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Washington Debrief: Stage 3 Delay Changes No Requirements in 2014

December 16, 2013
by Jeff Smith, Director of Public Policy at CHIME
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Jeff Smith, Director of Public Policy at CHIME

CMS Intends Delay for Stage 3 of Meaningful Use; Timelines, Penalties Remain for 2014

Key Takeaways:

  • CMS will look to push the start of Stage 3 Meaningful Use to 2017 for providers who began MU in 2011, 2012 and 2013.
  • The Stage 3 delay will not change any requirements for providers in 2014; all providers must use 2014 Edition CEHRT; all hospitals must be MU-ready by July 1, and all EPs must be MU-ready by October 1.

Next Steps: CHIME will continue to push for flexibility in 2014 for all providers; members are encouraged to share their MU story with CMS officials and Public Policy staff in Washington.

In a pair of blog announcements last week, CMS and ONC said they intend to initiate rulemaking that would delay the beginning of Stage 3 Meaningful Use from 2016 to 2017. However, the move does not change any requirements or deadlines for Meaningful Use in 2014, CMS confirmed. In an effort to stem misinformation contained in health IT trade publications, CHIME issued an announcement to clarify for members what the announcement said and did not say. “Hospitals still have to be Meaningful Use-ready by July 1, 2014, and physicians have to be ready by Oct. 1, 2014,” said CHIME President and CEO Russ Branzell. “While this announcement will benefit the program in 2017, it does nothing to address providers’ concerns today. Flexibility in 2017 will not matter if the program does not survive 2014.”

While CHIME believes that the federal agency’s announcement Friday gives vendors and policy makers flexibility to ensure the outcomes sought in Stage 3 are realized, it’s disappointed that the changes do not provide the flexibility for providers requested in previous recommendations. CHIME strongly urged CMS to consider previous recommendations to give EHs and EPs flexibility in meeting the start date of Stage 2. CHIME reiterated its belief that some providers will need an additional year to install, test, implement and operationalize the new certified EHR software.

SGR Repeal: 3 month Patch and Permanent Fix Efforts

Key Takeaway: Washington moves one step closer to a permanent “doc fix” that repeals the Sustainable Growth Rate (SGR) approach and replaces it with a permanent Medicare physician payment structure that includes bonuses for providing quality care and using health information technology.

While Congress continues to negotiate a permanent fix, a three month SGR patch (ending March 31) that generally maintains the status quo has been attached to the budget deal passed by the House last week. This patch includes a 0.5% increase in payments each year for three years for surgeons.

Payment reform is one of the main focuses for SGR repeal legislation. As previously reported, Medicare payment would be frozen for 10 years with incentives for physicians that successfully participate in existing Medicare programs, including Meaningful Use, the Physician Quality Reporting System and the value-based modifier. The goals of the bonus payments include reducing waste in the healthcare system and therefore reducing healthcare costs, and providing better quality care for Medicare patients. Penalties also will be used to cut reimbursement for physicians that don’t meet certain quality thresholds. Changes to long-term care are also expected as noted in this article. To prevent a 24% cut in reimbursement, Congress must take some action before December 31.

CMS Tip Sheet Offers Guidance on Security Risk Assessments

Key Takeaway: The Centers for Medicare & Medicaid Services recently released a “tip sheet” on conducting a security risk assessment (SRA), which is required under both HIPAA and Meaningful Use.