HHS Secretary Announces Meaningful Use Stage 1 Extension In a move that has been choreographed for months, this week HHS Secretary Kathleen Sebelius said that doctors and hospitals who attest this year will not have to adopt new standards until 2014. Wednesday’s announcement stands to positively impact all those hospitals who attested prior to November 30 and all those doctors who can attest before February 28, 2012. These groups will be eligible for three payments based on meeting Stage 1 requirements.

The delayed transition from Stage 1 to Stage 2 was first recommended by the Health IT Policy Committee’s Meaningful Use Workgroup in June, who urged a start date of 2014, not 2013, as written in the 2010 final rule. Later in July, National Coordinator Dr. Farzad Mostashari endorsed the HITPC recommendation to delay until 2014 the start of Stage 2 Meaningful Use. In its transmittal letter to ONC, HITPC said, “With the anticipated release of the final rule for Stage 2 in June, 2012, it would require EHR vendors to design, develop, and release new functionality, and for eligible hospitals to upgrade, implement and begin using the new functionality by the beginning of the reporting year in October of 2012.” Because of this tight window, HITPC recommended that an extra year be given only to those who attest in FY 2011 or CY 2011.

What does this mean for CIOs?

• If you attested for incentive payments before November 30, 2011, you are now eligible for your second and third payments while still meeting Stage 1 criteria.
• If you are planning to attest in fiscal year 2012, you will still have until fiscal year 2014 to meet criteria for Stage 2 Meaningful Use. This remains the same as the 2010 final regulation.
• Eligible Professionals still have until February 29, 2012 to qualify for 2011 incentive payments.

For a comparison of how this announcement changes the final rule published in 2010, see the two charts below. Table 1 is from the final rule published in 2010.



Here is how the chart now looks (this is an unofficial version until the next MU notice of proposed rule-making is released):



Please send all comments and questions to Sharon Canner or Jeff Smith.

Obama Taps Tavenner to Follow Berwick as CMS Admin In an announcement that came late last Friday, CMS Administrator Donald Berwick will be stepping down December 2 and Deputy Administrator Marilyn Tavenner has been nominated by President Obama to take his place. In the week since the announcement, several healthcare groups have voiced their support for the nomination, including the AHA. AMA, Association of American Medical Colleges, the Alliance for Quality Nursing Home Care and the Federation of American Hospitals. Observers are hopeful that Ms. Tavenner’s nomination will not be as controversial as Dr. Berwick’s. According to The Hill’s Healthwatch blog, Sen. Orrin Hatch (R-Utah), the top Republican on the Finance Committee, said last week that the panel would thoroughly vet Tavenner, but he did not immediately express opposition to her nomination. And later in the week, House Majority Leader Eric Cantor (R-Va.) said Ms. Tavenner was “eminently qualified” to lead CMS. Rep. Cantor doesn’t get to vote, but as the Associated Press report points out, he’s got sway among a large swath of Republicans in both the House and Senate.

Congress Begins to Grapple with Sequestration Options Although President Obama has made statements in the last week warning Congress not to alter terms of the planned 2013 sequestration, Congress is abuzz with plans to exempt planed cuts to defense and healthcare.

In an effort to spare Medicare from getting cut as part of the August debt deal, Rep. Edolphus Towns (D-N.Y.) introduced H.R. 3519 this week. The bill was co-signed by six other House Democrats, who said hospitals would not be able to cope with reduced Medicare reimbursements required under the sequestration cuts. "Hospitals in New York are already slated to experience $15 billion in Medicare and Medicaid cuts under the Affordable Care Act over the next ten years," Rep. Towns said. "If sequestration occurs, hospitals will lose another $2.6 billion — or over $116 million in my district alone.” Democrats from Indiana, Missouri, Hawaii, Florida, California and the Virgin Islands joined Rep. Towns in his effort.

In other Sequestration news, House Majority Leader Eric Canter (R-Vir.) is rumored to be seeking support for a deal that would rework automatic spending cuts, extend payroll tax cuts and jobless benefits, and fix the reimbursement rate formula for physicians under Medicare. Leader Canter’s deal would delay by one year any sequestration of defense and non-defense discretionary spending cuts to find a “more responsible way” to reduce the federal deficit.

Finally, Sen. Joe Lieberman (I-Conn.) is quietly courting support for legislation he's drafting to suspend the super committee sequestration cuts and instead expedite a floor vote on “the Simpson-Bowles report or a very comparable package,” according to an email from Lieberman's office to 45 Senate chiefs of staff, obtained by Inside Health Policy.

CHIME Launches HIE Guide for CIOs The exchange of health information will be of significant concern to healthcare providers seeking to qualify for meaningful use payments and to participate in the evolving healthcare environment, which will place a premium on coordination of care through the seamless sharing of healthcare information. So CHIME, in collaboration with the eHealth Initiative, is pleased to bring the HIE Guide for CIOs to its members.

How health information exchange (HIE) is achieved over the next few years is expected to change. And as such, this guide is intended to be a starting point for identifying key issues for healthcare executives that are developing a ground-level understanding of how to accomplish health information exchange. As HIE evolves in the coming months, this guide will be further refined to provide ongoing guidance on HIE decisions. In addition, as industry experience with HIE continues to grow, we’ll look for and share real-world examples of how healthcare organizations are optimizing the use of HIE to achieve concrete results that could benefit other provider organizations.

Edited by Sharon Canner, Senior Director of Advocacy, CHIME