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Washington Debrief: Strong Finish for MU in 2014 Doesn’t Allay 2015 Concerns

January 20, 2015
by Jeff Smith, Vice President of Public Policy at CHIME
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Top News

MU Update: Hospitals Finish Strong in 2014; Concerns Over 2015 Persist

Key Takeaway:  Nearly 82 percent of hospitals successfully demonstrated meaningful use in 2014, meeting either Stage 1 or Stage 2, data from the Centers for Medicare and Medicaid Services (CMS) shows.  The strong finish by hospitals in 2014 was made possible through a number actions, including an extended attestation period, expanded hardship exception categories, and the ability for some to repeat Stage 1 if they had trouble obtaining 2014 Edition Certified EHR Technology (CEHRT).  Roughly 30 percent of hospitals meant to demonstrate Stage 2 repeated another year at Stage 1; indicating moderate use of new flexibilities offered by CMS through mid-year changes to the program.

Why it Matters:  The percentage of hospitals required to meet Stage 2 measures grows from 51 percent (2,563) in 2014 to 80 percent (3,952) in 2015.  With such a large portion of the nation’s hospitals required to meet Stage 2 for the entire year, CHIME and other organizations continue to fight for flexibility in 2015 through a shortened reporting period to help providers stay engaged with the program. 

Last week, officials from the Office of the National Coordinator for Health IT (ONC) and CMS reported on hospital attestations for program year 2014.  ONC’s analysis indicated that 77 percent of hospitals “eligible” to meet Stage 2 in 2014 had done so through November.  However, CMS’ data – which was complete through the full program year – indicated that 71 percent of hospitals eligible to meet Stage 2 in 2014 had done so. 

CHIME and other organizations, including the AHA, AMA and HIMSS, had raised concerns over the availability of Certified EHR Technology (CEHRT) earlier in the year, which led to the September 2014 rule.  This rule provided new pathways for providers to meet MU in 2014, which 30 percent of hospitals took, though it was an incomplete fix.  The September rule allowed providers who struggled to obtain CEHRT the ability to do Stage 1 again, but in reviewing 2015 provisions, it required these same providers to have 2014 Edition CEHRT beginning October 1.

CMS data indicates 45 percent of those required to meet Stage 2 for a full year have demonstrated an ability to do so for 90 days.  It remains to be seen if these providers, and the roughly 2,000 additional hospitals can make the transition to a full year reporting period.

CHIME wants to hear from you:  How has the 2015 MU reporting period gone thus far?  Please participate in this snapshot survey to let us know.

Legislation & Politics

Flex-IT Reintroduced, Congressional Leaders Recognize Immediate Need for MU Flexibility

Key Takeaway: The Flexibility in Health IT Reporting Act (Flex-IT) was reintroduced with bipartisan support in the House of Representatives. The legislation would retroactively institute a 90-day reporting period for Meaningful use eligible professionals (EPs) and eligible hospitals (EHs) in 2015.

Why It Matters: The Flex-IT Act would give EPs and EHs the option to choose any three-month quarter for EHR reporting in 2015.

Last week the Flexibility in Health IT Reporting Act or “Flex-IT” Act was reintroduced by Representative Renee Ellmers (R-NC-02), with bipartisan support from Representatives Ron Kind (D-WI-03), Marsha Blackburn (R-TN-07), David Scott (D-GA-13) and Glen Thompson (R-PA-05). The legislation would retroactively institute a 90-day reporting period for Meaningful Use eligible professionals (EPs) and eligible hospitals (EHs) in 2015.

CHIME President and CEO Russell P. Branzell, FCHIME, CHCIO said, “We commend the leadership demonstrated by a bipartisan group of House Members on this critically important issue. With such across-the-isle support, Congress has underscored how fundamental this program is to the future of healthcare in the U.S.”

Branzell added, “While CHIME remains committed to the success of Meaningful Use, and to making sure improved patient care is the program’s lasting legacy, we believe significant changes are needed to address increased dissatisfaction with EHRs and growing disenchantment with the program. This bill, if passed, would begin that much-needed course correction.”

The Flex-IT Act currently has 13 cosponsors, including Michael Burgess (R-TX-26), Danny K. Davis (D-IL-07), Richard Hanna (R-NY-22),  Pete Olson (R-TX-22), Kevin Cramer (R-ND-AL), Pat Meehan (R-PA-7), Mike Kelly (R-PA-3), Gregg Harper (R-MS-3) and Pete Sessions (R-TX-32).

The legislation was first introduced in the 113th Congress last September by Rep. Ellmers, gaining 23 cosponsors, but failed to pass the House of Representatives before the end of the legislative session.

Legislators Seek Stakeholder Feedback on Draft Telehealth Legislation

Key Takeaways: Members of a bipartisan congressional “telehealth working group” have circulated draft legislation to address Medicare payments for telehealth services for stakeholder comment.

Why It Matters: Known as the “Advancing Telehealth Opportunities in Medicare Act,” the draft legislation would waive certain restrictions on reimbursement of telehealth services under Medicare. The draft contains language that would allow Medicare to make additional payments for telehealth services if they meet specific requirements, including providing unmet medical needs or reduced cost.

Last week, members in the House circulated a draft bill that would grant HHS more freedom to waive Medicare restrictions on reimbursements for telehealth services. The draft bill does not directly address the state-by-state licensure issue, instead offers the sense of Congress that states should collaborate on common licensure requirements for telehealth services. The CMS chief actuary would be required to ensure that the telehealth payments would reduce or not increase net program spending.

The draft bill was circulated by eight members of the House Committee on Energy and Commerce, including Chairman Fred Upton (R-MI-6) and Ranking Member Frank Pallone (D-NJ-6.) If the industry feedback is supportive, the working group expects to introduce a bill as early as February.

The draft legislation is open for stakeholder review until January 26th.


Tavenner Leaving CMS in February

Key Takeaway: Last Friday, CMS Administrator Marilyn Tavenner announced she’d be leaving the agency at the end of February.

Why It Matters: The announcement comes amid other high-profile departures at CMS, which creates a number of leadership positions to fill, but also creates an opportunity to bring in fresh ideas to deal with health IT policy issues.

Prior to assuming her leadership role at CMS, Marilyn Tavenner served for four years as the Commonwealth of Virginia’s Secretary of Health and Human Resources and spent 25 years working for the Hospital Corporation of America (HCA).  Ms. Tavenner was confirmed by the Senate 91-7 in May 2013, three years after first joining the agency. She was the first CMS Administrator to be confirmed in over nine years.

Principal Deputy Administrator Andy Slavitt will be the acting administrator once Ms. Tavenner departs.

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