cms-has-released-the-final-rules-for-stage-3-meaningful-use

CMS Has Released The Final Rules for Stage 3 Meaningful Use

On October 6, 2015, after much anticipation, CMS released the final rules for the Stage 3 Meaningful Use incentive program and the corresponding certification requirements for EHR vendors. The final rules for 2015 Edition Health IT Certification Criteria (2015 Edition) and final rules with comment period for the Medicare and Medicaid Electronic Health Records (EHRs) Incentive Programs will help continue to move the health care industry from a paper-based system, where a doctor’s hand-writing had to be interpreted and patient files could be misplaced.

Sculpting the ‘Final’ Rules

CMS heard from numerous physicians about the challenges and burdens they face making electronic health records work well for their practices and their patients. In recognition of these concerns, the final rules for stage 3 are reported to ‘make significant changes to current requirements by easing the reporting burden for providers, supporting interoperability, and improving patient outcomes.’ Additionally, the stage 3 ‘final’ rules were sculpted to enable the development of user-friendly technology, allowing individuals easier access to their information so they can be engaged and empowered in their care.

In addition to the ‘final’ rules, CMS is also encouraging providers to apply for exemptions if they had difficulty with, or need to switch, their EHR vendor. This exemption also applies to those who have experienced challenges due to the timing of the rules and EHR implementation.

An Overview of the Rules

After receiving some 2,500 comments from industry stakeholders on the two proposed rules, CMS made some big changes to the regulations:

  • Give providers and state Medicaid agencies 27 months, until Jan. 1, 2018, to comply with the new requirements and prepare for the next set of system improvements.
  • Give developers more time to create the next advancements in technology that CMS says will be easier to use and more appropriate to new models of care and access to data by consumers.
  • Support provider exchange of health information and interoperable infrastructure for data exchange between providers and with patients.
  • Give developers additional time to create the next advancements in technology that will be easier to use and more appropriate to new models of care and access to data by consumers.
  • Address health information blocking and interoperability between providers.

Stage 3 major provisions

The Stage 3 rules are optional for providers beginning in 2017, but become mandatory in 2018. All providers who opt to start Stage 3 that year will have a 90-day reporting period. Come 2018, all providers must comply with Stage 3 regulations using a certified EHR.

According to a CMS fact sheet detailing the final rules, major provisions pertaining to Stage 3 meaningful use include:

  • 8 objectives for eligible docs, eligible hospitals and CAHs: In Stage 3, more than 60 percent of the proposed measures require interoperability, up from 33 percent in Stage 2.
  • Public health reporting with flexible options for measure selection.
  • CQM reporting aligned with the CMS quality reporting programs.
  • Finalize the use of application program interfaces that enable the development of new functionalities to build bridges across systems.

Additionally, for the EHR Incentive Programs in 2015 through 2017, major provisions include:

  • 10 objectives for eligible professionals including one public health reporting objective, down from 18 total objectives in prior stages.
  • 9 objectives for eligible hospitals and critical access hospitals including one public health reporting objective, down from 20 total objectives in prior stages.
  • Clinical Quality Measures (CQM) reporting for both EPs and eligible hospitals/CAHs remains as previously finalized.

For Stage 3 of the EHR Incentive Programs in 2017 and subsequent years, major provisions include:

  • 8 objectives for eligible professionals, eligible hospitals, and CAHs: In Stage 3, more than 60 percent of the proposed measures require interoperability, up from 33 percent in Stage 2.
  • Public health reporting with flexible options for measure selection.
  • CQM reporting aligned with the CMS quality reporting programs.
  • Finalize the use of application program interfaces (APIs) that enable the development of new functionalities to build bridges across systems and provide increased data access. This will help patients have unprecedented access to their own health records, empowering individuals to make key health decisions.

Uncertainty Lies Ahead

With less than 1 in 5 providers meeting the requirements for Stage 2, many in the healthcare industry have called for a delay, asking for time to catch up and reevaluate the goals of the program.

“The whole purpose of this program is to benefit patients, so that they and their health care providers have quicker and better access to their health histories and their doctors and hospitals and pharmacists can provide them with better care,” said Republican Tennessee Senator Lamar Alexander speaking at his Senate HELP Committee’s sixth hearing on electronic health records in recent months. “There is no reason not to take time to do it right.”

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