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  • Washington Highlights

    CMS Releases Proposed Rule Modifying Meaningful Use for 2015 through 2017

    Len Marquez, Senior Director, Government Relations

    The Centers for Medicare and Medicaid Services (CMS) April 15 published in the Federal Register a proposed rule modifying the Electronic Health Record (EHR) Incentive Program for 2015 through 2017. Comments on the proposed rule are due June 15. 

    The rule is the third in a series of regulations published recently by CMS and the Office of the National Coordinator for Health Information Technology (ONC) related to the “meaningful use” EHRs and is separate from the Meaningful Use Stage 3 and the 2015 Edition Health IT Certification Criteria proposed rules.

    Although the changes are similar to CMS’ proposed modifications for Meaningful Use Stage 3, the proposed rule would go into effect this calendar year (CY). The rule contains several critical changes to the EHR Incentive Program, proposing to:

    • Align the reporting period, beginning in 2015, for hospitals with the calendar year rather than the federal fiscal year;
    • Permit all hospitals and eligible professionals (EPs) a 90-day reporting period in 2015, instead of the current requirement for a full year. For 2015 only, CMS proposes that hospitals may begin an EHR reporting period as early as Oct. 1, 2014, and end by Dec. 31, 2015; 
    • Remove the “menu” and “core” reporting structure currently in place under Stages 1 and 2, such that all objectives and measures would now be required and not optional; 
    • Modify the patient action measures in the Stage 2 objectives related to patient engagement to reduce the burden on providers, despite proposing to make these measures more stringent in Stage 3; and
    • Remove reporting requirements for Stages 1 and 2 of the Medicare and Medicaid Incentive programs that have become redundant, duplicative, or “topped” out through advancements in EHR function and provider performance.

      The rule requests public comment on the current definition of a hospital-based EP for purposes of the EHR incentive program. Under the current definition, an EP is hospital-based – and thus not eligible for EHR incentive payments or subject to Medicare EHR payment penalties – if he or she furnishes 90 percent or more of his or her covered professional services in sites of services identified as inpatient hospital (POS 21) or emergency room (POS 23) settings in the year preceding the payment year.

    CMS also seeks comment on whether other place of service codes should be included in the definition of a hospital-based EP and how the inclusion of additional settings might affect EP eligibility for EHR incentive payments. 

    Additionally, CMS seeks comment on whether the agency should implement only the current proposed modifications, from 2015 through 2017, and begin Stage 3 in 2018, removing the previous proposal to begin Stage 3 in 2017.