Meaningful Use of Health Information Technology

On December 30, 2009, CMS  and the Office of the National Coordinator for Health Information Technology released documents clarifying what physicians and hospitals must do to qualify for government incentive payments for the “meaningful use” of electronic health care records.  The standards for Stage 1 of the  meaningful use requirements were finalized on July 13^th, so physicians and hospitals are now eligible to qualify for the first round of incentive payments.  Outpatient rehabilitation organizations will not be eligible for the first round of incentive payments, and it is not clear when they might become eligible. Clinicient is monitoring of all of the developments in this area, and is well positioned to meet the eligibility requirements for outpatient rehabilitation facilities when and if that becomes a reality.

Medicare Plans of Care and Progress Reports

In my experience, Medicare requirements for tracking Progress Reports and Plans of Care are a source of confusion for many Physical and Occupational Therapists. Anyone who treats Medicare patients should review these requirements in detail by reviewing the appropriate Medicare Policy Manual. (Chapter 15, which covers most outpatient clinics, is linked here:  Medicare Benefits Policy Manual.)

This is a very brief summary of those requirements for most settings:  A Plan of Care (POC) is established as part of the evaluation by the therapist. The POC can be as long as 90 days, but may be shorter. The Plan of Care must be reviewed and approved by the referring physician in a reasonable time and you are responsible to keep a written record of the POC Approval.  A new Plan of Care must be done if the there is a substantial change to the plan.
In addition to the POC, there is a separate requirement for a written Progress Report that must be sent to the referring physician at least every 10 visits or 30 calendar days, whichever comes first. The Progress Report does not require physician approval and does not take the place of a POC.