CMS rule to help providers make use of Certified EHR Technology

Rule also proposes to extend Stage 2 of the EHR Incentive Programs through 2016

Today, HHS published a new proposed rule that would provide eligible professionals, eligible hospitals, and critical access hospitals more flexibility in how they use certified electronic health record (EHR) technology (CEHRT) to meet meaningful use. The proposed rule, from the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC), would let providers use the 2011 Edition CEHRT or a combination of 2011 and 2014 Edition CEHRT for the EHR reporting period in 2014 for the Medicare and Medicaid EHR Incentive Programs.

Beginning in 2015, all eligible hospitals and professionals would still be required to report using 2014 Edition CEHRT. Since the Medicare and Medicaid EHR Incentive Programs began in 2011, more than 370,000 hospitals and professionals nationwide have received an incentive payment.

“We have seen tremendous participation in the EHR Incentive Programs since they began,” said CMS Administrator Marilyn Tavenner. “By extending Stage 2, we are being receptive to stakeholder feedback to ensure providers can continue to meet meaningful use and keep momentum moving forward.”

The proposed rule also includes a provision that would formalize CMS and ONC’s previously stated intention to extend Stage 2 through 2016 and begin Stage 3 in 2017. These proposed changes would address concerns raised by stakeholders and will encourage the continued adoption of Certified EHR Technology.

“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,” said Karen DeSalvo, M.D., M.P.H, M.Sc., national coordinator for health information technology.

Proposed changes to meaningful use timeline

First Payment Year	Stage of Meaningful Use
	2011	2012	2013	2014	2015	2016	2017	2018	2019	2020	2021
2011	1	1	1	2	2	3 -> 2	3	TBD	TBD	TBD	TBD
2012		1	1	2	2	3 -> 2	3	TBD	TBD	TBD	TBD
2013			1	1	2	2	3	3	TBD	TBD	TBD
2014				1	1	2	2	3	3	TBD	TBD
2015					1	1	2	2	3	3	TBD
2016						1	1	2	2	3	3
2017							1	1	2	2	3
						Current Stage 2 Start Date
							Proposed Stage 3 Start Date

	You would be able to attest for MU:
If you were scheduled to demonstrate:	Using 2011 Edition CEHRT to do:	Using 2011 & 2014 Edition CEHRT to do:	Using 2014 Edition CEHRT to do:
Stage 1 in 2014	2013 Stage 1 objectives and measures	2013 Stage 1 objectives and measures -or- 2014 Stage 1 objectives and measures	2014 Stage 1 objectives and measures
Stage 2 in 2014	2013 Stage 1 objectives and measures	2013 Stage 1 objectives and measures -OR- 2014 Stage 1 objectives and measures -OR- Stage 2 objectives and measures	2014 Stage 1 objectives and measures -OR- Stage 2 objectives and measures

Changes at Health IT Policy Committee and FDASIA Update

There were some changes announced in the membership of the Health IT Policy Committee (HITPC) at the May 5, 2014 meeting. Three departing members who have been with the HITPC from the beginning are:

• Neil Calman, M.D., CEO of the Institute for Family Health, one of the largest networks of community health centers in New York State;
• Judy Faulkner, CEO of Epic Systems;
• Art Davidson, M.D., director of Public Health Informatics for Denver Public Health

The three new members replacing them are:

• Christoph U. Lehmann, M.D., the founding medical director of the American Academy of Pediatrics Child Health Informatics Center and a professor in Pediatrics and Biomedical Informatics at the Monroe Carell Jr. Children’s Hospital at Vanderbilt University in Tennessee, as an expert on vulnerable populations;
• Neal Patterson, co-founder, chairman and CEO of Cerner Corp. as a vendor representative;
• Kim J. Schofield, health educator and advocacy chair for the Lupus Foundation of America’s Georgia Chapter, representing consumers and patients.

Notable is the departure of the Epic CEO, Judy Faulkner, being replaced by the Cerner CEO, Neal Patterson as a vendor representative. They also received an update from the FDASIA workgroup.

HIT Policy Committee FDASIA Update

Next weeks very important Proposed Risk-Based Regulatory Framework and Strategy for Health IT Workshop convened by the FDA should provide even greater clarity into the development of the Health IT Safety Center and important development of potential regulations for software which falls into the Health Management Functionality category.

Karen DeSalvo also announced during the meeting that new workgroups are being formed. The ONC is Congressionally mandated to update its Health IT strategic plan, and will be adjusting its organizational structure and creating new workgroups to align with overall goals and available resources. The categories for new workgroups are being formed along:

• Health IT Strategic Planning
• Advanced Health Models and Meaningful Use
• Interoperability & Health Information Exchange (HIE)
• Health IT Implementation, Usability and Safety
• Privacy and Security
• Consumer

The HIT Strategic Planning and Interoperability & HIE Workgroups will begin forming first, followed by the Advanced Health Models and Meaningful Use and Health IT Implementation, Usability and Safety Workgroups later this year. For now the activities of the Privacy/Security and Consumer groups will continue as planned.