Health Information Management

CMS proposes delay to EHR deadlines

APCs Insider, January 10, 2014

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CMS recently proposed to delay Stage 2 and Stage 3 implementation of meaningful use for Medicare and Medicaid electronic health records (EHRs), avoiding a deadline of October 1, 2014, that coincided with the implementation of ICD-10.
Under the revised proposal, providers will now have through 2016 in order to meet Stage 2 requirements. Stage 3, which requires providers to have completed at least two years of Stage 2, will begin in 2017.
Benefits of the delay, according to CMS, include: 
  • More analysis of feedback from stakeholders on Stage 2 progress and outcomes
  • More available data on Stage 2 adoption and measure calculations–especially on new patient engagement measures and health information exchange objectives
  • More consideration of potential Stage 3 requirements
  • Additional time for preparation for enhanced Stage 3 requirements
  • Ample time for developers to create and distribute certified EHR technology before Stage 3 begins, and incorporate lessons learned about usability and customization
Between 2009 and 2012, EHR adoption doubled among physicians and tripled among hospitals, according to CMS. By October 2013, 85%of hospitals had received EHR incentive payments. Those payments can total up to $44,000 over five years for facilities that demonstrate meaningful use of EHRs according to CMS standards.
Soon after CMS announced the delay, the Office of the Inspector General (OIG) released a report that found few Medicare contractors had adapted to the challenges EHR bring to detecting fraud and improper payments.
Unlike paper records, EHR allow providers to copy and paste information, as well as provide electronic signatures that may mask the authorship of a record, according to OIG. The report recommended that CMS work with contractors to develop new guidance and tools in order to detect errors.
The implementation of EHR will bring new challenges for providers, CMS, and Medicare contractors. The delay at least gives providers more breathing room as they work to integrate the changes ICD-10 will bring, while also giving CMS more time to create clear guidance for facilities and contractors.



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