CMS issues final rule to specify stage 3 Meaningful Use requirements

The CMS has issued a final rule that clarifies stage 3 requirements of the Meaningful Use incentive program for electronic health record implementation.

The ruling was issued in the wake of calls from the American Academy of Ophthalmology and other medical societies to create a hardship exception for providers affected by delayed rulemaking for Meaningful Use stages 1 and 2 and to delay finalization of the proposed stage 3 rule.

The final rule specifies requirements that eligible professionals, eligible hospitals and critical access hospitals must meet in order to qualify for Medicare and Medicaid EHR incentive payments and avoid a 3% penalty for noncompliance. It also changes the Medicare and Medicaid EHR incentive program reporting period in 2015 to 90 days.

“The final rule ... also removes reporting requirements on measures that have become redundant, duplicative, or topped out from the Medicare and Medicaid EHR incentive programs. In addition, this final rule with comment period establishes the requirements for stage 3 of the program as optional in 2017 and required for all participants beginning in 2018. The final rule with comment period continues to encourage the electronic submission of clinical quality measure data, establishes requirements to transition the program to a single stage, and aligns reporting for providers in the Medicare and Medicaid EHR incentive programs,” the final rule document said.

AAO leadership has mixed feelings about the final rule.

“The final rule provides physicians much of the critical relief that the Academy has been fighting for. However, it’s far from a perfect solution,” Michael X. Repka, MD, MBA, AAO medical director of government affairs, said in a statement from the AAO. “For physicians who have been waiting to begin reporting based on relief in the rule, the rule’s delayed timing makes it impossible to be successful in the program because there are fewer than 90 days left in 2015. The Academy will continue to demand accommodations for these providers.”

According to the AAO statement, the final rule relaxed the requirements for encouraging patients to use online portals. Physicians must have one patient, not 5% of patients, view, download and transmit electronic health information.

The statement said that shortening the reporting period to 90 days “only helps if there are more than 90 days left in the 2015 calendar year, which there are not. The shortened reporting period isn’t permanent. The 90-day period is only for 2015.”

Additionally, the rule did not delay stage 3 reporting requirements, the statement said.

“Across medicine and within Congress, the belief is that the only way to preserve the overall goals of the Meaningful Use program would have been to pause rulemaking for stage 3. No other action can ensure that the Meaningful Use program is aligned with the changes stemming from the Medicare Access and CHIP Reauthorization Act of 2015. A pause was also the only chance to completely understand stages 1 and 2’s impact,” the AAO statement said.

The AAO, American Medical Association and other medical societies will urge CMS to create a hardship exception for eligible professionals affected by delayed rulemaking. The exception would help physicians avoid penalties for the 2015 reporting year, the AAO statement said.

The societies will also urge CMS to extend the 2015 reporting period into the 2016 calendar year.

The final rule can be viewed at

https://s3.amazonaws.com/public-inspection.federalregister.gov/2015-25595.pdf. – by Matt Hasson