CMS Releases Proposed Rules Allowing Meaningful Use CEHRT Flexibility and Extending Stage 2

CMS recently issued proposed rules that would modify 2014 EHR certification requirements and revise the meaningful use Stage 2 and Stage 3 timeline.

In response to industry complaints that many eligible professionals and hospitals will not be able to implement 2014 certified EHR technology (“CEHRT”) in time to meet meaningful use in 2014, CMS proposes to revise 2014 meaningful use reporting requirements. The proposed rules grant flexibility to providers who are experiencing difficulties obtaining or fully implementing 2014 Edition CEHRT to attest this year using EHRs that have been certified under the 2011 Edition, the 2014 Edition, or a combination of both. Beginning in 2015, all eligible professionals and hospitals would be required to report using 2014 Edition CEHRT.

The revised reporting options are only available to eligible professionals and hospitals that cannot fully implement 2014 CEHRT for the reporting year due to availability and timing of EHR installation, deployment of new processes and workflows, employee training or other unforeseen implementation delays. “Increasing the adoption of EHRs is key to improving the nation’s health care system and the steps we are taking today will give new options to those who, through no fault of their own, have been unable to get the new 2014 Edition technology, including those at high risk, such as smaller providers and rural hospitals,” National Coordinator Karen DeSalvo, M.D., MP.H., M.Sc., said in a public statement.

2014 participation options
Under the proposal, valid only for the 2014 reporting year, providers could use 2011 Edition CEHRT for either Stage 1 or Stage 2, and would have the option to attest to the 2013 definition of meaningful use core and menu objectives, and use the 2013 definition of clinical quality measures.

Providers currently working on Stage 1 in 2014 who have been unable to fully implement 2014 Edition due to delays in 2014 CEHRT availability would be able to demonstrate:

• Stage 1 (2013 Definition) using 2011 Edition CEHRT, or using a combination of 2011 and 2014 Edition CEHRT; or
• Stage 1 (2014 Definition) using 2014 Edition CEHRT.

Providers currently working on Stage 2 in 2014 who have been unable to fully implement 2014 Edition due to delays in 2014 CEHRT availability would be able to demonstrate:

• Stage 1 (2013 Definition) using 2011 Edition CEHRT, or using a combination of 2011 and 2014 Edition CEHRT;
• Stage 1 (2014 Definition) using 2014 Edition CEHRT; or
• Stage 2 (2014 Definition) using 2014 Edition CEHRT.

Meaningful use timeline extension
The proposed rule also includes a provision to extend Stage 2 an additional year through 2016 and delay Stage 3 until 2017 for those providers that have completed at least two years in Stage 2. This Stage 3 delay is no surprise considering CMS has not yet announced criteria for Stage 3 and is waiting for the results from Stage 2 to inform its development of the criteria for Stage 3 meaningful use. As proposed, Stage 3 will begin on Jan. 1, 2017 for EPs and Oct. 1, 2016 for hospitals and CAHs.

ONC modifications
To support the CMS revisions, ONC has made modifications to its CEHRT definition to reflect the proposed new required start dates. ONC’s proposed revisions would move the required start dates for the 2014 Edition of CEHRT to Oct. 1, 2014 for hospitals and Jan. 1, 2015 for eligible professionals.

Public comments
The proposed rule solicits public comments, which may be submitted electronically or by regular mail. The deadline for public comment is 5 p.m. on July 21, 2014.