Key Takeway: Last week, the Centers for Medicare & Medicaid Services (CMS) released a final rule impacting the meaningful use program. The rule combined modifications to the current reporting years—2015-2017—as well as Stage 3 criteria. Simultaneously, regulations were issued for the 2015 Edition of Certified EHRs.
Why it Matters: Having heard concerns from providers about the 365-day reporting period, including strong advocacy from CHIME and CHIME members, CMS modified Stage 2 to incorporate a 90-day reporting period in 2015. While several members are positioned to take advantage of this shorter period, others will be challenged to meet it since there are fewer than 90 days remaining in the year. CHIME will continue to advocate for CMS to implement a hardship exemption for those unable to meet this timeframe.
Unfortunately, the agency decided to move forward with Stage 3 rulemaking. CHIME, other healthcare associations and members of Congress had urged CMS to hold off on issuing a final rule in order to ensure that it is in sync with new payment models being advanced by Medicare. Delaying rulemaking would also give stakeholders time to address such key issues as interoperability before moving forward. However, in a rare move, the administration published this regulation as a “final rule with comment,” leaving open the opportunity for the industry to provider further input into the policymaking process. CMS will be accepting comments on the Stage 3 portion of the rule only.
While CHIME is disappointed that CMS moved ahead with publishing the requirements for Stage 3, we are nonetheless very pleased with the opportunity this affords us to offer further feedback. CHIME’s pressure on the administration was instrumental in this outcome as initially we believe there had been no plans to proceed with another comment period.
Separately, the Office of the National Coordinator for Health IT (ONC) published an accompanying final rule defining the 2015 Edition Health IT Certification Criteria for Stage 3. Taken together the rules are approximately 1,500 pages.
With the clock ticking, providers are focused on successfully meeting Meaningful Use in 2015 and avoiding a penalty in 2017. In an effort to help senior health IT leaders focus on what is needed to meet this reporting year with success, CHIME will be rolling out support materials detailing what’s included in the Stage 2 modifications first. More details on the Stage 3 provisions will also be coming, including information about ways to share your feedback and concerns to best inform future rulemaking.
Modified Stage 2 Highlights
- Finalizes a continuous 90-day reporting period for 2015
- Attestation opens January 4, 2016 and closes February 29, 2016
- Expanded hardship for extreme and uncontrollable circumstances to include switching products and technology upgrades (application process to open in 2016 to avoid 2017 penalty)
- Patient access requirements on view, download and transmit:
- 2015 & 2016: One patient must view, download or access information electronically
- 2017: 5 percent of patients must view, download or access information electronically
- Public Health:
- Measures consolidated from six to four
- EHs/CAHs must meet three measures and EPs must meet two
- The bi-directional requirement for measure 1 (immunization registry reporting) was removed
- Health Information Exchange (formerly known as “Summary of Care”)
- Must have ability to send all required lab data but option to work with vendors to send what provider determines is appropriate
- At a minimum, however, the current problem list, current medication list, and current medication allergy list must be included.
- CIO Cheat Sheet: Summary of Modified Stage 2 Rule
- CIO Cheat Sheet: Detailed List of Measures, Objectives, and Exclusions for Modified Stage 2 015-2017)
- Modified Stage 2 Rule
- Fact Sheet
- Fact Sheet on CMS final rule and ONC final rule
- EHR Incentive Program website
- 2015 requirements
- Tipsheet for hospitals and CAHs
- Tipsheet for EPs