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CMS Proposes Meaningful Relief on Meaningful Use Timeline

CMS Proposes Meaningful Relief on Meaningful Use Timeline


Legal HIMformation
(June 3, 2014)

On May 20, 2014, the Centers for Medicare and Medicaid Services ("CMS") filed a proposed rule, to be published in the Federal Register on May 23, that offers eligible hospitals, eligible professionals, and critical access hospitals ("CAHs") participating in the Medicare and Medicaid Electronic Health Record Incentive Programs ("EHR Incentive Programs") an extra year to use 2011 Edition certified electronic health record technology ("CEHRT").

CMS issued the proposed rule in response to widespread industry concern, cited by technology developers and health care providers alike, that the time frame to install and implement the 2014 Edition CEHRT is too short. The September 4, 2012 publication of the Stage 2 final rule for the EHR Incentive Programs and the requirement to use 2014 Edition CEHRT to adopt, implement, or upgrade, or to successfully demonstrate meaningful use for Stage 1 or Stage 2 in 2014, has created a several-month backlog for the updated technology providers need to successfully attest for 2014.

More specifically, CMS proposes to permit eligible hospitals, eligible professionals, and CAHs that are unable to fully implement 2014 Edition CEHRT for a full EHR reporting period in 2014 based on delays in the availability of the 2014 version to continue to use 2011 Edition CEHRT, or a combination of 2011 Edition and 2014 Edition CEHRT, for the applicable 2014 reporting periods. Providers that choose to use 2011 Edition or a combination of 2011 Edition and 2014 Edition CEHRT for Stage 1 attestations, and providers that otherwise would be scheduled to begin Stage 2 for 2014 but cannot do so due to the delay in the availability of the 2014 edition and that accordingly attest to the 2014 Stage 1 measures, must attest that they are unable to fully implement the 2014 version due to availability delays. CMS emphasizes, however, that all providers will be required to use 2014 Edition CEHRT for the applicable 2015 reporting periods and thereafter until further rulemaking.

In extending Stage 2 by one year for providers that first became meaningful users in 2011 or 2012, CMS's goals are to permit it and ONC to focus on successfully implementing enhanced patient engagement, health information exchange, and interoperability requirements in Stage 2 and to use data from Stage 2 to inform policy decisions about Stage 3. The extension allows 2011 and 2012 first-time meaningful users who take advantage of the extension to begin Stage 3 on October 1, 2016 (for hospitals and CAHs) or January 1, 2017 (for eligible professionals).

The clinical quality measures ("CQMs") to be reported by providers in 2014 will depend on what CEHRT edition the provider uses for its 2014 reporting period and to what objectives and measures the provider chooses to attest. The following table summarizes the various options for CQM reporting.

CEHRT Version

Attestation Year/Stage Objectives & Measures

Reporting Requirement

2011

Per Stage 1 Final Rule CQMs

2011 & 2014

2013/1

Per Stage 1 Final Rule CQMs

2011 & 2014

2014/1

Per Stage 2 Final Rule (2014 requirements/policies)

2011 & 2014

2014/2

Per Stage 2 Final Rule (2014 requirements/policies)

2014

2014/1 or 2

Per Stage 2 Final Rule (2014 requirements/policies)

Providers who are participating in the Medicaid EHR Incentive Program will submit CQMs in accordance with their state's requirements, as approved by CMS, pursuant to the Stage 2 Final Rule.

CMS will accept public comments on the proposed rule for 60 days after its publication in the Federal Register, or through July 22. The proposed rule is available at http://www.gpo.gov/fdsys/pkg/FR-2014-05-23/pdf/2014-11944.pdf.

Copyright 2014, American Health Lawyers Association, Washington, DC. Reprint permission granted.

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