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Washington Debrief: Pressure Mounts on Administration Surrounding MU

October 5, 2015
by Leslie Kriegstein, Interim Vice President of Public Policy, CHIME
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Federal Affairs

Meaningful Use Attestation in 2015

Key Takeaway:  The Centers for Medicare & Medicaid Services’ (CMS) portal to attest to meaningful use for 2015 is closed until January 4, 2016.

Why it Matters: CMS has not yet finalized the so-called modifications rule that proposes several changes to the current stages of the meaningful use program.  Importantly, the proposal called for a shorter, 90-day reporting period, as opposed to 365-days, and moving the deadlines for attesting for 2015 until no earlier than January 4, 2016.

In spite of the rule not yet being finalized—though publication is expected any day now—CMS did confirm with CHIME staff last week their intention to move the 2015 attestation period to early January. However, many stakeholders were either unaware of the change or had anticipated that the final rule was needed in order to make the change. Providers visiting the website will find an alert noting the system is undergoing maintenance and an alert that says:

EHR Program Announcement—The Attestation System will open on January 4, 2016 for Eligible Professionals, Eligible Hospitals, and Critical Access Hospitals to attest for Medicare Electronic Health Record Incentive Program for Program Year 2015.

CHIME has pointed out to CMS that providers feel hamstrung by their inability to attest in 2015 and that many providers’ balance sheets were counting on incentives, which are critical to provider budgets and are needed to continue making ongoing investments in infrastructure and patient care.

Leslie Kriegstein

GAO Reports Tackle Interoperability & Quality

Key Takeaway: A recent Government Accountability Office (GAO) report analyzed interoperability efforts currently underway in both the private and public sectors In “Electronic Health Records: Nonfederal Efforts to Help Achieve Health Information,” GAO, the government’s auditing arm,  not only noted that there are several efforts underway, but that significant barriers remain to achieving true interoperability.

Why It Matters: The topic of interoperability is not only being hammered out on the front lines of healthcare, the topic is under the microscope of policymakers who are scrutinizing how to further advance the needle forward and what barriers still exist. The Office of the National Coordinator for Health IT (ONC) has been tasked with “solving” this problem which they recognize will take both public and private sector solutions. 

Most interviewed for the report, who have initiatives underway, noted that their products and services would be more widely available within two years. As Washington policymakers— including those on the Hill—study this issue, pressure is increasing to ensure the promise of health IT to help providers deliver better care in a more efficient way and that the HITECH funding was well spent. Those interviewed by the GAO noted five areas that present challenges to realizing interoperability:

(1) insufficiencies in health data standards,

(2) variation in state privacy rules,

(3) accurately matching patients’ health records,

(4) costs associated with interoperability, and

(5) the need for governance and trust among entities, such as agreements to facilitate the sharing of information among all participants in an initiative.

Thirteen of the eighteen organizations interviewed by the GAO described work involving patient identification. CHIME has been blazing a trail forward on identifying a solution for a unique patient identifier through its National Patient ID Challenge.  As a recognized leader representing those on the front lines grappling with interoperability challenges, GAO sought CHIME’s perspective for this report. The U.S. Department of Health & Human Services (HHS) is prohibited under current law from implementing a national patient identifier until legislation is specifically enacted to approve a standard. Still, there is growing momentum in the private sector to find a unique patient identification solution. CHIME’s Hero X initiative is a great example of the private sector taking the lead on a complex issue. CHIME will nonetheless continue our advocacy with public policy makers on the need to remove this prohibition so that widespread adoption can occur across the entire healthcare system.