Docs Press Medicare for Final Rule With EHR Program Changes

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By Alex Ruoff

Aug. 16 — Physician groups are pushing regulators to cement proposed changes to the federal EHR program so doctors have more time to prepare for upcoming Medicare reimbursement changes.

Some of the country's largest industry groups for physicians want the CMS to quickly release a final rule that would shorten the reporting periods and make other changes to the meaningful use program that encourages doctors to adopt electronic health records. The groups are also pushing the agency to delay the start of the proposed Merit-Based Incentive Payment System (MIPS) to give doctors more time to prepare for the new payment system.

For the past three years, doctors have pressed the CMS to give them similar breaks from the reporting requirements of Medicare's various incentive programs only to be granted last-minute changes in October and December, Rob Tennant, director of health information technology policy for the Medical Group Management Association, told Bloomberg BNA. The MGMA and other doctors' groups are hoping the Medicare agency will issue final rules sooner this year, he said.

“If they're going to do this, to reduce the reporting period and the burden on providers, then don't wait until the end of the year to make that decision,” Tennant said. “Doctors are trying to meet their obligations for meaningful use and get ready for MIPS, and some certainty would go a long way.”

The meaningful use program offers Medicare and Medicaid incentive payments to doctors and hospitals that adopt electronic health records and meet certain reporting requirements. As of June, the program has paid $34.92 billion in incentive payments to nearly 5,000 hospitals and 483,798 health-care providers.

Physicians have long claimed that a full-year reporting period gives them no time to prepare for the next year of the program, which typically requires them to upgrade their EHR systems and collect new data about their patients to report to the CMS.

In July, the CMS released the proposed Medicare outpatient hospital payment rule that would allow hospitals and doctors that have previously participated in the meaningful use program to report during any continuous 90-day period within the calendar year on their compliance with meaningful use program requirements. The proposed rule would also eliminate the clinical decisions support and the computerized provider order entry objectives for hospitals participating in the second and third phases of the program.

Needed Changes

Both the MGMA and the American College of Cardiology have asked the Centers for Medicare & Medicaid Services to make the changes as soon as possible.

The ACC said in an Aug. 9 letter to the CMS that the changes will help doctors avoid Medicare penalties levied against those who fail to meet the requirements of the meaningful use program and, in coming years, MIPS.

Doctors are spending more and more of their time on their computers logging patient data into their EHRs rather than tending to their patients because of the demands of the meaningful use program, James Tcheng, chair of the ACC’s informatics and health IT task force, told Bloomberg BNA. The program's year-long reporting periods mean doctors never have a break from the program, he said.

“The CMS is trying to bring about change very, very quickly, in less-than-a-year cycles,” Tcheng said. “We're doing the best we can, but we need time to catch up.”

History of Late Rules

In October 2015, the CMS, in response to lobbying from groups like the MGMA and the American Medical Association, shortened the reporting period of the meaningful use program from a full year to 90 days.

Many physicians complained that the change came too late, weeks after the final 90-day reporting period in 2015, and are hoping the CMS doesn't do the same this year, Tennant said.

However, the agency has refused to make this change permanent in the past year, he said. Various federal lawmakers proposed legislation to alter the program's reporting period in both 2015 and 2016, but the bills have never been made law.

Physicians begin their first year reporting quality measures under MIPS on Jan. 1, 2017, which the CMS will use to determine their Medicare payment adjustments in 2019. Tennant said doctors need more time to prepare for the new program, the requirements for which haven't been completed.

“It's incredibly frustrating having to meet all these requirements for meaningful use by the end of the year then be expected to jump right into another program,” he said.

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To contact the editor responsible for this story: Kendra Casey at

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