Physician Practice

CMS, ONC release final rules for Stage 3 EHR Incentive Programs and 2015 Edition Health IT Certification Criteria

Physician Practice Insider, October 20, 2015

CMS and the Office of the National Coordinator (ONC) released final rules October 6 with the intention of simplifying EHR requirements and allowing providers and consumers to exchange health information with greater flexibility. This includes the final rule with comment period for the EHR Incentive Programs and final rule for the 2015 Edition Health IT Certification Criteria.

The final rule with comment period addresses two proposed rules, the March 30 proposal Medicare and Medicaid Programs; Electronic Health Record Incentive Program Stage 3, and the April 9 proposal Medicare and Medicaid Programs; Electronic Health Record Incentive Program—Modifications to Meaningful Use in 2015 through 2017.

In the proposals, CMS and ONC proclaimed a desire to simplify the EHR Incentive Programs, driving interoperability and allowing providers to further focus on patient care. The final rule with comment period eases reporting burdens by giving providers and state Medicaid agencies until January 1, 2018, to comply with new requirements—an additional 27 months of preparation.

Developers will also be allowed that additional 27 months to meet requirements and will be required to meet fewer criteria. They can begin developing EHRs and other health IT products that align with 2015 Edition requirements.

The EHR final rule with comment period changed the reporting period for 2015 to a 90-day continuous reporting period that aligns with the calendar year and states that those reporting for the 2015 period must do so by February 29, 2016. The rule removed reporting requirements on measures considered “redundant, duplicative, or topped out.” It also extended the 90-day reporting period to new providers in 2016 and 2017 and to those who adopt the 2018 measures a year early. The rule finalized the move from fiscal year to calendar year reporting.

The rule states that the Stage 3 requirements are optional in 2017 but required for all meaningful use participants in 2018. Those who begin Stage 3 in 2017 will have a 90-day reporting period. Just as the proposed rule did, the final rule encourages electronic submission of clinical quality measure (CQM) data, establishes requirements for transitioning the program to a single meaningful use stage, and aligns reporting for the Medicare and Medicaid EHR incentive programs. The rule also finalized changes to the menu and core structure of stages 1 and 2 and reduced the number of objectives to which providers must attest.

Major provisions for the EHR Incentive Programs for 2015–2017 include reducing objectives for eligible professionals from 18 to 10 and reducing objectives for eligible hospitals and critical access hospitals (CAH) from 20 to 9—one public health reporting objective is included for each provider type. CQM reporting remains the same.

Major provisions for Stage 3 of the EHR Incentive Programs for 2017 and beyond include requiring eight objectives for eligible hospitals, eligible professionals, and CAHs, flexible measure selection for public health reporting, and CQM reporting alignment with CMS quality reporting programs. The use of application program interfaces was finalized to enable new functionality and increased data access, which should lead to increased data access for patients.

The 2015 Edition final rule allows for more rigorous testing of health IT exchange capabilities and sets forth requirements for in-the-field surveillance and transparency of health IT. The changes should make the technology more reliable and offer providers more purchasing options.

CMS will accept comments on the EHR Incentive Programs final rule for 60 days after it appears in the Federal Register. In particular, CMS is seeking comments about the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and its Merit-based Incentive Payment System, which would incorporate meaningful use. The feedback will help shape future EHR rulemaking and will also be considered as CMS works to develop rulemaking around MACRA, which was passed by Congress earlier this year to replace the sustainable growth rate. Additional information about MACRA is expected in spring 2016. Comments can be submitted electronically. The final rule is expected to appear in the Federal Register October 16 and will be effective 60 days thereafter.

“We have a shared goal of electronic health records helping physicians, clinicians, and hospitals to deliver better care, smarter spending, and healthier people. We eliminated unnecessary requirements, simplified and increased flexibility for those that remain, and focused on interoperability, information exchange, and patient engagement. By 2018, these rules move us beyond the staged approach of ‘meaningful use’ and focus on broader delivery system reform,” said Patrick Conway, MD, MSc, CMS deputy administrator for innovation and quality and chief medical officer, in a press release. “Most importantly we are seeking additional public comments and plan for active engagement of stakeholders so we take time to get broad input on how to improve these programs over time.”

Click here to read the EHR Incentive Program and Health IT Certification Program Final Rule fact sheet.

Click here to read the EHR Incentive Programs in 2015 and Beyond fact sheet.

Click here for more information about ONC’s editions of certification criteria.

This article originally appeared in the free HCPro e-newsletter HIM-HIPAA Insider.

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