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Washington Debrief: CMS Proposed Rule Creates New MU Pathways in 2014

May 28, 2014
by Jeff Smith, Director of Public Policy at CHIME
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CMS Proposed Rule Creates New MU Pathways in 2014

Key Takeaway: The Centers for Medicare and Medicaid Services (CMS) will allow providers to meet Stage 1 or Stage 2 meaningful use with any combination of Certified EHR Technology (CEHRT) regardless of which requirements the provider is scheduled to meet in 2014.

Why it Matters: Attestations for this critical year of meaningful use have lagged due to CEHRT availability and tight implementation deadlines. The rule proposed by CMS would create new pathways for providers to meet MU in 2014, rather than force them to file hardship exceptions and forego incentives.

Signs that CMS had taken action to address lagging attestations for meaningful use were first revealed two weeks ago. The agency responsible for EHR incentives, and forthcoming penalties, sent a rule to the Office of Management and Budget, entitled “Modifications, Revisions: Medicare and Medicaid Electronic Health Record Incentive Programs for 2014.” The proposed rule published a week later contained several provisions to help struggling providers and EHR vendors deal with Meaningful Use requirements in 2014. Among those are new flexibilities that will allow providers to choose different pathways to meet MU this year. Depending on what Edition of Certified EHR Technology a provider has and which Stage they would like to attest, CMS and the Office of the National Coordinator for Health IT (ONC) have made available several distinct options.

If you were scheduled to attest to Stage 2 in 2014, you may:

  • Attest to Stage 2 objectives using 2014 Edition CEHRT;
  • Attest to Stage 2 objectives using a combination of 2014 and 2011 CEHRT;
  • Attest to 2014 Stage 1 objectives using 2014 Edition CEHRT or a combination of 2011 and 2014 Edition CEHRT; or
  • Attest to 2013 Stage 1 objectives using 2011 Edition CEHRT or a combination of 2011 and 2014 Edition CEHRT.

If you were scheduled to attest to your second year of Stage 1, you may choose from options three or four above. The differences between 2014 Stage 1 objectives and 2013 Stage 1 objectives are outlined in this CHIME crosswalk; and this CMS tip sheet outlines changes resulting from Stage 2 final rules.

For Eligible Hospitals (EHs) and Critical Access Hospitals (CAHs), the decision on how to proceed must be made quickly and without the certainty of a final rule, which will not be available until after July 1 – the beginning of the last reporting period. Given the realities of timing, CIOs should consider their options carefully; but they should also note the proposed rule requires 365-days of data in 2015. For many providers this means having 2014 Edition CEHRT in place to meet Stage 2 requirements by October 1, 2014.

CHIME will provide further guidance in the coming days. Please direct all questions or comments to Jeff Smith, Sr. Director of Federal Affairs.

Senators Applaud Changes to Meaningful Use in 2014

Key Takeaway: Last Thursday Sens. Lamar Alexander (R-TN), John Thune (R-SD), Richard Burr (R-NC), Mike Enzi (R-WY) and Pat Roberts (R-KS) commended ONC and CMS’ decision to alter the requirements for providers to achieve Meaningful Use in 2014.


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