Final Rules Shorten EHR Meaningful Use Reporting Period

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By Alex Ruoff

Oct. 6 — The federal government Oct. 6 released two final rules establishing the requirements for the final stage of the Medicare and Medicaid EHR Incentive programs and shortening the programs' reporting period for 2015.

The Centers for Medicare & Medicaid Services in a release said the rules will bring simplicity and flexibility to the meaningful use program. The CMS also said it will give hardship exemptions to providers and hospitals that switch to new electronic health record systems.

“We eliminated unnecessary requirements, simplified and increased flexibility for those that remain, and focused on interoperability, information exchange, and patient engagement,” Patrick Conway, deputy administrator and chief medical officer for the CMS, said. “By 2018, these rules move us beyond the staged approach of ‘meaningful use’ and focus on broader delivery system reform.”

The CMS rule (RIN 0938-AS26 and 0938-AS58) establishes the requirements providers and hospitals must meet to obtain a Medicare or Medicaid incentive payment through Stage 3 of the meaningful use program, set to begin in 2017. The CMS rule also makes the first year of Stage 3 (2017) optional.

A second rule (RIN 0991-AB93) from the Office of the National Coordinator for Health IT establishes the criteria for electronic health records to be used by the providers and hospitals meeting Stage 3 requirements.

Both rules will be published in the Oct. 16 Federal Register, and the agencies will accept comments on the final rules until Dec. 15.

The meaningful use program offers Medicare and Medicaid incentive payments to health-care providers and hospitals that adopt EHR systems. The program has paid more than $30 billion to more than 5,000 hospitals and more than 400,000 providers since 2011.


Industry groups and lawmakers in recent weeks have repeatedly pressured the CMS to delay release of the rule establishing Stage 3 and publish only modifications to Stage 2, which would shorten the 2015 reporting period.

However, Conway said on an Oct. 6 call with reporters that a delay could result in penalties to thousands of providers and hospitals. He said a delay to Stage 3 rulemaking wouldn't delay the penalties, which are established by law.

The CMS final rule released Oct. 6 does shorten the reporting period for hospitals and providers.

Previously, providers eligible for meaningful use program incentive payments had to report meeting the requirements of the program for a full year, running from Jan. 1 to Dec. 31. The CMS rule shortens that period to 90 days.

Hospitals were on the fiscal year, running from September 2014 to Oct. 1, 2015. The CMS rule also transitioned hospitals to the calendar year.

Conway said hospitals and providers have until Feb. 29, 2016—five months from the release of the rules—to report on meeting the requirements of meaningful use in 2015.

The move to shorten the reporting period has garnered support from a number of physician groups, including the American Medical Association and the American Hospital Association, which have said thousands of doctors faced the possibility of failing to meet the meaningful use program's requirements if the reporting period wasn't shortened.

Delayed Attestation

The changes to the reporting period also mean hospitals will have to wait until early 2016 to attest to the federal government that they met requirements of the meaningful use program in 2015, the CMS separately announced Oct. 6.

The CMS's online attestation portal for hospitals didn't launch as originally scheduled on Oct. 1, the end of the 2015 fiscal year, Elizabeth Holland, a program manager with the CMS's Center for Clinical Standards and Quality, said at a special joint meeting of the Office of the National Coordinator for Health IT's Policy and Standards committees.

The agency will open the attestation portal from Jan. 4, 2016, to Feb. 29, 2016, in anticipation of modifications to the meaningful use program that will change the hospital reporting time frame from the fiscal year to the calendar year and shorten the reporting period from 12 months to 90 days, she said.

Hospitals and doctors can't receive Medicare or Medicaid EHR incentive payments until they attest to meeting the program's requirements. They also must attest to meeting the program requirements to avoid Medicare penalties in 2017.

The delay in opening the attestation portal will postpone hospitals' meaningful use payments, a CMS spokesman told Bloomberg BNA Oct. 6.

Health-care providers in the meaningful use program, unlike hospitals, are already on the calendar year and already are expected to attest starting in January 2016.

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