Published Final Rule (Federal Register)

The Centers for Medicare & Medicaid Services (CMS) published the Final Rule on July 28, 2009.  A PDF version of the Federal Register is available from Health Monitoring Systems website. –kjh

Final Rule

The Website HIPAA Survival Guide (aka HITECH Survival Guide) has resources for HIPAA compliance.  One nice posting includes a readable version of the final rule.  Digging through the Federal Register for the language is challenging.  This page presents the information in a nicely outline manner.  — kjh

§495.6 Meaningful use objectives and measures for EPs, eligible hospitals, and CAHs.

(a) Stage 1 criteria for EPs.

(1) General rule regarding Stage 1 criteria for meaningful use for EPs. Except as specified in paragraphs (a)(2) and (a)(3) of this section, EPs must meet all objectives and associated measures of the Stage 1 criteria specified in paragraph (d) of this section and five objectives of the EP‘s choice from paragraph (e) of this section to meet the definition of a meaningful EHR user.

(2) Exclusion for non-applicable objectives.

(i) An EP may exclude a particular objective contained in paragraphs (d) or (e) of this section, if the EP meets all of the following requirements:

(A) Must ensure that the objective in paragraph (d) or (e) of this section includes an option for the EP to attest that the objective is not applicable.

(B) Meets the criteria in the applicable objective that would permit the attestation.

(C) Attests.

(ii) An exclusion will reduce (by the number of exclusions applicable) the number of objectives that would otherwise apply. For example, an EP that has an exclusion from one of the objectives in paragraph (e) of this section must meet four (and not five) objectives of the EP‘s choice from such paragraph to meet the definition of a meaningful EHR user.

(3) Exception for Medicaid EPs who adopt, implement or upgrade in their first payment year. For Medicaid EPs who adopt, implement, or upgrade certified EHR technology in their first payment year, the meaningful use objectives and associated measures of the Stage 1 criteria specified in paragraphs (d) and (e) apply beginning with the second payment year, and do not apply to the first payment year.

(b) Stage 1 criteria for eligible hospitals and CAHs.

Read More Here…


Information for States on Meaningful Use

The Centers for Medicare & Medicaid Services have posted materials for states giving direction regarding what is necessary for meaningful use.  This information is not specific to public health, but it provides insight into the overall requirements.  Here is an article from their website that gives an introduction. — kjh

States may voluntarily offer the Medicaid EHR Incentive Program to their Medicaid eligible professionals and eligible hospitals. This page provides resources for states to understand the program and learn more about what is required to offer the programs.

Health IT Documents

To qualify to receive 90% federal matching funds for administering the Medicaid EHR Incentive Program, states must develop:

  • Health Information Technology Planning Advance Planning Document (HIT PAPD) – A plan of action that requests federal matching funds and approval to accomplish the planning necessary for a state agency to determine the need for and plan the acquisition of HIT equipment, services, or both.
  • State Medicaid Health Information Technology Plan (SMHP) – A document that describes the state’s current and future Health IT activities, as well as the path between, in support of the Medicaid EHR Incentive Program (see the SMHP template in the “Downloads” section below).
  • Health Information Technology Implementation Advance Planning Document (HIT IAPD) – A plan of action that requests federal matching funds and approval to acquire and implement the proposed SMHP services, equipment, or both.

The HIT PAPD, SMHP, and HIT IAPD lay out the process states will use to implement and oversee the Medicaid EHR Incentive Program. These documents help states construct a Health IT roadmap to develop the systems necessary to support providers in their adoption and meaningful use of certified EHR technology.

  • States are required to submit these documents in order for CMS to approve receipt of the 90% Federal match.
  • Prior approval is required for the HIT PAPD and HIT IAPD. The SMHP is the deliverable resulting from the HIT PAPD. The SMHP will be reviewed and approved before implementation funds are authorized under the IAPD. The APD and SMHP processes allow states to update their Advance Planning Documents and SMHP when they anticipate changes in scope, cost, schedule, etc. This allows states to add additional tasks to the contract which they may have not thought of at the time the HIT PAPD was written, as they worked through the original tasks on the original submission.

As states begin developing their SMHPs, they can also begin receiving the 90% federal matching funds to be used to support their initial Medicaid EHR Incentive Program planning activities, as long as the relevant Advance Planning Documents are approved. For example, initial planning regarding the design and development of the anticipated SMHP may be eligible for the 90% federal matching funds as an expense related to the administration of the Medicaid EHR incentive payments and, more broadly, for promoting health information exchange.  Read more here…

Welcome to the Blog!

In recent weeks, Health Monitoring Systems has been fielding a lot of questions regarding meaningful use from both hospitals and public health departments.  And, we have been doing a lot of digging, too.  While we aren’t the experts, we thought it would be useful to share the information we have and our views.

And so, we created this blog.

The purpose of the blog is to provide both resources and opinion regarding trends in healthcare related to healthcare data exchange (its what we do!).  Meaningful Use affects both of the HMS products MediCenter and EpiCenter.

EpiCenter collects and analyzes healthcare data, providing a view into regional health conditions for public health and healthcare.  MediCenter reverses the flow and provides patient medication history to clinicians at the point of care.  With all of the activity around meaningful use and health information exchange, it is safe to say we are heavily invested in this area.

Please participate by registering on the site and leaving comments.  We turned on registration, not to harvest email addresses but to prevent SPAM comments.

If you have some thoughts on these topics, please drop me a line at  We are actively seeking guest bloggers to provide their opinions and insights.

Once again, welcome to the blog.

— kjh