Do You Qualify for “Meaningful Use” Exclusions?

For those physicians looking at the Medicare and Medicaid electronic health record (EHR) incentive programs, it pays to be prepared. Incentives are available to eligible physicians who "meaningfully use" a certified EHR – up to $44,000 under Medicare and up to $63,750 under Medicaid.

All eligible physicians who participate in the EHR incentive program must meet all of the meaningful use objectives, unless the objective provides an exclusion.  An exclusion can be claimed if the meaningful use objective or measure is not applicable to the physician.  

Meaningful use requires physicians to complete a set of 15 core criteria and to choose 5 of 10 criteria on a menu set.  Of these criteria, 14 of 25 allow for certain exclusions.  If you are eligible for an exclusion, you can attest this information during the reporting process and be excluded from meeting the measure of that objective.   

There are no blanket exclusions among physician specialties; eligible physicians must evaluate whether they individually meet the exclusion criteria applicable for each objective. 

Meaningful Use Core Measures: 1-15
(Program requires that physicians complete all 15 core measures.)

Measure Number

Title

Exclusion

1

CPOE for medication order

Any physician who writes fewer than 100 prescriptions during the EHR reporting period.

2

Drug interaction check

No exclusion.

3

Maintain an up-to-date problem list of current and active diagnoses

No exclusion.

4

Generate and transmit permissible prescriptions electronically (eRx)

Any physician who writes fewer than 100 prescriptions during the reporting period.

5

Maintain active medication list

No exclusion.

6

Maintain active medication allergy list

No exclusion.

7

Record demographics

No exclusion.

8

Record vital signs

Any physician who either sees no patients 2 years or older, or who believes that all three vital signs of height, weight, and blood pressure of their patients have no relevance to the scope of their  practice.

9

Record smoking status

Any physician who sees no patients 13 years or older.

10

Clinical quality measures (CQMs)

No exclusion.

11

Clinical decision support rule

No exclusion.

12

Electronic copy of health information

Any physician who has no requests from patients or their agents for an electronic copy of patient health information during the EHR reporting period.

13

Clinical summaries

Any physician who has no office visits during the EHR reporting period.

14

Electronic exchange of clinical information

No exclusion; however, an unsuccessful test of electronic exchange of key clinical information will still meet the measure of this objective.

15

Protect electronic health information

No exclusion.

  

Meaningful Use Menu Set Measures: 1-10
(Program requires that physicians choose five of 10 measures.)

Measure Number

Title

Exclusion

1

Drug formulary checks

Any physician who writes fewer than 100 prescriptions during the EHR reporting period.

2

Clinical lab test results

Any physician who orders no lab tests whose results are in either a positive/negative or numeric format during the reporting period.

3

Patient lists

No exclusion.

4

Patient reminders

A physician who has no patients 65 years or older or 5 years or younger with records maintained using certified EHR technology

5

Patient electronic access

Any physician who neither orders nor creates lab tests or information that would be contained in the problem list, medication list, or medication allergy list during the reporting period.

6

Patient-specific education resources

No exclusion.

7

Medication reconciliation

Any physician who was not the recipient of any transitions of care during the EHR reporting period.

8

Transition of care summary

Any physician who neither transfers a patient to another setting nor refers a patient to another provider during the EHR reporting period.

9

Immunization registries data submission

No exclusion.

10

Syndromic surveillance data submission

A physician who does not collect any reportable syndromic information on his or her patients during the EHR reporting period or does not submit such information to any public health agency that has the capacity to receive the information electronically

For more information, see the Centers for Medicare & Medicaid Services (CMS) in-depth guide to the Meaningful Use Criteria [PDF]. 

More than 50,000 physicians and providers have signed up to receive services from the regional extension centers (RECs).  Four Texas RECs, each with teams of experts, are ready to provide on-site consultation to help your practice reach the meaningful use criteria.  To learn more about available services, eligibility, and federal incentive guidelines, visit the Texas Regional Extension Center Resource Center on the TMA website, call the TMA Health Information Technology Helpline at (800) 880-5720, or e-mail hit@texmed.org.

Save this date – Friday, April 1, 12:30-2 pm – for a national call on registration for the Medicare EHR Incentive Program. More information, including registration details, will follow soon on the CMS website.


Action, March 15, 2011 


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