Healthcare providers, particularly doctors, should be aware of several key laws and regulations regarding Electronic Medical Records (EMR):
Health Information Technology for Economic and Clinical Health (HITECH) Act
The HITECH Act, part of the American Recovery and Reinvestment Act of 2009, was a significant stimulus for the adoption of EMR technology. It established the Meaningful Use program, which provided financial incentives for healthcare providers to adopt and demonstrate meaningful use of EMR technology. By January 2014, maintaining patient records in digital form became mandatory for healthcare providers participating in Medicare, with penalties for non-compliance.
Federal payments were available for qualifying healthcare providers, known as Eligible Professionals (EPs) in federal regulations. Initially, a maximum of $21,250 of Medicaid EHR/EMR payments could be obtained independently of EMR use. However, the majority of Medicaid payments and all Medicare payments required an EP’s “meaningful use” of an EMR system certified by a proper certification authority. These regulations aimed to foster the widespread adoption and integration of EMR technology into the healthcare system.
It was important to understand that there were three stages to meaningful use. The deadline for complying with Meaningful Use Stage 1 was October 2012, indicating it was a past requirement. Additionally, the deadlines for meeting Meaningful Use Stage 2 standards were postponed until the calendar year 2014. Compliance with these stages, including the yet-to-be-issued regulations for future stages, was mandatory for receiving meaningful use payments. This system underscored the gradual, structured approach to integrating EMRs into healthcare practices, reflecting a phased effort to modernize and enhance the efficiency of healthcare record-keeping.
Health Insurance Portability and Accountability Act (HIPAA)
HIPAA sets the standard for protecting sensitive patient data. Any company that deals with protected health information (PHI) must ensure that all the required physical, network, and process security measures are in place and followed. This includes specific guidelines for the sharing and use of PHI, with provisions allowing for the sharing of information for treatment, payment, and healthcare operations without explicit patient consent. Violations of HIPAA can lead to significant civil penalties.
HIPAA Security Rule
The HIPAA Security Rule specifically focuses on electronic PHI (ePHI) and mandates appropriate administrative, physical, and technical safeguards to ensure the confidentiality, integrity, and security of ePHI.
HIPAA, among other things, offers protection for personal health information, including medical records. The HIPAA law gave patients more control over their health information, set limits on the use and release of their medical records, and established a series of privacy standards for healthcare providers, which provides penalties for those who do not follow these standards.
HIPAA grants patients several fundamental privacy rights over their medical records, as outlined in this HIPAA compliance as part of the rollout of EMR systems.
Certain parties are exempted from HIPAA requirements, which means some medical information may be shared without a patient’s knowledge in limited circumstances. Information shared with other providers in order to treat any patient is always exempted. Full HIPAA regulations are quite complex and are detailed here.
With respect to HIPAA and EHR / EMR requirements, these systems typically use data encryption to protect patient medical records stored on an EMR system. Data encryption technology protects electronic records while they are stored and while they are being transferred, ensuring that only the intended recipients are able to view them.
In addition, while the HIPAA deadline of October 1, 2013, for the transition from ICD-9 to ICD-10 encoding is for hospital treatment inpatient procedures only, integrated treatment plans will increasingly require ICD-10 use by most healthcare providers. Since Stage 3 meaningful use standards have yet to be issued in preliminary rulings as of October 2012, it is unclear whether all providers will require ICD-10 compliance, but it remains a possibility.
Certified EHR Technology (CEHRT)
The Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) require healthcare providers to use CEHRT to efficiently capture and share patient data. This ensures that EHR systems meet specific criteria and can support activities such as evidence-based decision support, quality management, and outcomes reporting.
Meaningful Use Program
The Meaningful Use program, now known as the Promoting Interoperability program, sets specific objectives that providers must meet to qualify for incentive payments and avoid penalties. These objectives are related to the use of EHR technology to improve patient care.
21st Century Cures Act
This act, among other things, aims to promote interoperability, prevent information blocking, and enhance the use of EHRs across the healthcare system. It also includes provisions for patient access to health information.
State-Specific Laws and Regulations
In addition to federal regulations, many states have their own laws governing the use of EMR. Providers must be aware of and comply with these state-specific requirements as well.
Healthcare providers should stay informed about these regulations and ensure their practices are in compliance to avoid penalties, protect patient information, and provide high-quality care. Regular training, risk assessments, and updates to policies and procedures are essential components of maintaining compliance.
FAQ
Here are some frequently asked questions when it comes to EMR Laws & Regulations For Health Care Providers.
When was EMR Mandated?
In 2009, the HITECH act came into effect requires all healthcare providers to turn patients’ medical records into digital form. The use of electronic medical records thus came into existence. However, it was in January 2014 the rule to have patient records in digital form was mandatory. Failure to comply and maintain EMRs lead to penalties- reduced medicare reimbursement, the percentage which keeps increasing each year, if not compliant.
What are the rights of a patient under HIPAA?
Patients have the right to ask for a written notice about how their health information is used and shared, and to view their medical records. They can request a copy of their file, and also request that any mistakes be corrected. In most cases, healthcare providers must produce these documents within 30 days of receiving the request but may charge reasonable fees to cover any expenses associated with making copies, if the patient requests these.
What is meant by Meaningful Use?
Meaningful use refers to a set of standards required for EHRs and outlines how patient information must be exchanged between entities such as hospitals, insurance companies, physicians, etc.