Tuesday, April 26, 2011

Meaningful User: Attestation Easy, Registration Not

HDM Breaking News, April 25, 2011

Successfully attesting to meaningful use of electronic health records when attestation opened on April 18 was easy for MedCentral Health System, a two-hospital delivery system. The difficult part was getting registered for the meaningful use program in early January--a process that because of Medicare bureaucracy didn't actually finish until mid-March. "Get in the registration process early," advises Mike Mistretta, CIO.

The problem? While MedCentral's Medicare contractor for a decade has accepted a certain document listing the delivery system's direct deposit routing and account numbers, the contractor that the Centers for Medicare and Medicaid Services is using to register for attestation would not accept the document. The registration contractor wanted a copy of a cancelled paper check for an electronic account. Obviously, electronic accounts don't use paper checks.

CMS wouldn't budge either, Mistretta says. "They said, 'This is the process that we have defined.'" After going back and forth between the contractor and Medicaid, the contractor then said it would accept a notarized letter from MedCentral's bank that included the exact same information as the document used by MedCentral's contactor that previously was rejected.

Aside from the difficulty in registering, there were no other real surprises during the attestation process, Mistretta says. But some of the meaningful use measures don't make sense, he adds. For instance, non-pediatric hospitals don't see kids much after they're born, but still must meet the meaningful use criteria of maintaining a growth chart. "So, there are pieces that bring little clinical value to us but we have to do it."

After an attestation is successful, a status tab on the attestation Web site confirms that an incentive payment will be made with the statement: "Locked for payment. The payment process has been initiated." The tab also lets attesters know that payment will be made in four to six weeks. What's not available yet under the status tab, and Mistretta hopes soon will be, is how much the payment will be. He expects MedCentral, which includes a 326-bed flagship hospital and a 25-bed rural facility and uses Soarian Clinicals from Siemens, will receive $4 million this year and a little over $12 million in total during the meaningful use incentive program.

--Joseph Goedert

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