Meaningful Use Relief Rule Doesn't Go Far Enough, Health IT Groups Say

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By Alex Ruoff

Sept. 2 — The final rule intended to ease EHR certification requirements for meaningful use participants this year offers only temporary relief for those struggling to meet the program's requirements, health information technology industry associations said Sept. 2.

The final rule allows providers and hospitals to use EHR systems certified under the 2011 Edition certification program to qualify for meaningful use program incentive payments in 2014. The rule (CMS-0046-F and CMS-0052-F; RINs 0938-AR71 and 0938-AS30) is to be published by the Centers for Medicare & Medicaid Services in the Sept. 4 Federal Register.

The rule will ensure providers can continue to participate in the meaningful use program even if they are unable to upgrade their EHR systems to meet the latest federal standards, the CMS said Aug. 29 when it released the final rule.

The rule offers no relief for providers and hospitals in fiscal year 2015, which begins for hospitals Oct. 1, the same day the final rule takes effect.

However, the rule offers no relief for providers and hospitals in fiscal year 2015, which begins for hospitals on Oct. 1, the same day the final rule will take effect.

The College of Healthcare Information Management Executives (CHIME) and the American Hospital Association said in separate statements this week that the final rule should have also shortened the required period of time hospitals and providers have to report meeting the requirements of the meaningful use program in FY 2015, from a full year to three months.

“CHIME is deeply disappointed in the decision made by CMS and ONC [Office of the National Coordinator for Health IT] to require 365-days of EHR reporting in 2015,” Russ Branzell, president and chief executive officer of CHIME, said in a release. “This single provision has severely muted the positive impacts of this final rule. Further, it has all but ensured that industry struggles will continue well beyond 2014.”

Providers and hospitals are currently required to adopt EHRs certified under the 2014 Edition certification criteria to be eligible for incentive payments in 2014 and avoid Medicare penalties in 2015. However, program participants have complained they have been unable to update their systems to the newest edition this year.

Under the final rule, providers and hospitals can either continue to use their 2011 Edition-certified EHRs or use a combination of2011 Edition and 2014 Edition-certified EHR systems to earn incentive payments through the meaningful use program. The final rule doesn't approve the use of 2011 Edition EHRs beyond 2014.

The final rule also delays the start of Stage 3 of the meaningful use program until 2017.

Readiness for Stage 2

According to CHIME, roughly 85 percent of the more than 5,000 hospitals and critical access hospitals eligible to participate in the meaningful use program will be required to move to Stage 2 of the program. However, CHIME said, only about 50 percent of those hospitals and critical access hospitals are expected to be ready to meet the requirements of Stage 2 by Oct. 1.

“Most hospitals who take advantage of new pathways made possible through this final rule will not be in a position to meet Stage 2 requirements beginning October 1, 2014,” Branzell said. “This means that penalties avoided in 2014 will come in 2015, and millions of dollars will be lost due to misguided government timelines.”

Providers and hospitals that fail to meet the requirements of the meaningful use program in 2014 or 2015 face a 1 percent Medicare reimbursement penalty, according to the CMS.

Chantal Worzala, director of policy for the AHA, echoed Branzell's concerns in a Sept. 2 e-mail to Bloomberg BNA.

“The American Hospital Association appreciates the flexibility offered by CMS,” she said. “Unfortunately, this rule offers little relief because CMS did not grant a shorter reporting period for FY 2015, which begins on Oct. 1.”

Pressing Forward

While some industry groups asked for more relief from meaningful use program requirements, Joel White, executive director of Health IT Now, a coalition of health-care provider and payer organizations, told Bloomberg BNA Sept. 2 that further delays to the meaningful use program could compromise the program's goal of improving the interoperability of EHR systems.

“We remain concerned that multiple timing changes and delays put off interoperability between doctors and hospitals, which ultimately harms patients,” White said in a release. “We also believe ONC must capitalize on the opportunity a delay creates to more aggressively address the interoperability challenge in a way that reduces burdens on providers by making EHRs more usable and useful.”

White said the CMS and the ONC should use the meaningful use program to combat information blocking practices by EHR developers and health-care providers. He said this would make EHRs more appealing to providers.

White said the ONC should de-certify EHRs that don't share health data with other EHR systems.

“By delaying Stage 3, it's addressing the symptoms of the problem not the causes,” White said. “We've got to work to make these systems more interoperable so providers want to use them.”

EHRA Comments

Mark Segal, chairman of the Electronic Health Record Association (EHRA), an industry group for EHR developers, said in a release that he was glad the CMS worked quickly to issue the final rule. The CMS published the proposed rule May 23 (CMS-0052-P; RIN 0938-AS30).

“EHRA is pleased that CMS has released the Final Rule so quickly, as they had indicated they would, to minimize confusion and delays for both EHR developers and providers,” Segal said. “We appreciate that many of our customers will have more flexibility in achieving meaningful use for 2014 given the timing issues created by the Stage 2/2014 regulatory and certification schedule.”

To contact the reporter on this story: Alex Ruoff in Washington at

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


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