[Federal Register Volume 77, Number 75 (Wednesday, April 18, 2012)]
[Proposed Rules]
[Pages 23193-23196]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-9331]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Parts 412, 413, and 495
[CMS-0044-CN]
RIN 0938-AQ84
Medicare and Medicaid Programs; Electronic Health Record
Incentive Program--Stage 2; Corrections
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Proposed rule; correction.
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SUMMARY: This document corrects technical errors and typographical
errors in the proposed rule entitled ``Medicare and Medicaid Programs;
Electronic Health Record Incentive Program--Stage 2'' which appeared in
the March 7, 2012, Federal Register.
FOR FURTHER INFORMATION CONTACT: Travis Broome, (214) 767-4450.
SUPPLEMENTARY INFORMATION:
I. Background
In FR Doc. 2012-4443 of March 7, 2012 (77 FR 13698), the proposed
rule entitled ``Medicare and Medicaid Programs; Electronic Health
Record Incentive Program--Stage 2'' there were a number of technical
errors and typographical errors that are identified and corrected in
the Correction of Errors section.
[[Page 23194]]
II. Summary of Errors
A. Summary of Errors in the Preamble
On page 13698, in the ``For Further Information Contact'' section
we made an error in the contact listed for clinical quality measures
issues.
On pages 13700 and 13745, in our discussion of reporting on
clinical quality measures, we made an error in referencing the name of
a national committee.
On pages 13704 and 13731, in our discussion of the objective for
making patient health information available electronically, we
inadvertently omitted the term ``transmit.''
On pages 13706 and 13728, in our reference to the Office of the
National Coordinator for Health Information Technology (ONC) criteria
for certification of EHR technologies, we inadvertently
mischaracterized the criteria as the Stage 2 criteria instead of 2014
certification criteria.
On page 13707, in our discussion regarding eligible professionals
(EPs) who practice in multiple locations, we inadvertently omitted the
timeframe by which the determination is made on whether a practice/
location is equipped with Certified EHR Technology.
On page 13711, in our solicitation of comments regarding the
variations among facility types for an electronic prescribing measure,
we inadvertently stated an erroneous threshold percentage.
On page 13723, we used the incorrect term to describe when health
information should be shared in context of transitions of care and
referrals. In our discussion in the preamble, we used in one instance
the term ``discharged'' instead of ``transitioned.''
On page 13725, in our listing of the objectives that fall under
public health, we made technical errors in our description of the
objective to have the capability to report to cancer registries.
On page 13746, in Table 6, we erroneous included an additional
measure steward and its contact information.
On pages 13749 through 13754 in Table 8, we made errors in
referencing a national quality assurance program.
On pages 13760 through 13763, in Table 9, we incorrectly listed
some of the measure stewards and their respective contact information.
On pages 13743, 13759, 13766, 13769, and 13803 through 13812, we
made technical and typographical errors, which include the spelling out
of acronyms, errors in the order of bulleted text, the omission of
bullets, regulatory citations, and the number of section headings.
B. Summary of Errors in the Regulations Text
On page 13821, in Sec. 495.6(l)(16)(ii), we made an error in the
regulations text for the measure for the objective for electronic
medication administration record (eMAR). In addition, in Sec.
495.6(m)(1)(iii) we inadvertently omitted the term ``reporting
period''.
On page 13816, in Sec. 495.6(d)(8)(ii)(C), contains an incomplete
reference to another section of the regulation.
On page 13817 we made the following errors:
In Sec. 495.6(f)(1)(ii)(B) and Sec.
495.6(f)(7)(i)(E)(2), we used the word ``Beginning'' when referring to
regulations that would apply to only 1 year; therefore, we are
replacing ``Beginning'' with ``For''.
In Sec. 495.6(f)(7)(ii)(B) and Sec. 495.6(f)(7)(ii)(C),
we only included the new measure in the regulation text not both the
existing measure and the new measure as indicated in the preamble. The
regulation text is corrected to include both the existing and new
measure.
In Sec. 495.6(h)(2)(ii)(B), we included a duplicative
word in the regulation text. The text is revised to remove the
duplicative word.
On page 13818, in Sec. 495.6(j)(6)(ii)(B) and on page 13820 in
Sec. 495.6 (l)(5)(ii)(B), the phrase used in the regulation text for
the measure does not adequately reflect the discussion in the preamble.
The phrase ``has enabled the functionality'' is replaced with ``has
enabled and implemented the functionality''.
III. Correction of Errors
In FR Doc. 2012-4443 of March 7, 2012 (77 FR 13698), make the
following corrections:
A. Correction of Errors in the Preamble
1. On page 13698, third column, first partial paragraph, lines 1
through 2, the phrase, ``or Maria Durham, (410) 786-6978,'' is removed.
2. On page 13700, third column, first full paragraph, lines 13
through 15, the phrase ``National Council for Quality Assurance (NCQA)
for medical home accreditation'' is corrected to read ``National
Committee for Quality Assurance (NCQA) for medical home recognition''.
3. On page 13745, first column, last two lines through the second
column, first partial paragraph, line1, the phrase ``National Council
for Quality Assurance (NCQA) for medical home accreditation'' is
corrected to read ``National Committee for Quality Assurance (NCQA) for
medical home recognition''.
4. On page 13704, third column, first full paragraph, line 4, the
phrase ``view online and download'' is corrected to read ``view online,
download, and transmit.''
5. On page 13706, first column, second paragraph, lines 7 through
9, the phrase ``included in the ONC EHR certification criteria as
finalized for Stage 2 of meaningful use.'' is corrected to read
``included in the ONC 2014 EHR certification criteria.''
6. On page 13707, first column, first full paragraph, lines 11
through 15, the sentence ``We have also received requests for
clarification on what it means for a practice/location to be equipped
with Certified EHR Technology.'' is corrected to read ``We have also
received requests for clarification on what it means for a practice/
location to be equipped with Certified EHR Technology at the beginning
of the EHR reporting period.''
7. On page 13711, second column, first partial paragraph, line 1,
the phrase ``50 percent'' is corrected to read ``65 percent''.
8. On page 13723, second column, seventh paragraph, line 5, the
term ``discharged'' is corrected to read ``transitioned''.
9. On page 13725, first column, fourth bulleted paragraph, line 3,
the phrase ``where authorized,'' is corrected to read ``except where
prohibited,''.
10. On page 13728, second column--
a. Third paragraph, line 9, the phrase ``standards required under
Stage 2'' is corrected to read ``standards for Certified EHR
Technology''.
b. Last paragraph, line 10, the phrase ``standards required under
Stage 2'' is corrected to read ``standards for Certified EHR
Technology''.
11. On page 13731, first column, first full paragraph, line 7, the
phrase ``view and download'' is corrected to read ``view online,
download, and transmit''.
12. On page 13743, second column, first partial paragraph, line 14,
``EHs/CAHs'' is corrected to read ``eligible hospitals and CAHs''.
13. On page 13746 in Table 6--Potential Core Clinical Quality
Measure Set To Be Reported by Eligible Professionals Beginning in CY
2014, Column 3 (Clinical Quality Measure Steward & Contact Information)
for the following entry is corrected to read as follows:
[[Page 23195]]
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Clinical quality
Measure No. Clinical quality measure title and measure steward and Domain
description contact information
----------------------------------------------------------------------------------------------------------------
TBD.................. Title: Closing the referral loop: Centers for Medicare Care Coordination.
receipt of specialist report. and Medicaid
Description: Percentage of patients Services (CMS) 1-
regardless of age with a referral 888-734-6433 or
from a primary care provider for http://
whom a report from the provider to questions.cms.hhs.g
whom the patient was referred was ov/app/ask/p/
received by the referring provider. 21,26,1139.
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14. On pages 13749 through 13754 in Table 8--Clinical Quality
Measures Proposed for Medicare and Medicaid Eligible Professionals
Beginning With CY 2014, column 4 (Other quality measure programs that
use the same measure) is corrected for the following entries:
Table 8--Clinical Quality Measures Proposed for Medicare and Medicaid Eligible Professionals Beginning With CY
2014
----------------------------------------------------------------------------------------------------------------
Other quality measure programs that use the same measure
Measure No. **
----------------------------------------------------------------------------------------------------------------
NQF 0004............................................ EHR PQRS, HEDIS, State use, ACA 2701, NCQA-PCMH
Recognition.
NQF 0014............................................ EHR PQRS, NCQA-PCMH Recognition.
NQF 0031............................................ EHR PQRS, ACO, Group Reporting PQRS, ACA 2701, HEDIS,
State use, NCQA-PCMH Recognition.
NQF 0032............................................ EHR PQRS, ACA 2701, HEDIS, State use, NCQA-PCMH
Recognition, UDS.
NQF 0033............................................ EHR PQRS, CHIPRA, ACA 2701, HEDIS, State use, NCQA-PCMH
Recognition.
NQF 0034............................................ EHR PQRS, ACO, Group Reporting PQRS, NCQA-PCMH
Recognition.
NQF 0043............................................ EHR PQRS, ACO, Group Reporting PQRS, NCQA-PCMH
Recognition.
NQF 0045............................................ PQRS, NCQA-PCMH Recognition.
NQF 0046............................................ PQRS, NCQA-PCMH Recognition.
NQF 0069............................................ PQRS, NCQA-PCMH Recognition.
NQF 0070............................................ EHR PQRS, NCQA-PCMH Recognition.
NQF 0081............................................ EHR PQRS, Group Reporting PQRS, NCQA-PCMH Recognition.
NQF 0097............................................ ACO, Group Reporting PQRS, NCQA-PCMH Recognition.
NQF 0110............................................ NCQA-PCMH Recognition.
NQF 0271............................................ PQRS, NCQA-PCMH Recognition.
NQF 0399............................................ PQRS, NCQA-PCMH Recognition.
NQF 0400............................................ PQRS, NCQA-PCMH Recognition.
NQF 0401............................................ PQRS, NCQA-PCMH Recognition.
NQF 0405............................................ PQRS, NCQA-PCMH Recognition.
NQF 0406............................................ PQRS, NCQA-PCMH Recognition.
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15. On page 13759, first column, third paragraph, lines 10 through
16, the bulleted list that begins `` Clinical Process/
Effectiveness.'' and ends `` Population & Public Health.'' is
corrected to read as follows:
`` Patient & Family Engagement.
Patient Safety.
Care Coordination.
Population & Public Health.
Efficient Use of Healthcare Resources.
Clinical Process/Effectiveness.''
16. On page 13760 through 13763, in Table 9--Clinical Quality
Measures Proposed for Eligible Hospitals and Critical Access Hospitals
Beginning With FY 2014, the Measure Steward and Contact Information,
column 3 (Measure steward and contact information) is corrected for the
following entries:
Table 9--Clinical Quality Measures Proposed for Eligible Hospitals and Critical Access Hospitals Beginning With
FY 2014
----------------------------------------------------------------------------------------------------------------
NQF No. Measure steward and contact information
----------------------------------------------------------------------------------------------------------------
0480................................................ The Joint Commission (http://www.jointcommission.org.)
0495................................................ CMS/Oklahoma Foundation for Medical Quality (OFMQ)
Qualitynet.org and click on ``Questions & Answers''.
0497................................................ CMS/OFMQ Qualitynet.org and click on ``Questions &
Answers''.
0132................................................ CMS/OFMQ Qualitynet.org and click on ``Questions &
Answers''.
0142................................................ CMS/OFMQ Qualitynet.org and click on ``Questions &
Answers''.
0137................................................ CMS/OFMQ Qualitynet.org and click on ``Questions &
Answers''.
0160................................................ CMS/OFMQ Qualitynet.org and click on ``Questions &
Answers''.
0164................................................ CMS/OFMQ Qualitynet.org and click on ``Questions &
Answers''.
0163................................................ CMS/OFMQ Qualitynet.org and click on ``Questions &
Answers''.
0639................................................ CMS/OFMQ Qualitynet.org and click on ``Questions &
Answers''.
0148................................................ CMS/OFMQ Qualitynet.org and click on ``Questions &
Answers''.
0147................................................ CMS/OFMQ Qualitynet.org and click on ``Questions &
Answers''.
0527................................................ CMS/OFMQ Qualitynet.org and click on ``Questions &
Answers''.
0528................................................ CMS/OFMQ Qualitynet.org and click on ``Questions &
Answers''.
0529................................................ CMS/OFMQ Qualitynet.org and click on ``Questions &
Answers''.
0300................................................ CMS/OFMQ Qualitynet.org and click on ``Questions &
Answers''.
0301................................................ CMS/OFMQ Qualitynet.org and click on ``Questions &
Answers''.
0453................................................ CMS/OFMQ Qualitynet.org and click on ``Questions &
Answers''.
[[Page 23196]]
0136................................................ CMS/OFMQ Qualitynet.org and click on ``Questions &
Answers''.
0284................................................ CMS/OFMQ Qualitynet.org and click on ``Questions &
Answers''.
0218................................................ CMS/OFMQ Qualitynet.org and click on ``Questions &
Answers''.
0496................................................ CMS/OFMQ Qualitynet.org and click on ``Questions &
Answers''.
1653................................................ CMS/OFMQ Qualitynet.org and click on ``Questions &
Answers''.
1659................................................ CMS/OFMQ Qualitynet.org and click on ``Questions &
Answers''.
----------------------------------------------------------------------------------------------------------------
17. On page 13766, second column, last paragraph, last line, the
reference ``Sec. 495.10'' is corrected to read ``Sec. 495.8''.
18. On page 13769, second column--
a. First full paragraph, line 1, the phrase ``Except as provided''
is corrected to read `` Except as provided''.
b. Second full paragraph, line 1, the phrase ``We would create'' is
corrected to read `` We would create''.
19. On page 13803, third column, after the first partial paragraph,
the section heading, ``4. Medicare Incentive Program Costs'' is
corrected to read ``3. Medicare Incentive Program Costs''.
20. On page 13808, top half of the page following Table 28, second
column, after the first partial paragraph, the section heading, ``5.
Medicaid Incentive Program Costs'' is corrected to read ``4. Medicaid
Incentive Program Costs''.
21. On page 13810, bottom half of the page, after Table 34, first
column, before the first paragraph, the section heading ``6. Benefits
for All EPs and All Eligible Hospitals'' is corrected to read ``5.
Benefits for All EPs and All Eligible Hospitals''.
22. On page 13811--
a. First column, after the first partial paragraph, the section
heading, ``7. Benefits to Society'' is corrected to read ``6. Benefits
to Society''.
b. Second column, after first partial paragraph, the section
heading, ``8. General Considerations'' is corrected to read ``7.
General Considerations''.
c. Third column, before the last full paragraph, the section
heading, ``9. Summary'' is corrected to read ``8. Summary''.
23. On page 13812, bottom half of the page, after Table 36, first
column, before the first full paragraph, the section heading, ``10.
Explanation of Benefits and Savings Calculations'' is corrected to read
``9. Explanation of Benefits and Savings Calculations''.
B. Correction of Errors in the Regulations Text
1. On page 13816, second column, seventh full paragraph (Sec.
495.6(d)(8)(ii)(C)), line 2, the reference ``paragraph (d)(8)(ii)(B)''
is corrected to read ``paragraph (d)(8)(ii)(B)(1)''.
2. On page 13817,
a. First column,
(1) Fourth full paragraph (Sec. 495.6(f)(1)(ii)(B)), line 1, the
phrase ``Beginning 2013, subject to'' is corrected to read ``For 2013,
subject to''.
(2) Sixth full paragraph (Sec. 495.6(f)(7)(i)(E)(2)), line 1,
``Beginning 2013, plot and display'' is corrected to read ``For 2013,
plot and display''.
(3) Seventh full paragraph (Sec. 495.6(f)(7)(ii)(B)), the
paragraph beginning with the phrase ``For 2013, subject to paragraph
(c)'' and ending with the phrase ``recorded as structured data.'' is
corrected to read as follows:
``(B) For 2013--(1) Subject to paragraph (c) of this section, more
than 50 percent of all unique patients admitted to the eligible
hospital's or CAH's inpatient or emergency department (POS 21 or 23)
during the EHR reporting period have blood pressure (for patients age 3
and over only) and height/length and weight (for all ages) recorded as
structured data; or
(2) The measure specified in paragraph (f)(7)(ii)(A) of this
section.''
(4) Eighth full paragraph (Sec. 495.6(f)(7)(ii)(C)), line 2, the
phrase ``in paragraph (f)(7)(ii)(B)'' is corrected to read ``in
paragraph (f)(7)(ii)(B)(1)''.
b. Third column, sixth full paragraph (Sec. 495.6(h)(2)(ii)(B)),
line 14, the phrase ``must meet the remaining the'' is corrected to
read ``must meet the remaining''.
3. On page 13818, second column, last paragraph (Sec.
495.6(j)(6)(ii)(B)), the phrase ``has enabled the'' is corrected to
read ``has enabled and implemented the''.
4. On page 13820, second column, ninth paragraph (Sec.
495.6(l)(5)(ii)(B)), the phrase ``has enabled the'' is corrected to
read ``has enabled and implemented the''.
5. On page 13821, third column--
a. First full paragraph (Sec. 495.6(l)(16)(ii)), lines 3 through
6, the sentence ``(ii) Measure. eMAR is implemented and in use for the
entire EHR reporting period in at least one ward/unit of the
hospital.'' is corrected to read ``(ii) Measure. More than 10 percent
of medication orders created by authorized providers of the eligible
hospital's or CAH's inpatient or emergency department (POS 21 or 23)
during the EHR reporting period are tracked using eMAR.''.
b. Fifth full paragraph (Sec. 495.6(m)(1)(iii)), last line, the
phrase ``the EHR'' is corrected to read ``the EHR reporting period.''
(Catalog of Federal Domestic Assistance Program No. 93.778, Medical
Assistance Program) (Catalog of Federal Domestic Assistance Program
No. 93.773, Medicare--Hospital Insurance; and Program No. 93.774,
Medicare--Supplementary Medical Insurance Program)
Dated: April 12, 2012.
Jennifer M. Cannistra,
Executive Secretary to the Department.
[FR Doc. 2012-9331 Filed 4-17-12; 8:45 am]
BILLING CODE 4120-01-P