The Eagle Has Landed: Stage 3 Meaningful Use Final Rules
Finally, the Stage 3 Meaningful Use Final Rule is in. Last April during HIMSS15 we were promised by CMS delivery of the Final Rule no later than August 1st. Well, August came and went without the much anticipated Rule. The delayed gestation ended October 6th and providers are now relieved of much of the anxiety that has been building on a daily basis. Two Final Rules were issued. The Final Rule for the 2015 Edition of Certified technology (not required until 2018) will be a topic for another day. For now, gentle reader, let’s review what is in store for the MU side of things. The 752 page CMS Final Rule is available for reading as is a CMS tipsheet. Below are the highpoints that get my attention.
One of the problems has been the time squeeze in which vendors of Certified Electronic Health Records Technology (CEHRT) had to interpret new rules, accomplish development and certification, and then roll out an implementation to providers. The Rule provides for more than adequate time for the process to play out. The next version of required CEHRT will not be required until 1/1/2018, 27 months away.
The Meaningful Use reporting period for 2015 will be any consecutive 90 days for all providers no matter where they are in the MU process. For Eligible Professionals (EPs) this is within the current calendar year and for Eligible Hospitals (EHs) within the October 1, 2014 – December 31, 2015 period. The 2015 attestation period will be Jan 4, 2016-Feb 29, 2016 and could possibly be extended. In 2016 and 2017 new providers will only need a 90 day reporting period. In addition, any providers choosing in 2017 to move to the optional Stage 3 will only need to meet MU for 90 days.
In 2018 all providers will need to be at Stage 3 Meaningful Use and must be using 2015 Edition CEHRT. All EPs and EHs must report a full year of MU in 2018 except Medicaid EPs in their first year.
We have final confirmation of significant changes to several Stage 2 measures. The MU requirements for patient action at their portal (EP/EH) and Secure Electronic Messaging (EP) have been significantly reduced as anticipated.
One major hospital concern had been the requirement that the Menu Measure for e-prescribing was to become a Core Measure. The Final Rule brings relief in the publication of an “alternative exclusion”. Here is the text: “Alternate Eligible Hospital/CAH Exclusion: The eligible hospital or CAH may claim an exclusion for the eRx objective and measure if for an EHR reporting period in 2015 if they were either scheduled to demonstrate Stage 1, which does not have an equivalent measure, or if they are scheduled to demonstrate Stage 2 but did not intend to select the Stage 2 eRx objective for an EHR reporting period in 2015; and, the eligible hospital or CAH may claim an exclusion for the eRx objective and measure for an EHR reporting period in 2016 if they were either scheduled to demonstrate Stage 1 in 2016 or if they are scheduled to demonstrate Stage 2 but did not intend to select the Stage 2 eRx objective for an EHR reporting period in 2016.”
Another issue of interest in the Final Rule is the process by which the EHR Incentive programs, which will sunset and morph in 2019 to the Merit-Based Incentive Payment System (MIPS). A 60 day public comment has been established to address concerns related to transition.
Jim Tate is known as the most experienced authority on the CMS Meaningful Use (MU) audit and appeal process. His unique combination of skills has brought successful outcomes to hospitals at risk of having their CMS EHR incentives recouped. He led the first appeal challenge in the nation for a client hospital that had received a negative audit determination. That appeal was decided in favor of the hospital. He has also been successful in leading the effort to reverse a failed appeal, even after the hospital had received notification of the failure with the statement, “This decision is final and not subject to further appeal”. That “final” decision was reversed in less than a week. If you are a hospital with questions or concerns about the meaningful use audit process, contact him at: email@example.com.