CMS Provides Guidance on Meaningful Use Appeals Process

CMS has released additional guidance for hospitals and eligible professionals on the Medicare EHR Incentive Program appeals process.  The CMS Office of Clinical Standards and Quality (OCSQ), together with Provider Resources, Inc., the CMS appeals support contractor, will accept and review appeals filed by eligible professionals and hospitals. For those individuals and organizations participating in the Medicaid EHR Incentive Program, each state will have its own process for Medicaid appeals. 

CMS began accepting appeals December 1, 2011.  Appeals may be filed by eligible professionals and hospitals through an online web portal.  In addition to eligibility determinations, eligible professionals and hospitals may appeal denials of status as a meaningful user as well as incentive payment calculations.

For hospitals, the deadline to appeal eligibility determinations has been extended to January 30, 2012.  In general, a hospital or eligible professional has sixty (60) days after the issuance of an incentive payment to appeal the amount of the payment made.  Additionally, hospitals and eligible professionals have thirty (30) days to appeal denials of their status as a meaningful user after receipt of a letter with the results of a meaningful use audit conducted by CMS.  Limited extensions will be granted on a case-by-case basis under extenuating circumstances.

The first OCSQ informal review determination was released on January 19, 2012.  CMS plans on making this and other OCSQ appeals opinions available in February on its EHR Incentive Program Appeals website.  These opinions may provide additional guidance to eligible professionals and hosptials seeking to attest in 2012 for their first payment year.

Over $2 billion paid in Meaningful Use Incentive Payments and Counting

In a report submitted to the Health Information Technology Policy Committee on January 10th, CMS highlighted progress in the Medicare and Medicaid EHR Incentive Programs ("Meaningful Use") and registration and attestation numbers for eligible hospitals and eligible professionals ("EPs"). For 2011, the two programs paid out over $2.5 billion in Meaningful Use incentive payments to EPs and hospitals who attested to Meaningful Use for 2011.

In 2011, 124,089 EPs registered for Medicare, 39, 503 EPs registered for Medicaid, and 2,834 hospitals registered for both programs.  Out of the 842 hospitals that attested to Meaningful Use for FY 2011, 100% were succesful, with 99% of EPs that attested for 2011 also succesful.

CMS has made available additional information on a state-by-state basis which can be viewed on its EHR Data and Reports page.  You'll notice also that CMS has "modernized" the look and feel of its webpages, not only for Meaningful Use, but in general for Medicare, Medicaid and other web resources.   

Hospitals in their second payment year will generally need to meet Stage 1 Meaningful Use requirements for the full 12-month period in FY 2012.  Due to concerns about the ability of EHR vendors to certify their products in compliance with Stage 2 requirements, once finalized, HHS has proposed to delay Stage 2 Meaningful Use, which was originally set to begin in 2013 for those who attested in 2011. 

Input from the vendor community and the provider community makes clear that the current schedule for compliance with Stage 2 meaningful use objectives in 2013 poses a challenge for those who are attesting to meaningful use in 2011.  The current timetable would require EHR vendors to design, develop, and release new functionality, and for providers to upgrade, implement, and begin using the new functionality as early as October 2012.

HHS has indicated that those hospitals and EPs that attested in 2011 would be able to attest to Stage 1 requirements for an additional year, giving them the benefit of attesting to the more lenient Stage 1 requirements again in their third payment year (FY 2013 for hospitals).

The delay is not expected to affect hospitals and EPs who attest to Meaningful Use for their first payment year in 2012.  It would also not affect any hospitals or EPs who attested under Medicaid for "Adoption, Implementation and Upgrade" incentive payments for their first payment year in 2011. 

CMS is expected to formalize this delay in the proposed rule for Stage 2 which is expected to be released this month or in February.  For more information about the Medicare/Medicaid EHR Incentive Programs, visit the CMS EHR Meaningful Use webpage

Helen Oscislawski Invited to Speak at National HIPAA Summit

I attend the annual National HIPAA Summit in Washington D.C. eHIPAA Summit.pngvery year to keep on top of developments with HIPAA and related topics, and so I was thrilled to find out that one of the Co-Chairs of the ONC Privacy and Security Tiger Team recommended that I be asked to speak on HIPAA and its implications on Health Information Exchange (HIE) at this year's event. The 20th National HIPAA Summit will run from March 26-28th and take place at the Renaissance Hotel in Washington, D.C.  You can review the full intenerary here.

I am scheduled to speak on HIPAA and HIE during the afteronnon session of March 27 (Day 2), and will be joining Dr. William R. Braithwaite, MD, PhD (aka "Dr. HIPAA"), Joy Pritts, Esq., the Chief Privacy Officer for the ONC, and Deven McGraw, Esq., Co-Chair of the ONC Privacy and Security Tiger Team, who will be speaking on related topics during this afternoon segment.

The annual HIPAA Summit will provide the most up-to-date information on the status and schedule for publication of the new regulations. Comprehensive presentations by leading regulators from the Centers for Medicare & Medicaid Services, the Office for Civil Rights, and the Office of the National Coordinator for Health Information Technology, provide unique insights. Private sector leaders will add practical advice from their many experiences in implementation. The HIPAA Summit will address privacy and security and data breach changes and challenges and the legal and policy issues implicated, as well as electronic health record adoption issues. It will also cover developments and requirements for transactions and code sets and operating rules about how they are being implemented. It will also include training sessions for HIPAA privacy and security professionals who intend to apply for certification. 


This is an event not to be missed by anyone who needs to keep on top of the most recent trends and developments in health care information privacy, and security.

To register for the HIPAA Summit, visit

For other events which Attorneys at Oscislawski are participating in, visit our new Upcoming Events page.