CMS Issues Final Rule Providing Flexibility for Providers Unable to Fully Implement 2014 Technology to Demonstrate Meaningful Use in 2014

In response to providers being unable to fully implement 2014 Edition certified electronic health record technology (CEHRT) due to limited availability, CMS adopted changes proposed earlier this year through a final rule allowing additional options for the 2014 reporting period and amending the meaningful use stage timeline. Providers who received 2014 Edition CEHRT in time to attest during this program year must still attest to Stage 1 or Stage 2 based on their original timeline using the 2014 CEHRT in order to receive incentive payments and avoid future payment reductions. But the final rule offers additional flexibility to providers who cannot satisfy Stage 2 or revised Stage 1 requirements in program year 2014 because of delays in the availability of 2014 Edition CEHRT.

The reporting period for 2014 will be a three-month quarter in calendar year 2014 for eligible professionals (EPs) or fiscal year 2014 for eligible hospitals and critical access hospitals (CAHs). EPs, eligible hospitals, and CAHs that are demonstrating meaningful use for the first time in 2014 can use any continuous 90-day period as their 2014 reporting period.

The final rule provides three options for providers that are unable to fully implement 2014 Edition CEHRT for an EHR reporting period in 2014 due to a delay in availability:

1. 2011 Edition CEHRT: Under this option, EPs, eligible hospitals, and CAHs can attest to the Stage 1 objectives, measures, and clinical quality measures (CQMs) that were in effect for 2013, regardless of whether they are scheduled to be in Stage 1 or Stage 2 for 2014. EPs, eligible hospitals, and CAHs who choose this option must attest that they were unable to fully implement 2014 Edition CEHRT because of issues related to 2014 Edition CEHRT availability delays when they attest to meaningful use.
2. Combination of 2011 and 2014 Edition CEHRT: EPs, eligible hospitals, and CAHs scheduled to be in Stage 1 may use a combination of 2011 Edition and 2014 Edition CEHRT to: (1) meet 2013 Stage 1 objectives, measures, and CQMs; or (2) meet 2014 Stage 1 objectives, measures, and CQMs. If scheduled to begin Stage 2, the EPs, eligible hospitals, and CAHs may choose either of the above two options or may attest to Stage 2 objectives and measures and 2014 CQMs. EPs, eligible hospitals, and CAHs who choose this option must attest that they were unable to fully implement 2014 Edition CEHRT because of issues related to 2014 Edition CEHRT availability delays when they attest to meaningful use.
3. 2014 Edition CEHRT: EPs, eligible hospitals, and CAHs scheduled to begin Stage 2 can attest to 2014 Stage 1 objectives, measures, and CQMs or Stage 2 objectives and measures and 2014 CQMs. EPs, eligible hospitals, and CAHs scheduled to begin Stage 2 who choose to attest to 2014 Stage 1 must attest that they were unable to fully implement 2014 Edition CEHRT because of issues related to 2014 Edition CEHRT availability delays when they attest to meaningful use. EPs, eligible hospitals, and CAHs scheduled to meet Stage 1 can attest to 2014 Stage 1objectives, measures, and CQMs.

The final rule also extends Stage 2 for an additional year. For providers that became meaningful users in 2011 or 2012, Stage 3 meaningful use will now begin in calendar year 2017 for EPs and in fiscal year 2017 for eligible hospitals and CAHs. CMS explains that this delay will allow it to analyze data from Stage 2 as it makes policy decisions related to Stage 3.

The final rule did not alter the full-year reporting period for 2015. However, on Sept. 16, 2014, Representatives Renee Ellmers (R-NC) and Jim Matheson (D-UT) introduced H.R. 5481 that, if passed, will require a three-month quarter reporting period for 2015.