The Department of Health and Human Services, at long last, has published its final rule for Meaningful Use, combining the modifications to the incentive program for 2015 through 2017 with Stage 3.
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In a statement, CMS deputy administration Patrick Conway said that the organization has “a shared goal of electronic health records helping physicians, clinicians, and hospitals to deliver better care, smarter spending, and healthier people”.
Also in the statement, the organization insisted that the changes were made with the medical community in mind: “HHS heard from physicians and other providers about the challenges they face making this technology work well for their individual practices and for their patients”.
Health information exchange is also a larger part of the finalized modifications, with CMS stating that the measures were modified “so that more than 60 percent of measures rely upon exchange of health information, compared to 33 percent previously”. The CMS rule shortens that period to 90 days.
During a recent hearing, Senator Alexander told top CMS and ONC officials that possible legislative changes to the MU program could be included in the Senate HELP Committee’s developing biomedical innovation package to be approved by the Senate and combined next year with the House-passed 21st Century Cures Act. He added, “While we appreciate ONC’s and CMS’s efforts to address the many concerns that providers have with the direction of the MU program, at this point it would be better for the government to declare victory on EHR adoption and step back” (HealthLeaders Media, 10/7).
Stage 3 of the Meaningful Use program is meant to be the final stage. In addition, she said in a statement that HIMSS typically calls for at least 18 months between the publication of a new Meaningful Use rule and the start of a new Stage’s reporting period, and that the 27 months provided in this rule satisfy that requirement. We urge CMS to use the additional public comment period provided for stage 3 to further improve the program and consider changes related to the Medicare Access and CHIP Reauthorization Act, which was signed into law earlier this year.
2015 CEHRT will be required for meaningful use participation in 2018, CMS says in a fact sheet outlining the features of the final technology rule. It will also move the reporting period for participants to the calendar year rather than do it by the fiscal year. All providers will be required to participate in Stage 3 by 2018, and must use 2015 Edition CEHRT for attestation. The CMS also said it will give hardship exemptions to providers and hospitals that switch to new electronic health record systems.
A companion final rule setting 2015 standards for certifying EHR software as qualifying for the program requires the software to be capable of creating a hashing algorithm with security strength equal to or greater than SHA-2.
The Hospitals and Eligible Professionals were struggling to meet Stage 2 requirements.
Hospitals and doctors can’t receive Medicare or Medicaid EHR incentive payments until they attest to meeting the program’s requirements. “It will bring us closer to a world in which health care providers and consumers can readily, safely and securely exchange electronic health information”. All providers will be allowed to participate in a 90-day reporting period in 2015.
The single final rule is a consolidation of two proposed rules that were issued in March, 2015.
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CMS promises that Stage 3 will have alignment between Clinical Quality Measures reporting with CMS quality reporting programs. She explained that due to that lateness, there are built-in exemptions within the rules to lessen the burden on providers trying to meet Stage 2. “We also support the roadmap’s recommendations for broader, governmental action to promote consistent, national interoperability standards, including the use of open source application programming interfaces to support the secure transfer of information between and among different HIT platforms”. This will be done through “the implementation of appropriate technical, administrative, and physical safeguards”, according to the finalized rule.
