CMS proposed two rules related to the Federal EHR Incentive Program this spring, yet the healthcare industry is still awaiting the final word on both rules. The rules for meaningful use stage 3 were proposed in March, and the 2015 modification rule was proposed in April. However, without finalization from the government, hospitals and providers are left waiting, unsure what preparations are required to attest to the program.
Among changes in the modification rule for 2015-2017, CMS proposed a 90-day reporting period instead of the current one-year reporting period. However, Oct. 3, 2015, is the deadline to begin the final possible 90-day reporting period, a date which is now less than two months away, leaving hospitals and providers unsure of how to proceed with attestation.
The modification rule also offers a revised version of stage 2 requirements intended to ease the transition to stage 3. The modification rule, as proposed, offers some flexibility and exemptions for certain providers, but that flexibility would only be available in 2015. For example, the 90-day reporting would only be available in 2015, and providers who are not first-time attesters would have to return to full-year reporting in 2016.
CHIME, along with 17 other stakeholders, wrote a letter to HHS Secretary Sylvia Mathews Burwell asking for quick publication of the final rule for the proposed modifications. "If providers do not receive the final rule shortly, it will be very difficult to make workflow adjustments in a timely manner to meet programmatic deadlines and facilitate meaningful use tracking and reporting," the letter read.
On the other hand, the Senate Committee on Health, Education, Labor and Pensions is pushing for a delay of MU3. Rep. Renee Ellmers (R-N.C.) also introduced a bill in Congress that delay passing final stage 3 rules until 2017, so implementation of the rules would begin even later. Rep. Ellmers' rationale is that too many providers are still struggling with stage 2 that it would be unreasonable to begin stage 3 in 2018.
Jason Fortin, senior advisor with Impact Advisors, says a MU3 delay is likely, especially given the unknown fate of the modification proposed rule. "The modified stage 2 [rule] takes on a structure that is very similar to what they're proposing for stage 3," Mr. Fortin says. As such, finalizing modification rules and setting that quickly into action may help some providers transition to the eventual stage 3 requirements.
What's more, Mr. Fortin says he supports a delay of the stage 3 rules that were proposed, saying many of the requirements are not realistic. He points to the patient engagement requirement in particular, which, as outlined in the stage 3 proposed rules, would require 25 percent of patients to access or engage with their online health record. The requirement proposed under the 2015-17 modification rule is for one patient to do so. "To go from one patient in 2017 to 25 percent in 2018, that's not realistic," he says.
The main frustration among providers is the ambiguity surrounding the two proposed rules. Nobody knows what is going to happen or when CMS will publish either final rule, Mr. Fortin says. "The biggest thing providers want is just to know what the requirements are on a consistent basis ahead of time — and to have comfort that those requirements won't change at the last minute," Mr. Fortin says. "Providers are basically saying, 'Tell us what the requirements are going to be and let's all agree on what's reasonable'….Is there any reason this proposed rule couldn't have been done in January? I know there's a process to follow, but it seems like we're cutting it close."
For more information on the proposed modification rule, click here.
For more information on the proposed stage 3 rules, click here.
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Has MU failed its mission?
Hospital groups urge HHS to finalize MU Stage 2 rules
CMS' final IPPS rule for 2016: 10 things to know