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BREAKING NEWS: CMS and ONC Finalize Regulation on Stage 2 MU Reporting—Without Flexibility

August 29, 2014
by Mark Hagland
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“We are absolutely shocked” at the FY 2015 365-day requirement, CHIME’s Branzell Tells HCI exclusively

In what some in the healthcare IT field might find a surprise move, the federal Centers for Medicare & Medicaid Services (CMS) and Office of the National Coordinator for Health Information Technology (ONC) announced late on Friday afternoon, Aug. 29, that eligible healthcare providers would not be granted the opportunity to engage in a 90-day meaningful use reporting period for second-year reporting, but instead, would be required to engage in a 365-day reporting period in second-year Stage 2 reporting in 2015, whose fiscal year begins October 1, 2014. That move effectively puts hospitals and physicians on notice that they have barely more than one month to get certified electronic health record (EHR) software in place in time to begin the mandatory reporting.

Speaking exclusively to Healthcare Informatics, Russell P. Branzell, president and CEO of the Ann Arbor, Mich.-based College of Healthcare Information Management Executives (CHIME), said, “We’re extremely disappointed that there was no reporting-period change” in this instance. “And that means for our members that they have to be Stage 2-ready on October 1. We’ve just told them that for the new rule, it’s OK to use Stage 1 software for reporting during this last period. We had asked [CMS and ONC]  for a 90-day reporting period in 2015, instead of a 365-day reporting period. But now this means that everyone needs to be ready now on October 1, the beginning of the new fiscal year. For a program that we still believe is absolutely essential and absolutely important to gain momentum, we are absolutely shocked that no flexibility was given in this case, with regard to 2015. Their rationale was that they wanted to create more momentum. But this does the opposite.”

Russell P. Branzell

According to an announcement on the CMS website, “The Department of Health and Human Services (HHS) published a final rule today that allows health care providers more flexibility in how they use certified electronic health record (EHR) technology (CEHRT) to meet meaningful use for an EHR Incentive Program reporting period for 2014. By providing this flexibility, more providers will be able to participate and meet important meaningful use objectives like drug interaction and drug allergy checks, providing clinical summaries to patients, electronic prescribing, reporting on key public health data and reporting on quality measures.”

In a statement as part of that announcement, Marilyn Tavenner, R.N., CMS Administrator, said, "We listened to stakeholder feedback and provided CEHRT flexibility for 2014 to help ensure providers can continue to participate in the EHR Incentive Programs forward. We were excited to see that there is overwhelming support for this change."

The HHS/CMS/ONC announcement added that, “Based on public comments and feedback from stakeholders, the Centers for Medicare & Medicaid Services (CMS) identified ways to help eligible professionals, eligible hospitals, and critical access hospitals (CAHs) implement and meaningfully use Certified EHR Technology. Specifically, eligible providers can use the 2011 Edition CEHRT or a combination of 2011 and 2014 Edition CEHRT for an EHR reporting period in 2014 for the Medicare and Medicaid EHR Incentive Programs; All eligible professionals, eligible hospitals, and CAHs are required to use the 2014 Edition CEHRT in 2015.”

In a press release issued shortly after the federal agencies’ announcement, the leaders of CHIME said, “CHIME is deeply disappointed in the decision made by CMS and ONC to require 365-days of EHR reporting in 2015. This single provision has severely muted the positive impacts of this final rule. Further, it has all but ensured that industry struggles will continue well beyond 2014.” The CHIME release went on to say, “Roughly 50% of EHs [eligible hospitals] and CAHs [critical access hospitals] were scheduled to meet Stage 2 requirements this year and nearly 85% of EHs and CAHs will be required to meet Stage 2 requirements in 2015. Most hospitals who take advantage of new pathways made possible through this final rule will not be in a position to meet Stage 2 requirements beginning October 1, 2014. This means that penalties avoided in 2014 will come in 2015, and millions of dollars will be lost due to misguided government timelines.”

Branzell told HCI that “We will continue to analyze this new rule throughout this holiday weekend.” HCI will continue to provide updates to this developing story.