Physician Practice

CMS, ONC release EHR Incentive Programs and 2015 Edition Health IT Certification proposed rules

Physician Practice Insider, March 23, 2015


The Centers for Medicare and Medicaid Services (CMS) and Office of the National Coordinator for Health Information Technology (ONC) released two proposed rules designed to improve care delivery and experience and enhance the sharing of electronic health information.
The proposed rules for Stage 3 of the Medicare and Medicaid Electronic Health Records (EHR) Incentive Programs and 2015 Edition Health IT Certification Criteria, both of which were released March 20, are intended to offer increased flexibility for providers. By simplifying the EHR Incentive Programs, the proposed rules should drive interoperability and allow providers to further focus on patient care.
“The flow of information is fundamental to achieving a health system that delivers better care, smarter spending, and healthier people. The steps we are taking today will help to create more transparency on cost and quality information, bring electronic health information to inform care and decision making, and support population health,” HHS Secretary Sylvia M. Burwell said in a press release.
The Stage 3 proposed rule outlines requirements that eligible professionals, eligible hospitals, and critical access hospitals must meet to qualify for Medicare and Medicaid incentive payments as well as avoid negative Medicare payment adjustments. CMS believes the changes will provide a framework to reduce provider burden and streamline program reporting.
“This Stage 3 proposed rule does three things: it helps simplify the meaningful use program, advances the use of health IT toward our vision for improving health delivery, and further aligns the program with other quality and value programs,” Dr. Patrick Conway, M.D., M.Sc., CMS acting principal deputy administrator and chief medical officer, said in a press release. “And, in an effort to make reporting easier for health care providers, we will be proposing a new meaningful use reporting deadline soon.”
The Stage 3 proposed rule encourages electronic submission of clinical quality measure (CQM) data in 2017 and requires it in 2018 and beyond. The proposed rule states that a new method of adopting CQM changes and the associated reporting requirements is necessary to facilitate continuous quality improvement. To better align the Medicare and Medicaid EHR Incentive Programs with other quality reporting programs (e.g., physician quality reporting system and the hospital inpatient quality reporting system), CMS intends to include future updates for CQM reporting requirements in rulemaking such as the physician fee schedule and inpatient prospective payment system annual rules.
CMS proposed requiring all providers to report on Stage 3 meaningful use in 2018 regardless of the stage they reported the year prior. The rule also proposed establishing requirements for transitioning the program to a single meaningful use stage, which means Stage 3 would be the final stage in the program and would incorporate portions of Stages 1 and 2. In addition, CMS proposed the adoption of a full calendar year reporting period with limited exceptions for Medicaid providers demonstrating meaningful use for the first time. CMS proposed to maintain payment adjustment provisions finalized in the Stage 2 final rule.
The proposed rule for the 2015 edition of Health IT certification program requirements included:
  • Working toward a flexible certification program that supports developer innovation and focuses on interoperability
  • Adopting language and standards that allow for recording and exchange of electronic health information, including a well-defined Common Clinical Data Set
  • Enhancing data portability, transitions of care, and application programming interface capabilities in the 2015 Edition Base EHR definition
  • Adopting standards to help users address health disparities
  • Continuing to focus on the privacy and security of data by ensuring that health IT in line for certification meets privacy and security standards and addressing the exchange of information through the Data Segmentation for Privacy standard
  • Improving patient safety through user-center design principles, patient matching, the exchange of relevant electronic health information, certified health IT surveillance, and increased public availability of certified product information
  • Ensuring certified health IT is reliable and transparent by way of surveillance and disclosure requirements
The comment period for both proposed rules ends May 29. To comment, visit For additional information, see the related fact sheet and press release.


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