Obama Administration Delays Some Meaningful Use Requirements

On Friday, CMS announced in a final rule that it will delay some requirements of the meaningful use program, allowing health care providers to continue receiving incentive payments if they have not yet adopted electronic health records software that was certified in 2014, The Hill reports (Viebeck, The Hill, 8/29).

Under the 2009 economic stimulus package, providers who demonstrate meaningful use of certified EHRs can qualify for Medicaid and Medicare incentive payments (California Healthline, 5/21).

Under the delay, participating providers are now permitted to use EHR systems that were certified in 2011, or a combination of 2011- and 2014-certified technologies, until 2015. In 2015, all providers must begin to use only 2014-certified technology (Monegain, Healthcare IT News, 9/2). Providers will not be penalized for failing to move to meaningful use Stage 2 (The Hill, 8/29).

Further, CMS said in the final rule that Stage 3 of the program will no longer begin on Jan. 1, 2016. Instead, providers will have until Jan. 1, 2017, to meet Stage 2 requirements and begin working towards Stage 3 (Tahir, Modern Healthcare, 8/29).

CMS Says Delays Offer Flexibility

The delay was originally proposed in May after just four hospitals had attested to Stage 2 of the Meaningful Use program (The Hill, 8/29). CMS and the Office of the National Coordinator for Health IT had noted that the proposed timeline changes came in response to stakeholder feedback about needing more flexibility. The proposed rule acknowledged that many software vendors have had difficulty upgrading their EHR products, receiving certification and upgrading customers' systems in time to attest to the meaningful use program (California Healthline, 5/21).

The final rule did not change any of the proposed rule's provisions (Modern Healthcare, 8/29).

According to CMS, the delays will allow providers more latitude to participate in the program and meet certain objectives, such as:

• Checks for drug interactions and allergies;
• Electronic prescribing;
• Providing patients with clinical summaries; and
• Reporting public health data and quality measurements (Pedulli, Clinical Innovation & Technology, 8/29).

CMS Administrator Marilyn Tavenner in a statement said the agency "listened to stakeholder feedback and provided ... flexibility" for providers who want to continue participating in the program. She added, "We were excited to see that there is overwhelming support for this change" (The Hill, 8/29).

Reaction

According to Health Data Management, a majority of providers who commented on the proposed regulations said the delays would be implemented too late to be taken into consideration for 2014 reporting requirements.

The College of Healthcare Information Management Executives in response to the final rule said the group was "deeply disappointed" that providers would still be required to report for all 365 days of 2015, noting that the "provision has severely muted the positive impacts of this final rule" and "has all but ensured that industry struggles will continue well beyond 2014" (Geodert, Health Data Management, 8/30).

American Hospital Association Director of Policy Chantal Worzala said AHA "appreciates the flexibility offered by CMS" but the "rule offers little relief because CMS did not grant a shorter reporting period for [fiscal year] 2015, which begins on Oct. 1."

Meanwhile, Athenahealth Vice President of Government Affairs Dan Haley said he was also disappointed with the changes, noting that delaying the requirements could make it harder for earlier adopters to comply with interoperability metrics because they will likely have fewer providers with which they can communicate. He said that CMS should also allow "some type of relief/exception for (interoperability) measure(s)," adding, "Repeated delays only push off the date when health care in this country is truly connected" (Modern Healthcare, 8/29).