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Washington Debrief: Senate Bill Would Make MU Changes; MACRA Timeline May Change

July 18, 2016
by Leslie Kriegstein, Vice President of Congressional Affairs, CHIME
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Meaningful Use

Senate Bill Would Make Permanent 90-Day Reporting Period, Redefine Pass/Fail Construct of MU

Key Takeaway: A bill introduced into the Senate last week would add significant flexibility for Meaningful Use program participants in three key ways: permanent annual 90-day reporting periods, redefines a “Meaningful User” as meeting 70 percent of measures and extending current hardship exemptions.

Why It Matters: The bill introduced by the Senate “REBOOT” group, would leverage three reasonable policy changes to infuse flexibility into the Meaningful Use program beginning with the current program year, if passed.

The EHR Meaningful Relief Act (S. 3173), sponsored by Senator John Thune (R-SD), and cosponsored by Senators Lamar Alexander (R-TN), Mike Enzi (R-WY), Richard Burr (R-NC), Pat Roberts (R-KS) and Bill Cassidy (R-LA),  makes three policy changes to the Meaningful Use program:

  1. 90-Day Reporting Period – The legislation both would uphold the recent proposal from the Centers for Medicare and Medicaid Services (CMS) for a 90-day reporting period in 2016, but also continues the policy in perpetuity.
  2. Removal of All-or-Nothing Construct – The legislation adds a new threshold of 70 percent of metrics met in order to avoid a payment adjustment.
  3. Flexibility in Hardship Exemptions – At the end of 2015, Congress passed a law to expand CMS’ authority to grant hardship exemptions to Meaningful Use participants, including to those that are switching electronic health record (EHR) vendors.

CMS Administrator Acknowledges MACRA Timeline May Change During Senate Hearing

Key Takeaway: Appearing before the Senate Committee on Finance, Acting Administrator at the Centers for Medicare and Medicaid Services (CMS), Andy Slavitt, cited potential flexibility in either the start date of the Medicare Access and CHIP Reauthorization Act (MACRA) policies or a shortened reporting period to enable participants the best chance at success.

Why It Matters: CHIME, along with many other organizations in response to the proposed rules that would govern the Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APMs) under MACRA, have cited the timeline for the implementation of the new Medicare eligible clinician payment mechanisms to be overly aggressive, calling for adjustments in implementation timing. These concerns are shared by many lawmakers including Finance Committee Chairman Orrin Hatch (R-UT), who questioned whether a few months at the end of the year will give clinicians enough time to prepare.

Senators voiced their concerns about the ability of small and rural providers to successfully participate in MACRA, which includes a version of the Meaningful Use program renamed “Advancing Care Information.” Senator Debbie Stabenow (D-MI), expressed concerns about the lack of interoperability and challenges rural providers face leveraging their electronic health record, which is necessary for either pathway for payment under MACRA, to improve patient care.

The acting administrator highlighted efforts to infuse flexibility into how clinicians can participate in the new payment policies as well as intentions to reduce reporting burdens to demonstrate compliance. CMS is now in the process of finalizing the MACRA rule, which is expected to be released this fall.

Patient ID

House Committee Suggests in FY17 Budget Proposal, HHS Can Work on Patient Matching with Industry

Key Takeaway: To accompany the House version of the Labor, Health and Human Services and Education Appropriations bill, the Committee clarified that the lack of a national approach to patient matching is among the most significant barriers to nationwide interoperability and would allow the Department of Health and Human Services to work with the private sector on matching initiatives.




Hopefully this will give some relief for physicians who feel overburdened or overwhelmed. MACRA will be rewarding for providers who are able to optimize their results and reporting, and everyone should be afforded at least the potential to succeed in the program.