The Centers for Medicare & Medicaid Services (CMS) published a final rule on Nov. 1 that will allow providers in the Medicare EHR Incentive Program to report to a 90-day reporting period in 2016 and 2017 rather than a full calendar year.
The Outpatient Prospective Payment System (OPPS) final rule confirms what CMS proposed in July---that the agency would streamlining reporting requirements for hospitals and eligible providers (EPs) participating in the meaningful use program under the HITECH (Health Information Technology for Economic and Clinical Health) Act, and enact a 90-day electronic health record (EHR) reporting period in 2016, rather than a full calendar-year one, as CMS had earlier seemed to be insistent on.
Indeed, CMS is finalizing a 90-day EHR reporting period in both 2016 and 2017 for all returning EPs, eligible hospitals and CAHs (critical access hospitals) that have previously demonstrated meaningful use in the Medicare and Medicaid EHR Incentive Programs.
In a fact sheet, CMS said it is also “extending the 90-day EHR reporting period to include 2017 in response to stakeholder comments indicating concerns with implementing API functionalities for Stage 3, program and systems changes in 2017, as well as to allow eligible clinicians time to transition to the Merit-based Incentive Payment System (MIPS), and to provide flexibility for all healthcare providers that are preparing for Stage 3 and the implementation of 2015 Edition Certified EHR technology (CEHRT). The EHR reporting period will be any continuous 90-day period between January 1st and December 31st in CY 2016 and CY 2017.”
In its proposal, CMS also called for eliminating the Clinical Decision Support (CDS) and Computerized Provider Order Entry (CPOE) objectives and measures for eligible hospitals and critical access hospitals (CAHs), due to these rules having “topped out.” For this as well, CMS is finalizing these proposed changes to the objectives and measures for all eligible hospitals and CAHs that attest to CMS, including hospitals that are eligible to participate in both the Medicare and Medicaid EHR Incentive Programs (dual-eligible hospitals).
Drilling down further from a health IT standpoint, in the proposed rule, CMS called for the reduction of numerous thresholds in MU Stage 3 and in modified Stage 2 levels for 2017 and 2018. Several of the more noteworthy threshold reductions do revolve around requiring patient action. It looks like CMS has stuck to those reductions in the final rule, including the often discussed View, Download, Transmit (VDT) measure under the Patient Electronic Access objective which now requires just one single patient to perform the action.
Regarding new meaningful use participants in 2017, CMS is finalizing proposals that EPs, eligible hospitals, and CAHs that have not successfully demonstrated meaningful use in a prior year will be required to attest to modified Stage 2 objectives and measures, rather than Stage 3 objectives and measures. Returning EPs, eligible hospitals, and CAHs will report to different systems in 2017 and therefore are not affected by this policy.
What’s more, CMS is finalizing proposals that certain EPs, who are new participants in the EHR Incentive Program in 2017 and are transitioning to MIPS in 2017, can apply for a significant hardship exception from the 2018 payment adjustment using a CMS developed hardship exception application process specific to this policy.
The finalized rulings from CMS came with complete updated payment rates and policy changes in the Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center (ASC) Payment System for calendar year 2017. CMS is also adding new quality measures to the Hospital Outpatient Quality Reporting Program and the Ambulatory Surgical Center Quality Reporting Program that are focused on improving patient outcomes and experience of care. CMS said it received approximately 3,000 public comments on the proposed rule, which were carefully considered for the final rule with comment period.
CMS estimates that the updates in the final rule would increase OPPS payments by 1.7 percent and ASC rates by 1.9 percent in 2017.