Even with final rule, MU3 likely isn't finalized

CMS has handed down finalized versions for the remainder of the federal EHR incentive program, but there still remains an air of uncertainty about what is going to happen with meaningful use.

The final rule was released amidst calls for CMS to delay MU3, some even going so far as to request canceling the MU program altogether.

"There is no doubt that the EHR Incentive Payments program has been a vital and successful driver of health IT adoption nationwide, setting the foundation for better population health, improved care delivery and lower costs. However, the ongoing challenges with program implementation must be addressed," said CHIME in a statement supporting the delay of MU3.

Those seeking delays in stage 3 are largely concerned with the prescribed timeline: In the latest iteration of the MU3 rule, eligible providers and hospitals have to begin attesting in 2018. Additionally, the final rule does position meaningful use to become part of the Merit-Based Incentive Payment System in 2019, when meaningful use attestation becomes a piece of an eligible professional's total MIPS score.

Jason Fortin, senior advisor with Impact Advisors, says the rule still resides in a cloud of uncertainty, and there still may be the possibility the program will change.

"There's so much uncertainty about stage 3, you almost have to take it with a grain of salt at this point," Mr. Fortin says, adding he thinks Congress may act to implement delay recommendations.

The rule was delivered with a 60-day comment period, which further indicates the possibility the final MU3 requirements will change, though CMS has had plenty of opportunities to hear the comments, suggestions and complaints of key stakeholders, according to Mr. Fortin, as the proposed rule was issued in March. However, he says the alignment with MIPS is an element where comments could be helpful for CMS.

"MIPS aside, everyone has commented. I don't know what else to say about stage 3 requirements. We had a comment period about those requirements. MIPS is one thing, they certainly do need feedback on how that's going to shape the context of the eligible professional requirements. [But] everybody's been saying stage 3 is too much for a while now," Mr. Fortin says.

The final rule combined measures proposed for the MU 2015-2017 modification period with measures proposed for stage 3, though the proposed rules were originally submitted separately. By and large, the proposed 2015-2017 modification rules were finalized, including a 90-day reporting period for the next two years and the option for providers to begin attesting to stage 3 in 2017 if they want to.

Despite the fact the reporting period for 2015 began Oct. 3, four days before the final rule was even released, Mr. Fortin says the modification rule overall eases the burden for providers for the next couple of years.

As for stage 3 rules, with the lingering uncertainty and a quickly approaching 2018 go-live date, Mr. Fortin says the fate of stage 3 likely isn't solidified.

"If we've learned anything from [meaningful use], it's that implementing new requirements takes longer than a year or two," he says. "Vendors have to get certified, capabilities have to be implemented, workflows have to be changed, data has to be captured….Stage 3 very well could end up getting delayed."

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