Physician Practice

Meaningful use Stage 3 final rules elicit mixed reactions

Physician Practice Insider, October 20, 2015

Despite pleas from more than 100 members of Congress and various healthcare stakeholders for Stage 3 rules to be postponed, HHS CMS and ONC has released twin rules totaling 1,302 pages, signaling what it intends to publish in the Federal Register October 16. Many healthcare providers have yet to successfully achieve Stage 2.

HHS says it is providing a simpler, more flexible set of Stage 2 regulations for 2015–2017 as the meaningful use regulation era gives way to CMS's transition to value-based compensation.

After CMS' March and April notices of proposed rulemaking (NPRM) regarding Stage 3 and adjustments to Stage 2, Congress passed the Medicare Access and CHIP Reauthorization Act of 2015, which will sunset the meaningful use "payment adjustments," in essence, penalties for noncompliance, at the end of 2018. Instead, Congress has called for the establishment of a Merit-Based Incentive Payment System (MIPS), of which the meaningful use program will form one component.

Due to this interim congressional action, CMS in its final Stage 3 rule said it would allow for an additional 60-day comment period, starting upon enactment of the Stage 3 rule, regarding the transition from meaningful use to MIPS. Afterward, CMS may modify its final rules and lay the groundwork for an NPRM in mid-2016 detailing the implementation of MIPS.

Industry reaction

Initial reaction to the final rules was mixed. Providers applauded the relaxation of 2015 requirements, and some applauded the retirement of some process measures that currently must be satisfied in order for providers to successfully attest they have met meaningful use's requirements. But concerns remain about the complexity of the existing program, issues such as lack of interoperability among EHRs and what providers still say is too hasty a timetable for adoption of stage 3-certified EHR software.

The American Medical Association (AMA) applauded CMS for allowing a hardship exemption for physicians who are unable to attest in 2015.

"The AMA continues to believe that Stage 3 requires significant changes to ensure successful participation, and improve the usability and interoperability of electronic health record systems," said AMA president Steven Stack, MD, in a statement. "We urge CMS to use the additional public comment period provided for Stage 3 to further improve the program and consider changes related to the Medicare Access and CHIP Reauthorization Act, which was signed into law earlier this year. We also want to make sure that EHR vendors have the time they need to further test products for interoperability, usability, safety and security."

A meaningful use modification first introduced in the April NPRM, which had ignited strong opposition from some patients, will, in 2015 and 2016, require hospitals to demonstrate that only a single patient per hospital has viewed, downloaded, or transmitted his medical record, post-discharge. The current meaningful use rule, which required hospitals to demonstrate that 5% of patients used their EHRs in this manner, has been a source of frustration for hospitals.

This article was excerpted from HealthLeadersMedia.

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