As outlined in the last North Carolina Medical Society (NCMS) Bulletin, on Oct. 6, 2015, the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health IT (ONC) released a series of final rules on the Meaningful Use (MU) program. These rules outline the program requirements for a Modified Stage 2, Stage 3 and a new edition of certified technology.
The AMA advocated for many of the changes adopted in the Modifications rule (modified MU Stage 2, program years 2015-2017) but opposed finalizing Stage 3 due to a need to first assess the changes made to Stage 2 and a lack of alignment with the new Merit-Based Incentive Payment System (MIPS).
The AMA believes CMS made several immediate improvements in the Modifications rule, including:
- A shortened 2015 reporting period (from a full calendar year to any 90 consecutive days in 2015);
- Overall reduced number of measures;
- Reduced measure threshold for the View, Download or Transmit requirement (from 5 percent to just one patient in 2015 and 2016); and
- Reduced measure threshold for Secure Messaging (from 5 percent to simply having the capability in 2015 and one patient in 2016).
Given the lateness of the modifications rule, it is very difficult to educate physicians on the changes. In addition, the Administration increased the requirements for the Public Health and Clinical Data Registry Reporting Objective. A new requirement at this point in 2015 makes it extremely difficult for physicians to be successful. The AMA raised concerns with this objective to senior Administration officials, and they have indicated they will address the issue, though at this point it is unclear how that would occur.
While CMS did issue a final Stage 3 regulation, the agency is allowing for a 60-day comment period to hear feedback on how Stage 3 can better align with MIPS and alternative payment models. The agency made relatively few changes in the final Stage 3 regulation from the proposed regulation. Overall, publishing of the Stage 3 final rule signals to vendors that these are the requirements for the program, and they may begin developing their systems to meet these standards.
With respect to Stage 3, these requirements will be optional in 2017 and required for all participants beginning in 2018. CMS finalized increased threshold requirements for many of the measures that are well-beyond the previous Stage 2 levels. The rule also adds new requirements related to patient-generated data and the use of “app” technology, which may be overly ambitious given the state of current technology. Despite the 60-day comment period, the AMA has tremendous concerns with the final MU Stage 3. We will intensify our efforts to engage lawmakers and stakeholders to reset the direction of the Meaningful Use program.
The Administration also finalized the 2015 certification regulation. As a result of the release of this rule new or upgraded EHRs will be required for Stage 3 participation. ONC did make improvements in the final Certification regulation, including: price transparency and in-field testing. Yet, the AMA remains concerned additional requirements in the Certification regulation may divert attention away from solving usability and interoperability challenges.
If you’d like to learn more from CMS about the final rule, they have posted the presentation and recording from the Oct. 8 webinar titled , ”EHR Incentive Programs Final Rule Overview and What You Need to Know for 2015,” to the 2015 Program Requirements and eHealth events webpages.
Also, Terri Gonzalez, the North Carolina Medical Society Foundation’s Director of Practice Improvement will be leading a webinar on the final rule and the 2015 Meaningful Use Attestation Requirements on Nov. 12 from noon to 1 p.m. In order to ensure eligible professionals are using the right technology and meeting the program attestation objectives by the Feb. 29, 2016 deadline, the webinar will focus on the latest updates on Meaningful Use EHR incentive attestation requirements for Stage 2 and Stage 3. Get more information and register.