The Office of the National Coordinator for Health Information Technology health IT policy committee voted Thursday on long-awaited recommendations from its workgroups on how providers can qualify to receive incentives through the new stimulus package.

As part of a mandated series of steps the ONC policy committee accepted its workgroup's complex matrix of qualifications that will define "meaningful use" of health IT, a pivitol aspect to being a candidate for reimbursement bonuses and avoiding penalties under the American Recovery and Reinvestment Act of 2009 (ARRA). Bonuses will begin in 2011, while penalties will be enacted in 2017.

Among the revised criteria providers would have to follow are allowing patients to access their health records in a timely manner and developing capabilities to exchange health information where possible. For a complete list of workgroup recommendations, click here (PDF).

The recommendations will now have to be approved by National Coordinator for Health IT David Blumenthal, MD, before they are delivered to the Centers for Medicare and Medicaid Services (CMS) to be applied as it sees fit in writing a rule expected out for comment in December.

Several other ONC workgroups' recommendations were also approved at Thursday's meeting, and some were approved on a preliminary basis, with details yet to be worked out. Blumenthal and other members of the committee urged a vote in the interest of progress.

"We are in the business of making recommendations, not rulemaking," Blumenthal said.

Jodi Daniel, director of the Office of Policy and Research said ONC received 790 public comments on meaningful use over a 10-day period in June. Daniel said many who provided comments showed support for the improved health outcomes approach endorsed by ARRA.

Many of those who commented were concerned over the stringent time constraints, which will require providers to establish and meaningfully use health IT by next year. Specialty physicians were concerned the rules will not be specific to their scope of practice.

Physicians were also concerned over liability issues that may arise as electronic health records are shared between various providers.

Blumenthal said the question of liability is not one the policy committee could address. "If we were to have to think through everything that could cause medical liability, we could be tied in knots."

At its June meeting, the ONC policy committee tabled recommendations on meaningful use to work out some kinks. With today's approval of the new recommendation matrix, "there is going to be some limitation on what we can say and do after today," Daniel said. ONC and CMS will be working on the rule internally until December.