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D.C. Report: MU Stage 2 Timeline, HHS Policy Hearings, Partnership for Patients

May 10, 2011
by Sharon Canner, Sr. Director of Advocacy
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Options Weighed for Meaningful Use Stage 2 Timeline. At a meeting held this week, the HIT Policy Committee Workgroup on Meaningful Use reviewed comments received from over 400 stakeholders for Stage 2. Central to Tuesday’s discussion was how to address concerns about the timeline of attesting to Stage 2 MU. The workgroup highlighted four possible paths:
1. Maintain current timeline and one-year reporting period; or
2. Maintain current timeline and permit 90-day reporting period; or
3. Delay transition from stage 1 to stage 2 by one year (providers could get third-year payment for meeting stage 1 expectations); or
4. Phase-in approach that separates existing from new functionalities
a. 2013: Updated stage 1 requirements (“Stage 1 Prime”) with no new EHR functionality (e.g., move menu set items to core and increase thresholds of existing stage 1 functionality measures)
b. 2014: Stage 2 objectives requiring new EHR functionalities would not be expected to be implemented until FY 2014

Workgroup chair Dr. Paul Tang/Palo Alto Medical Foundation indicated he might be open to the idea of delaying Stage 2, but that it would come at a cost to providers who attest this year. “It only affects one group, the group that comes in, in 2011. Because of the way the rule is written, those people would be subject to a loss of one year’s incentive,” he said. Additionally, Tang acknowledged that a delay would give providers a third year to meet Stage 1 requirements, instead of two, and could increase overall participation in the EHR Incentive Payments program. Final recommendations for measures will be submitted to the full HIT Policy Committee next week and timing recommendations will issued in June. Also discussed at Tuesday’s meeting was a letter of recommendations for Stage 2 submitted by the Information Exchange Workgroup. Among the topics addressed in the letter were: Patients’ Ability to View/Download Information; Medication Reconciliation; and Longitudinal Care Plans & Care Teams.

Hearings Focus on HHS Policies and SGR Fixes. In a week filled with multiple hearings on health and related topics, health IT was one of many issues, though not a major focus. In testifying before the House Education and Labor Committee on the 2012 HHS Budget priorities, HHS Secretary Sebelius reported on the Medicare and Medicaid Incentive Program, noting that the first of the Medicaid incentive payments were made on January 5, 2011. As of March 31, 660 providers had received $64 million in Medicaid incentives. An increase of $17 million in ONC’s budget has been requested for FY 2012 for purposes of assisting providers to become meaningful users of health IT. Of questions directed to the Secretary, The Accountable Care Act drew the most attention from lawmakers.

House Energy and Commerce Health Subcommittee Chair Joe Pitts (D-PA-16) opened this week’s hearing on the SGR by summarizing 2010 and recent activity on Medicare physician payment: “Congress passed two 1-month overrides, two 2-month overrides, one 6-month override and, most recently, for 2011, Congress passed a 1-year override. All this was done without resolving the underlying problem. Meanwhile, the cost of fixing the problem continues to grow.” Former CMS Administrator Dr. Mark McClellan kicked-off a panel of witnesses that included the Coalition of State Medical and National Specialty Societies, AMA, American College of Surgeons, American Academy of Family Physicians and MedPAC. McClellan observed that as CMS Administrator five years ago he had testified on this topic many times. “We are in a better position to fix the problem than ever before,” he said. “Legislation including the Medicare Modernization Act and the Affordable Care Act has created or enhanced initiatives that help lay the foundation for needed payment reforms in Medicare, as have reforms in states and the private sector. They include paying more when physicians use health IT to actually improve care, and when physicians report on and achieve better quality of care.”


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