MSSNY eNews – May 14, 2019 – When Anti-Vaxers Attack

PRESIDENT’S MESSAGE< Arthur Fougner, MD MSSNY President MSSNY eNews May 17, 2019 Vol. 22  Number 19

 

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Colleagues:

“If you can trust yourself when all men doubt you,
But make allowance for their doubting too:
If you can wait and not be tired by waiting,
Or, being lied about, don’t deal in lies”…
If by Rudyard Kipling

This past Tuesday, the circus came to Albany. Led by Ringmaster RFK Jr., this troupe of not so merry pranksters dropped some anti-science fake knowledge on the capital, stating emphatically that measles is a benign disease and that vaccines are the product of Big Pharma and Big Medicine to hold our citizens hostage by the minions of big government. Mr. Kennedy is so far off the deep end that his own family members have publicly distanced themselves from his position.

Apparently, the only one missing was Theodoric of York. However, there’s nothing funny about this bunch. They have attacked mothers, like Jill Promoli, whose children succumbed to vaccine-preventable illnesses.

They attack physicians online – doctors, like Dr. Todd Wolynn, who’ve posted strong arguments for public health and vaccination. They post fake derogatory reviews on the online rating sites.

Much like the pod-created mob from Invasion of the Body Snatchers, they have even attacked state legislators.

They are clearly formidable opposition, so how do we protect our patients and the public health?

One way is by increasing vaccination through legislation. One bill before the Assembly is A2371 which would ensure that only well-defined medical exemptions to vaccines would be acceptable. On Monday, I called all the members of the Assembly Health Committee. With sufficient votes, this bill would get out of committee and onto the floor and most likely be passed.

Below, in the first item in Capital Update there are three steps to take to secure the passage of this legislation.

Oh and one last thing – Here’s another Kennedy on vaccines. 

Arthur Fougner, MD
MSSNY President 

Comments? comments@mssny.org; @mssnytweet; @sonodoc99

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Capital Update

This Week’s Podcast of MSSNY’s Legislative Priorities

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Physician Action Needed to Help Stop Measles Outbreak
In recognition of the measles epidemic expanding in New York State and across the nation, the Medical Society of the State of New York has been advocating for passage of legislation that would allow only medical exemptions for immunizations.  The measure, A.2371/S.2994, is in the Assembly & Senate Health Committees.

MSSNY President Arthur Fougner, MD will participate in a press conference next week at which he will call upon the NY State Legislature to ensure that the only exemption from immunizations is based on a medical reason.  MSSNY, along with 28 other medical organizations, patient advocacy groups and public health organizations, have been meeting with members of the Legislature to advocate for passage of this measure.

The Medical Society of the State of New York’s Memo in support of A.2371/S.2994 can be found here and a copy of the physician and public health organizations, and parent and patient advocacy memo is available here.

Your help is needed now!   There are action steps that you can do to move the legislation forward:

• Please call the following members of the Assembly Health Committee and tell them that you support passage of A.2371/S.2994, which would repeal the religious exemption, ensuring that the only allowable exemptions to vaccination will be for medical reasons.  There is an Albany and local office number listed:

• Richard Gottfried (518) 455-4941; (212)807-7900
      gottfrr@nyassembly.gov

• Michaelle Solages (518) 455-4465, (516) 599-2972
      solagesm@nyassembly.gov

• Andrew Hevesi: (518) 455-4926, (718) 263-5595
      hevesia@nyassembly.gov

• Amy Paulin: (518) 455-5585, (914) 723-1115
      paulina@nyassembly.gov

• Ron Kim: (518) 455-5411, (718) 939-0195
      kimr@nyassembly.gov

• Nader J. Sayegh: (518) 455-3662, (914) 779-8805
      sayeghn@nyassembly.gov

• Robin Schimminger: (518) 455-4767,  (716) 873-2540
      schimmr@nyassembly.gov

• Kevin A. Cahill: (518) 455-4436, (845) 338-9610
      cahillk@nyassembly.gov

• Steven Cymbrowitz: (518) 455-5214, (718) 743-4078
      cymbros@nyassembly.gov

• Aileen M. Gunther: (518) 455-5355, (845) 794-5807 and (845) 342-9304
      gunthea@nyassembly.gov

• Rodneyse Bichotte: (518) 455-5385, (718) 940-0428
      bichotter@nyassembly.gov

• Phil Steck: (518) 455-5931, (518) 377-0902
      steckp@nyassembly.gov

• Sandy Galef: (518) 455-5348, (914) 941-1111
      galefs@nyassembly.gov

• Linda B. Rosenthal:  (518) 455-5802,  (212) 873-6368
      rosentl@nyassembly.gov

• Edward C. Braunstein: (518) 455-5425,  (718) 357-3588
      braunsteine@nyassembly.gov

• Kevin Byrne: (518) 455-5783, (845) 278-2923
      byrnek@nyassembly.gov

• Marjorie Byrnes: (518) 455-5662, (585) 218-0038
      byrnesm@nyassembly.gov

• David McDonough: (518) 455-4633, (516) 409-2070
      mcdonoughd@nyassembly.gov

• Jake Ashby, (518) 455-5777,  (518) 272-6149
      ashbyj@nyassembly.gov

• Andrew Raia: (518) 455-5952, (631) 261-4151
      raiaa@nyassembly.gov

• Send a letter via the MSSNY Grassroots Action Center (GAC) to your          legislator!

• Work with your local county medical society and schedule a meeting within your area with your legislator! Or call your State Senator and Assembly Member’s office to voice your support of this legislation. There is strength in numbers!

• Please look them up here.

Joining the Medical Society in support of medical exemptions only are the following groups:

American Academy of Pediatrics, NYS District II, Chapters 1, 2 & 3, American Nurses Association – New York (ANA-NY),  Associated Medical Schools of New York, Autism Science Foundation, Citizen Committee for Children of New York, Inc., Children’s Defense Fund-New York, Erie County Department of Health, Ithaca Is Immunized, Kimberly Coffey Foundation, Nurses Who Vaccinate, March of Dimes, Meningitis B Action Project,  Nurse Practitioner Association New York State, New York American College of Emergency Physicians, NY Chapter American College of Physicians, NYS Academy of Family Physicians, NYS Association of County Health Officials (NYSACHO), NY Occupational and Environmental Medical Association (NYOEMA), NY State Neurological Society, NY State Neurosurgical Society, NYS Ophthalmological Society, NYS Society of Otolaryngology-Head and Neck Surgery, NYS Public Health Association, New York State Society of Anesthesiologists, Inc., The New York State Radiological Society, Schuyler Center For Analysis and Advocacy, The Children’s Agenda, Tompkins County Department of Health.   (CLANCY) 

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Varying Proposals to Address Surprise Medical Bills Contain Positive and Concerning Elements
US House and Senate leaders each released bi-partisan proposals this week to address the issue of “surprise” out of network medical bills received by patients.  Last week, past MSSNY President Dr. Andrew Kleinman had meetings in DC with the House Doctors Caucus, key health policy staff for several US Senators, and Senator Charles Schumer to share New York’s experience with its acclaimed surprise bill law.

While the House and Senate proposals share some similarities with New York’s law, there are also important differences that raise serious concerns.  MSSNY President Doctor Art Fougner made the following statement raising such concerns. Read that statement here.    Physicians are urged to send a letter from here urging their member of Congress to fight for a law that is consistent with New York’s approach.

The first proposal, developed by a bipartisan working group led by Dr. William Cassidy (R-LA), attempts to address several issues that cause patients to receive surprise bills in the first instance, including increasing insurer transparency of patient cost-sharing requirements and of networks for the varying plans offered by a particular insurer and annual reporting to HHS of the out of network services it has paid in the previous year.  Moreover, for “surprise” medical bills, it preserves state approaches to addressing surprise bills for patients insured in state-regulated plans.

With regard to ERISA regulated plans, it recommends using New York’s “baseball” arbitration approach. However, the IDR benchmark would be “commercially reasonable rates (which must be based on in-network rates and not charges) for that geographic area”, a greatly concerning prospect. This approach could greatly undermine New York’s law and eliminate any incentive for a health insurer to negotiate fairly with a physician.  To read more, click here.

The second proposal, from House Energy & Commerce Chair Frank Pallone (D-NJ) and Ranking Member Greg Walden (R-OR) would also prohibit balance billing for all emergency services; patients would only be held responsible for the amount they would have paid in-network.  It also preserves a state’s ability to determine their own payment standards for plans regulated by the state.

But of great concern, it would establish a minimum payment standard set at the median contracted (in-network) rate for the service in the geographic area in which the service was delivered. Again, this approach could greatly undermine New York’s law, potentially diminishing hospital ED on-call specialty care availability and eliminate any incentive for a health insurer to negotiate fairly with a physician. To read more, click here.

The American Medical Association will be testifying at a hearing of the House Ways & Means Committee next Tuesday, May 21 on this issue.    (AUSTER)

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Progressing Toward Insurance Reform: Your Action is Needed!
MSSNY members and staff are working with members of the legislature to advance a measure that would help physicians negotiate fairer contracts with insurance companies. The bill, which is carried by Senator Rivera (S.3462) and Assemblymember Gottfried (A.2393) would allow independently practicing physicians to communicate and negotiate collectively with health care plans in limited instances (when health plans have an undue advantage negotiating the terms of contracts with health care providers).

The bill is currently in the Senate Health Committee and Assembly Ways & Means Committee. Physicians are strongly encouraged to advocate for this bill by contacting their legislators and members of the health committees via phone or via email/letter. To take action, click here.

There are also a handful of other insurance related bills supported by MSSNY that are working their way through the legislature and physicians are encouraged to reach out to their legislators to voice their support for these bills. In order to locate your local legislator, click here.

• 2849/A.2969 would prevent mid-year formulary changes by insurance companies, helping to ensure that patients are able to access the drugs they need without unexpected cost increases mid-year. It has advanced out of the Senate Insurance committee for the first time this year and has passed the Assembly ever year since 2015. Please urge your legislator to support this bill by clicking here.

• 2847/A.3038 would implement a variety of prior authorization reforms, including reducing the time that insurance companies have to process prior authorizations, ensuring that authorizations are valid for the duration of treatment, and requiring peer-reviewed criteria for decision-making. The bill is scheduled for a vote next week in the Senate Health Committee and is awaiting action in the Assembly Insurance Committee. Please urge your legislator to support this bill by clicking here.

• 3463/A2835, which would assure due process protections for physicians whose contracts with insurers are non-renewed. The bill is on the Senate floor and in the Assembly Codes Committee.

• 4335/A.3077 would require insurance companies to utilize uniform credentialing referral forms to streamline processes and cut down on unnecessary and duplicative paperwork for physicians and their staff. The bill has passed the Assembly and will be eligible for a vote in the Senate next week. (AVELLA/AUSTER)
  

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Bill Requiring Physicians to Maintain Excessive Documentation of Discussion of Risks of Prescribing Opioids Moves to Senate Floor; Action Needed!
Physicians are urged to contact their legislators in opposition to legislation (S.4277-A/A.7285-A) which would require physicians and health practitioners who prescribe an opioid or other Schedule II Controlled Substance to discuss with patients’ the risks prior to prescribing the medications. The Medical Society is opposed to this measure and encourages physicians to send a letter to their legislator at the MSSNY Grassroots Action Center (GAC) here.

The bill is on the Senate floor and can be voted on at any time.  This legislation would require physicians to discuss (and by extension document that such discussions took place) the following: a) the risks of addiction and overdose associated with opioid medications; b) the reason why the prescription is necessary; c) alternative treatments that may be available; and, d) the risks associated with the use of these medications. Moreover, it would require the physician to counsel the patient on the risks of overdose and the availability of an opioid antagonist each year.

While this legislation is well intended, it ignores existing Public Health Law that essentially requires the patient’s informed consent. This means that when a patient needs treatment, their physician must give them information regarding risks so that they can make an informed decision.

Additionally, this is duplicative of requirements that currently exist under other laws mandating that after a physician prescribes the medication, the pharmacist is required to again inform the patient about the risks of taking a controlled substance. Moreover, for their patients who are on opioid medications longer than 90 days, physicians are required to have a written treatment plan that includes discussing with patients the risks of these medications and possible alternatives to these medications.  MSSNY is also concerned that such requirements will further discourage physicians from prescribing pain medications for patients who need them – already a growing concern – and could potentially scare patients who truly need pain medication away from taking this medication.  (CLANCY, AUSTER)

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Partial Fill Legislation Passes NYS Assembly; Awaits Action in Senate Health Committee
Assembly Bill 3918, sponsored by Assemblymember John McDonald, has passed the NYS Assembly.   This measure allows a prescriber to issue a prescription to a patient for a Controlled Substance II, III or IV that can be filled partially.  It also allows them to prescribe up to a 30-day supply of Controlled Schedule II, III, and IV with a notation to the pharmacist that he/she should only dispense the agreed to amount. Each partial filling would be dispensed and recorded in the same manner as a refilling (i.e., date refilled, amount dispensed, initials of dispensing pharmacist, etc.).

The total quantity dispensed in all partial fillings may not exceed the total quantity prescribed. Partial fills of prescriptions for Controlled Substance II are allowable under federal law but are currently prohibited in New York State. Its companion measure, Senate Bill S.1813 is sponsored by Senator Rivera and is in the Senate Health Committee. The Medical Society of the State of New York supports this measure.          (CLANCY)

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Legislation to Require Those Over 16 to be Restrained in Back Seat Passes NYS Senate; Vote Pending in Assembly

A measure that would require everyone to buckle up in the rear seat has passed in the Senate and is on the Assembly Calendar for a vote.  The bill, S.4336/A.6163, is sponsored by Senator Carlucci and Assemblymember Mosley.  The MSSNY House of Delegates recently unanimously adopted policy urging that seat belts be required in both front and rear seats.  One of the safest choices drivers and passengers can make is to buckle up and 89.6% of drivers and passengers did so in 2018, saving 14,955 lives.

According to the Insurance Institute for Highway Safety adult rear-row occupants were less likely to use seat belts, with just 70 percent of those age 20 to 54 and 86 percent of those 55 and older using restraints. Per IHS, adult rear seat passengers are at greater risk for chest injuries and traumatic brain injuries than front seat passengers.  MSSNY recently participated in a press conference with the bill’s sponsors in support of this measure. (CLANCY)

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Congress Passes Package of Prescription Drug Reforms Supported by AMA
On Thursday, the US House of Representatives passed a package of legislation that includes bills aimed at increasing transparency and expanding competition in the pharmaceutical drug sector. The bills, which are supported by the American Medical Association, seek to achieve the following:

• Penalize drug manufacturers that withhold samples from their generic rivals, potentially promoting competition by facilitating the timely entry of lower-cost generic and biosimilars.
• Ban “pay-for-delay” agreements where manufacturers pay each other to delay market entry, potentially removing incentives for generics and biosimilars to delay coming to market.
• Discourage “parking” of the 180-day exclusivity period by the first generic applicant, potentially allowing quicker market entry for additional generics.                                                                                              (AVELLA)
  

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Measles Outbreak in New York State Continues to Spread
Webinar Available at MSSNY CME Website

The number of measles cases in New York State continues to rise with approximately 772 of the 829 cases confirmed in the U.S. as of May 1^st occurring in New York State (495 in New York City, 225 in Rockland, 31 in Orange, 17 in Westchester and 2 in Sullivan; 1 in Suffolk and 1 in Greene counties).  MSSNY conducted a just-in-time Medical Matters webinar entitled “The Continued Public Health Threat of Measles 2018” in December, 2018.

This webinar has now been posted to the MSSNY CME website. You can also view MSSNY’s latest Medical Matters webinar entitled “What’s Your Diagnosis? Infectious Diseases” which involves a patient with a fever and a rash. Please check these out and keep yourself informed about the growing measles outbreak throughout New York State.  You can also listen to MSSNY’s brief podcast on the Measles, Mumps and Rubella vaccine here.              (HOFFMAN, CLANCY)

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Registration Now Open for Veterans Matters CME Webinar on June 5^th

Register now for MSSNY’s next Veterans Matters webinar. This webinar is entitled Substance Use Disorders in Veterans.  Register below for this program.

Veterans Matters: Substance Use Disorders in Veterans

When:  Wednesday June 5 2019 at 7:30am – Register here

Faculty: Frank Dowling, MD

Educational Objectives

1. Define Substance Use Disorders (SUDs), symptoms, warning signs, comorbidities
2. Explore evidence-based intervention and treatment options for SUDs among veterans
3. Identify barriers to diagnosis and treatment and methods to overcome them

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA/PRA Category 1 creditsä.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.         (HOFFMAN)

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pschuh@mssny.org	mauster@mssny.org	pclancy@mssny.org	mavella@mssny.org
charring@mssny.org

eNews

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MSSNY Seeking Information re NYS Physicians Having Difficulties with Walmart on Prescribing Practices
MSSNY is interested in hearing from physicians who may have received a letter from Walmart in regards to the prescribing practices for controlled substance.   Walmart, Walgreens, and CVS pharmacies have implemented the CDC Guidelines for Prescribing Opioids for Chronic Pain as corporate policy.  MSSNY has learned that Walmart has sent letters to physicians throughout the country about their prescribing practices.   In the letters, Walmart indicated that it will no longer be accepting physicians’ prescriptions for Controlled Substances II-V after Walmart’s review of a physician’s prescribing practice.

MSSNY is extremely concerned about corporate policies that could result in refusal to fill prescriptions above certain doses and to refuse to fill prescriptions from certain physicians based on the corporation’s arbitrary definitions of questionable prescribing patterns.  MSSNY is aware that a few NYS physicians have received this letter and several physicians have been told by Walmart that it will not honor any prescription for Controlled Substance II-V.   MSSNY has brought this matter to the attention of the NYS DOH Bureau of Narcotics and is awaiting further information from them.   Any physician who may have received this letter, please contact Pat Clancy, Sr. Vice President, Public Health and Education/Managing Director, at pclancy@mssny.org or by phone at 518-465-8085.

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AMA Hires 1st Chief Equity Officer; Push Came from MSSNY Disparities Committee
The AMA announced the hiring of Aletha Maybank, M.D., M.P.H., as its first ever chief health equity officer. Dr. Maybank joins the AMA after serving as deputy commissioner and founding director of the Center for Heath Equity within New York City’s Public Health Department. Prior to being deputy commissioner, Dr. Maybank was an assistant commissioner at the NYC Health Department 2009-2014. Dr. Frank Dowling commented, “The development of this new center started with a MSSNY resolution from the Healthcare Disparities Committee, then to the AMA HOD two years ago. Erick Eiting and Malcolm Reid were members of the Task Force that issued a report last year calling for the development of a center to address health inequities. It seems that Dr. Maybank may be meeting with the LGBTQ AC at the June AMA Meeting. I hope we will hear more about Dr. Maybank and the plans for the development of this center.”

See link below about the hiring of Dr. Maybank

https://www.ama-assn.org/press-center/press-releases/ama-announces-first-chief-health-equity-officer

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AAP and AAFP: New Guidance for Sports Physicals
Several medical groups, including the American Academy of Pediatrics and the American Academy of Family Physicians, have released new guidance on conducting a pre-participation physical evaluation, also known as the sports physical. The update includes new information on seeing female and transgender athletes, as well as evaluating a student’s mental health. Clinicians can address subjects like bullying, drug and alcohol use, and birth control during the sports physical.

The groups recommend doing the evaluation as part of the child’s regular health screening visit.

AAP news release; Background: NEJM Journal Watch Pediatrics and Adolescent Medicine coverage of cardiac screening of adolescent soccer players

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Planned Parenthood Offering Transgender Hormone Therapy at Two FL Clinics
The AP (5/15) reports Planned Parenthood is “now offering hormone therapy and other services for transgender patients in Florida, starting with two health centers in Miami this week,” with “plans to expand statewide within the year.” Planned Parenthood Florida President Lillian Tamayo said, “We were hearing from our allies and witnessing the kind of barriers that transgender people experience trying to secure healthcare and that is from just walking into a health facility and being treated with judgment and discrimination.” They have plans to extend offering statewide.

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Walmart Worried That CT/MRI Errors Lead to Too Many Employee Surgeries
Walmart Inc. is worried that too many of its workers are having health conditions misdiagnosed, leading to unnecessary surgery and wasted health spending. The issue crystallized for Walmart officials when they discovered about half of the company’s workers who went to the Mayo Clinic and other specialized hospitals for back surgery in the past few years turned out not to need those operations. They were either misdiagnosed by their doctor or needed only non-surgical treatment.

A key issue: Their diagnostic imaging, such as CT scans and MRIs, had high error rates, said Lisa Woods, senior director of benefits design for Walmart. So the company, whose health plans cover 1.1 million U.S. employees and dependents, has recommended since March that workers use one of 800 imaging centers identified as providing high-quality care. That list was developed for Walmart by Covera Health, a New York City-based health analytics company that uses data to help spot facilities likely to provide accurate imaging for a wide variety of conditions, from cancer to torn knee ligaments.

Although Walmart and other large employers in recent years have been steering workers to medical centers with proven track records for specific procedures such as transplants, the retail giant is believed to be the first to prod workers to use specific imaging providers Kaiser Health News, May 15.

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New York Rx Card Helps Patients Fill Their Prescriptions
Prescription drugs can be a significant cost for you, your employees, and your patients.  Here are some numbers to bear in mind:

• Pharmaceuticals account for about 22 percent of the cost of insurance premiums.
• Prices for popular brand name drugs rose 208 percent from 2008-2016.
• Buyers are spending over $450 billion annually to treat conditions such as high blood pressure, high cholesterol, diabetes, hepatitis C, multiple sclerosis and several cancers.
• 40 percent of people couldn’t manage payments and asked their doctor or pharmacist for a cheaper alternative.

New York Rx Card can help relieve the “sticker shock” your patient’s feel each time they pay for a prescription.  New York Rx Card is an Rx savings program you can offer to your patients and save up to 75 percent off the retail price.

This Rx savings program was launched to help uninsured and underinsured residents afford their prescription medications. New York Rx Card can be used by patients that have health insurance coverage with no prescription benefits, which is common in many health savings accounts (HSA) and high deductible health plans. The Rx savings program can also be used by individuals who have prescription coverage but are taking medications not covered by their insurance.

Any physicians who are interested in ordering free cards for their clinic/hospital can email Chez Ciccone, Program Director, at fciccone@nyrxcard.com or 800-931-2297.

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NY and 43 States Sue 20 Generic Drug Manufacturers Alleging Price Fixing
Attorney General Letitia James joined 43 states led by Connecticut Attorney General William Tong in announcing a lawsuit against Teva Pharmaceuticals and 19 of the nation’s largest generic drug manufacturers alleging a broad conspiracy to artificially inflate and manipulate prices, reduce competition, and unreasonably restrain trade for more than 100 different generic drugs. The drugs at issue account for billions of dollars of sales in the United States.  The States allege that the Defendants’ conduct artificially increased prices to health insurers, taxpayer-funded healthcare programs like Medicare and Medicaid, and individuals who paid and continue to pay inflated prices for their prescription drugs.

The complaint alleges that Teva, Sandoz, Mylan, Pfizer and 16 other generic drug manufacturers engaged in a broad, coordinated and systematic conspiracy to fix prices, allocate markets, and rig bids for more than 100 different generic drugs. The drugs span all types, including tablets, capsules, suspensions, creams, gels, and ointments; and classes, including statins, ace inhibitors, beta blockers, antibiotics, anti-depressants, contraceptives, non-steroidal anti-inflammatory drugs. They treat a range of diseases and conditions from basic infections to diabetes, cancer, epilepsy, multiple sclerosis, HIV, ADHD, and more. In some instances, the coordinated price increases were over 1,000 percent.

The complaint lays out an interconnected web of industry executives where these competitors who met with each other during industry dinners, lunches, cocktail parties, golf outings and communicated via frequent telephone calls, emails, and text messages sowing the seeds for their illegal agreements. Throughout the complaint, defendants are described as using terms like “fair share,” “playing nice in the sandbox,” and “responsible competitor” to describe how they unlawfully discouraged competition, raised prices, and enforced an ingrained culture of collusion.

The lawsuit, filed in the United States District Court for the District of Connecticut, seeks damages, civil penalties, and equitable relief to restore competition to the generic drug market.  “The evidence shows a multi-year, multi-faceted conspiracy to enrich pharmaceutical companies at the expense of consumers,” said Attorney General Letitia James. “The scope of the conspiracy is breathtaking, affecting generic drugs that people rely on every day to treat acute and chronic conditions, like diabetes and arthritis.  The blatant anticompetitive conduct alleged in the complaint harmed consumers’ health and well-being in multiple way and we intend to hold the wrongdoers accountable.”

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CMS

2015 Edition CEHRT Required in Program Year 2019 for All Promoting Interoperability Program Participants
Beginning this year, all Promoting Interoperability Programs participants must use 2015 Edition certified electronic health record technology (CEHRT) to avoid a downward Medicare payment adjustment.

We believe these up-to-date standards and functions of 2015 Edition CEHRT will better support interoperable exchange of health information and improve clinical workflows.

2019 CEHRT Requirements

• The 2015 Edition CEHRT did not need to be in place by January 1, 2019, but must be used for the entire EHR reporting period of any continuous, self-selected 90-day period.
• The 2015 Edition CEHRT functionality must be in place by the first day of the EHR reporting period and the product must be certified to the 2015 Edition criteria by the last day of the EHR reporting period.

Attestation Statements

In addition to using the 2015 Edition CEHRT, participants must attest to certain statements to demonstrate that they have not knowingly and willfully taken action to limit or restrict the compatibility or interoperability of their CEHRT. These statements are referred to as the “prevention of information blocking attestation.” For more details on information blocking, review this fact sheet.

For More Information

To learn more about 2015 Edition CEHRT requirements, review this fact sheet. Additional information on 2019 program requirements can be found on the Promoting Interoperability Programs website.

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