CMS Finalizes Meaningful Use Rules

The Centers for Medicare & Medicaid Services (CMS) has released the final rule modifying Meaningful Use Program requirements (2015-2017) in addition to postponing mandatory adoption of Meaningful Use Stage 3 requirements.   The changes simplify the Meaningful Use requirements for eligible hospitals and healthcare professionals.

The changes have taken some time to be finalized. Following on from the interim rule, comments were requested from the general public. Over 2,500 comments were received and reviewed, many of which highlighted the considerable reporting burden placed on healthcare professionals and hospitals participating in the Meaningful Use program.

After considering the comments, modifications were made to simplify Stage 3 requirements and add more flexibility to the program, which should ease the reporting burden. Changes were also made to support interoperability and improves outcomes.

Dr. Patrick Conway, M.D., M.Sc., CMS deputy administrator for innovation and quality and chief medical officer, said ““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.”

The aim is to “make electronic health information available when and where it matters most and for health care providers and consumers to be able to readily, safely, and securely exchange that information.”

The new rule should help with the transition to the merit based incentive payment system (MIPS), under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

Developers have also been given more time to implement new technologies to facilitate data access by patients and introduce new models of care. Similarly, more time has been allowed for a new interoperable infrastructure to be introduced by eligible professionals to facilitate healthcare data exchange.

The rule makes provisions for the 2015-2017 period which reduce the objectives from 18 to 10 for all eligible professionals, with the addition of a public health reporting objective. There will be 9 objectives for eligible hospitals and critical access hospitals (CAHs) instead of 20, with one public health reporting objective. Clinical Quality Measures (CQM) reporting for eligible professionals and eligible hospitals/CAHs will remain the same.

Entities participating in the Meaningful Use Program could find it difficult to incorporate the changes in time for 2015 reporting requirements. To ease the burden and allow time to incorporate the changes, the deadline has been extended to 90 days for 2015 for all providers, and also for new providers in 2016 and 2017, as well as for any provider wishing to adopt 2018 requirements a year early. From January 1, 2018. Stage 3 Meaningful Use will become mandatory.

The number of Meaningful Use objectives have also been reduced from 20 to 8 for eligible professionals, eligible hospitals, and CAHs in 2017 and beyond. The proposed measures also require greater efforts to be made toward interoperability, 60% of objectives in Stage 3 require interoperability. There will also now be public health reporting requirements and the new rule also takes the current data security landscape into account, increasing cybersecurity requirements.

Additional provisions include “CQM reporting aligned with the CMS quality reporting programs,” and to improve patient access to their medical records, the rule requires “the use of application program interfaces (APIs) that enable the development of new functionalities to build bridges across systems and provide increased data access.”

The new rule change will have a 60-day public commenting period. The information gathered from the comments will be used to tailor future Meaningful use requirements.

In addition to the new rule on EHR Incentive Programs, the ONC has released the final rule for the 2015 Edition Health IT Certification Criteria, which aims to improve interoperability and secure health information exchange. According to a statement from National Coordinator for Health IT, Karen DeSalvo, “This rule is a key step forward in our work with the private sector to realize the shared goal of making actionable electronic health information available when and where it matters most to transform care and improve health for the individual, community and larger population.” She went on to said that the aim is to create an environment where “health care providers and consumers can readily, safely and securely exchange electronic health information.”

Author: Steve Alder has many years of experience as a journalist, and comes from a background in market research. He is a specialist on legal and regulatory affairs, and has several years of experience writing about HIPAA. Steve holds a B.Sc. from the University of Liverpool.