CMS delays start of Meaningful Use 3

Physicians and other eligible providers taking part in the government’s meaningful use (MU) program will have more time and flexibility for meeting the requirements for the third state of the program under the Final Rule the government issued last week.

The Rule also gives electronic health record (EHR) vendors additional time to develop the technology that users will need in order to meet the requirements for the third stage of Meaningful Use. Among other changes the Rule:

• Delays the start of the third phase of meaningful use until January 1, 2018, with the option of starting in 2017 for providers who feel they are ready to do so

• Reduces the number of objectives providers must meet from 18 to 10 during the reporting years 2015

• Reduces the thresholds for stage 2's requirement for viewing, downloading, and transmitting patient information from 5% of a provider’s patient panel to a single patient and reduces the secure messaging requirement from 5% to simply having the capability

• Allows physicians and other providers to attest to their EHR use for any continuous 90-day period in calendar year 2015 by February 29, 2016

• Allows new MU participants for both Medicare and Medicaid 90-day periods in 2016 and 2017 to report on their EHR use

• Gives EHR manufacturers until the start of 2018 to develop the products required to meet new certification expectations

• Supports exchange of patient health information among providers and a more useful interoperable infrastructure for information exchange between providers and their patients.

“We eliminated unnecessary requirements, simplified and increased flexibility for those that remain, and focused on interoperability, information exchange and patient engagement,” Patrick Conway, M.D., deputy administrator of the Centers for Medicare & Medicaid Services (CMS) and chief medical officer, said in a written statement accompanying CMS’ announcement of the Rule. “By 2018, these rules move us beyond the staged approach of ‘meaningful use’ and focus on broader delivery system reform.”

Next: Further action

Conway added that CMS is encouraging providers to apply for hardship exceptions if they feel they need to switch EHR vendors or encounter technological difficulties.  It is also taking public comment for 60 days to obtain additional feedback about the MU program. Public comments will be considered when CMS begins its rulemaking process for implementing the Medicare Access and CHIP Reauthorization Act (MACRA), Conway said.

The complete rule can be viewed at https://s3.amazonaws.com/public-inspection.federalregister.gov/2015-25595.pdf

The following are industry reactions to the news:

Electronic Health Records Association (EHRA): "EHRA members are committed to helping our clients to be successful with Meaningful Use and other important industry initiatives, and we are appreciative that CMS finalized the critical modification changes for 2015-2017. We are pleased by the fact that both CMS and ONC heard some of our feedback on the original Stage 3 and 2015 certification proposals, yet we will be conducting our review with a careful eye toward whether any portions of the final ONC rule could introduce increased complexity with questionable value added to our clients' clinical practice or their patients' outcomes, which should be a benchmark in the regulatory review process. We are also concerned that future changes to the Stage 3 final rule after the 60-day comment period could impact the time available to implement and deliver software to our customers. We will evaluate possible comments during the 60-day comment period in coming weeks." -Leigh Burchell, vice chair, executive committee.

Healthcare Information and Management Systems Society (HIMSS): "HIMSS appreciates the continued efforts of CMS and ONC to simplify and provide flexibility for meeting the Meaningful Use program requirements. HIMSS has called for at least 18 months between the publication of a new Meaningful Use rule and the start of a new stage's reporting period-the 27 months provided in this final rule appears to address this issue.” -Carla Smith, MA, FHIMSS, the executive vice president, HIMSS North America.

American College of Physicians: “The ACP is pleased that CMS adopted many of the changes we recommended for Stage 2 meaningful use in its final rule. At the same time, we are disappointed that CMS released the rule at this late date in the year because it means that very few of our members will be able to successfully attest to Stage 2 in 2015.We view the fact that CMS chose to institute a 60-day public comment period before finalizing the rule for Stage 3 as a positive development. Doing so will allow us and other stakeholders to provide recommendations as to how the next stage of the program can best function under the Medicare Access and CHIP Reauthorization Act of 2015.”  -Shari Erickson, MPH, Vice President, Governmental Affairs and Medical Practice, American College of Physicians