Special status clinicians do not need to submit an application and will automatically be reweighted. Applications will need to be reviewed and will result in approval or dismissal. 

Information needed for the application includes: contact information, Taxpayer identification number or National Provider Identifier (NPI), and hardship exception category. Be prepared to provide supplemental information on the hardship exception category selected.

Apply for the QPP Hardship Exception online here.

Or apply verbally by calling the QPP Service Center: 866-288-8292

Deadline
MIPS-eligible clinicians need to submit a QPP Hardship Exception Application by March 31, 2018. If you qualified for the QPP Hardship Exception, there is still time to apply and report MIPS measures to avoid a negative a negative payment adjustment for 2017.

Further Reading:
About Hardship Exceptions




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