Two regulations issued by the Centers for Medicare and Medicare Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) will “help implement the EHR (electronic health record) incentive programs enacted under the American Recovery and Reinvestment Act of 2009.”

In the CMS proposed rule, criteria for individuals who would qualify for incentives are "still in development, and will be defined through regulation and additional guidance materials." According to the proposed rule, a "meaningful EHR user" would demonstrate meaningful use of a certified EHR, the electronic exchange of health information to improve the quality of health care, and reporting on clinical quality and other measures using certified EHR technology.

CMS encourages the public to review the proposed rule and to provide feedback within the 60-day comment period on the proposal.

The ONC also welcomes comment on its interim final regulation (IFR) on the topic, which sets initial standards, implementation specifications, and certification criteria for EHR technology.

“These regulations are closely linked,” said Charlene Frizzera, CMS acting administrator. “CMS’s proposed regulation would define and specify how to demonstrate ‘meaningful use’ of EHR technology, which is a prerequisite for receiving the Medicare incentive payments. Our rule also outlines the proposed payment methodologies for the Medicare and Medicaid EHR incentive programs. ONC’s regulation sets forth the standards and specifications that will enhance the interoperability, functionality, utility, and security of health information technology.”

National Coordinator for Health Information Technology David Blumenthal, MD, MPP, said in a message posted online  that he supports the CMS and ONC suggestion to use an incremental approach.

"While well-defined data and technical standards are the foundation for interoperability between systems—allowing for reliable, consistent, secure, and accurate information exchange—we recognize that a high-level of nationwide interoperability will take time and will occur at varying rates," he wrote. "Therefore, our approach to the adoption of standards and certification criteria is pragmatic, yet forward looking. The criteria are designed to be supportive of the staged meaningful use requirements, but at the same time lay the foundation for future growth in information exchange and technological innovation."

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