CMS Released Final Rule with Modifications to the 2014 EHR Incentive Program

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On Friday, Aug. 29, CMS issued the Modifications to the Medicare and Medicaid Electronic Health Record (EHR) Program final rule, following CMS' notice of proposed rulemaking (NPRM) issued on May 20.
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Their new rule creates flexible certified electronic health record technology (CEHRT) options for providers unable to fully implement the 2014 edition CEHRT to demonstrate meaningful use (MU) for the 2014 reporting period.

Select highlights from the rule include:

Flexibility in Meeting CEHRT Editions and MU Requirements: The final rule allows eligible professionals (EPs), eligible hospitals (EHs) and critical access hospitals (CAHs) to demonstrate MU in 2014 using 2011, 2014, or a combination of 2011 and 2014 Edition CEHRT. This is a significant change from the Stage 2 EHR Incentive Program Final Rule that required all providers to demonstrate MU using the 2014 Edition CEHRT in 2014 and beyond. This change applies to providers participating in Stages 1 or 2 of the Medicare and Medicaid EHR Incentive Programs.

Stage 3 Delayed Until 2017: CMS will extend Stage 2 for providers that began demonstrating MU in 2011 or 2012 by one-year-Stage 3 for these providers will now begin in 2017, instead of 2016.

Exemption for the Stage 2 Summary of Care Objective: CMS will allow providers that are unable to meet the Stage 2 summary of care objective due to a shortage of receiving providers using the 2014 Edition CEHRT, to attest to the 2014 Stage 1 objectives and measures for the 2014 reporting period.

Finalized Clinical Quality Measure (CQM) Reporting Requirements in 2014: CMS finalized three options for reporting CQMs to map to the three CEHRT edition options finalized in this rule.

The flexibility in CEHRT options for demonstrating MU in 2014 underscores CMS’ acknowledgment of industry-wide concerns surrounding the inadequate time for implementing the 2014 Edition CEHRT; however, the flexibility provided will be short-lived. Unfortunately, CMS delayed addressing industry concerns until May, after reviewing data from March 2014 that showed that only 4 EHs and 50 EPs had successfully demonstrated Stage 2 of MU using the 2014 Edition. As such, the timing of this final rule only provides a brief period of flexibility.

In addition, the flexibility only benefits providers that were unable to fully implement a 2014 Edition CEHRT, and offers no relief to providers struggling to meet more complex Stage 2 requirements. This flexibility does, however, allow vendors a little more time to get their customers onto the 2014 edition CEHRT. This final rule would make the first day of FY 2015 ( October 1, 2014 for EHs and CAHs) and CY 2015 (January 1, 2015 for EPs) the new required start date for exclusive use of 2014 Edition certified Complete EHRs and EHR Modules to meet the CEHRT definition. Further, providers must attest to MU using the 2014 Edition CEHRT for the entire reporting year in 2015, unless they are attesting to MU for the first time in 2015.

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