Congress Inquires CMS to Scrap Prior Authorization for Home Health

Congress expects CMS will reconsider its intended demonstration for prior authorization for home health services.

A CMS proposal to need a prior authorization screening for every home health service would be an administrative nightmare and may produce hurdles to care for needy sufferers, a group of 116 lawmakers stated in a letter to CMS this week.

"This demonstration project enforces costs on sufferers, providers and taxpayers,” the letter stated. “Delaying patient care while waiting for CMS to pass home health services may put patient health in jeopardy and cause sufferers to stay in the hospital longer than necessary."

In the month of February 2016, CMS proposed a prior authorization demonstration program for Medicare home health services in the state of Florida, Texas, Illinois, Michigan, and Massachusetts. The announcement was involved in a Paperwork Reduction Act notice in the Federal Register. These states, excluding Massachusetts, are currently involved in the HHS/Department of Justice fraud enforcement program.

Comment Period for the Stage 2 Meaningful Use NPRM Ends in 5 Days

The Proposed Rule for Stage 2 Meaningful Use Comment Period Ends on May 7

On March 7, 2012, the Centers for Medicare & Medicaid Services (CMS) posted the Notice of Proposed Rulemaking (NPRM) for Stage 2 meaningful use to the Federal Register. The proposed rule outlines the requirements for the next stage of the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs, which are administered by CMS. Take a look at the NPRM located in the Federal Register. 

The 60-day comment period for this NPRM ends on Monday, May 7, 2012. CMS welcomes your feedback on this rule. Visit the Regulations.gov comment page to comment on this rule. 

For more information:

• You can view the Stage 2 Corrections to this NPRM  (published April 18, 2012)


• CMS has developed an overview of the rule and how Stage 2 expands upon Stage 1 of meaningful use. You can view a slideshow of this overview and a fact sheet, which can be found on the CMS Newsroom website.


• A Microsoft Word version of the Stage 2 NPRM is also available.

Want more information about the EHR Incentive Programs?

Make sure to visit the EHR Incentive Programs website at http://www.cms.gov/EHRIncentivePrograms for the latest news and updates on the EHR Incentive Programs.

Comment Period for the Stage 2 Meaningful Use NPRM Ends in 11 Days

The Proposed Rule for Stage 2 Meaningful Use — Comment Period Ends on May 7

On March 7, 2012, the Centers for Medicare & Medicaid Services (CMS) posted the Notice of Proposed Rulemaking (NPRM) for Stage 2 meaningful use to the Federal Register. The proposed rule outlines the requirements for the next stage of the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs, which are administered by CMS. Take a look at the NPRM located in the Federal Register. 

The 60-day comment period for this NPRM ends on Monday, May 7, 2012. CMS welcomes your feedback on this rule. Visit the Regulations.gov comment page to comment on this rule. 

For more information:

• You can view the Stage 2 Corrections to this NPRM  (published April 18, 2012)


• CMS has developed an overview of the rule and how Stage 2 expands upon Stage 1 of meaningful use. You can view a slideshow of this overview and a fact sheet, which can be found on the CMS Newsroom website.


• A Microsoft Word version of the Stage 2 NPRM is also available.

Want more information about the EHR Incentive Programs?

Make sure to visit the EHR Incentive Programs website at http://www.cms.gov/EHRIncentivePrograms for the latest news and updates on the EHR Incentive Programs.

Rule OKs E-Scripts for Controlled Rx

The Drug Enforcement Administration in the Department of Justice has published a long-delayed interim final rule, with a comment period, to permit electronic prescriptions for controlled substances.

The rule is available at the Federal Register's public inspection site at federalregister.gov/inspection.aspx, and will be officially published on March 31, effective 60 days later. The DEA will accept public comments during the 60-day interval.

Controlled substances are drugs that have the potential for abuse or dependence, including opiates, stimulants, depressants, hallucinogens and anabolic steroids. These drugs account for up to 20 percent of all prescriptions, according to various studies, which has forced providers that have adopted electronic prescribing to still maintain paper processes.

The rule will permit pharmacies to receive, dispense and archive electronic prescriptions for controlled substances. The regulations, according to DEA, are an addition to, not a replacement of, existing rules governing controlled substances.

"The regulations provide pharmacies, hospitals and practitioners with the ability to use modern technology for controlled substance prescriptions while maintaining the closed system of controls on controlled substances dispensing; additionally, the regulations will reduce paperwork for DEA registrants who dispense controlled substances and have the potential to reduce prescription forgery," according to the interim final rule. "The regulations will also have the potential to reduce the number of prescription errors caused by illegible handwriting and misunderstood oral prescriptions. Moreover, they will help both pharmacies and hospitals to integrate prescription records into other medical records more directly, which may increase efficiency, and potentially reduce the amount of time patients spend waiting to have their prescriptions filled."

It's these expected benefits that industry stakeholders, and a growing number of members of Congress, have been trying to convince DEA to appreciate for nearly a decade. The agency has considered such a rule since at least May 2001 when it issued an advanced notice of proposed rulemaking on the topic. But it wasn't until four years later than the DEA began to examine how to revise its rules to permit electronic prescriptions.

In December 2007, a 50-member coalition of stakeholders sent President Bush a letter asking for movement on the issue. "The country can no longer afford to have a two-tiered prescribing system," the letter stated. Nineteen U.S. Senators soon followed with their own letter. The agency finally published a proposed rule in June 2008, and 11 senators sent another letter in May 2009 asking for the final rule.

--Joseph Goedert

Do Consumers Like HIEs?

The Office of the National Coordinator for Health Information Technology plans to survey more than 2,500 households across the nation to assess consumer attitudes toward health information exchanges.

ONC will conduct the survey using computer-assisted telephone interviews over an eight-week period. The office will prepare a draft report and conduct a Web seminar to discuss findings prior to publishing a final report at http://healthit.hhs.gov.

The survey "will permit us to better understand individuals' attitudes toward electronic health exchange and its associated privacy and security aspects as well as inform policy and programmatic objectives," according to an ONC notice published in the Federal Register.

--Joseph Goedert