More than 1,300 pages of new regulations released in October outline requirements for the electronic health record (EHR) meaningful use program, with several changes applying this year. The AMA has identified some of the most important changes that will affect physician practices.  The regulations fall under two new rules—one that modifies Stage 2 of the meaningful use program and finalizes requirements for Stage 3, and one that establishes technological parameters for the new edition of certified EHR technology.

On the upside, the first rule eases and streamlines some of the requirements for Stage 2. But the rule simultaneously ignores calls from Congress and physicians to hold off on Stage 3 until the program is reassessed for practicality and alignment with new payment and delivery reforms.  Immediate improvements to Stage 2 include:

• Physicians have a shortened reporting period for 2015 – just 90 consecutive days instead of the full calendar year.
• The overall number of measures physicians must report on has been reduced.
• The threshold for the requirement for patients to view, download or transmit their records has been cut down from 5% of patients to just one patient in 2015 and 2016.
• The threshold for the secure messaging requirement has been scaled back from 5% of patients to simply having the capability to send secure messages in 2015, and doing so with at least one patient in 2016.

While these are positive modifications, CMS didn’t release the final regulations until Oct. 6—several days into the final 90-day period of the year. Equally concerning, the regulations now require a public health and clinical data registry reporting objective that previously was optional.

Fortunately, physicians can apply for a hardship exemption and avoid penalties if they are unable to meet meaningful use requirements this year as a result of the delayed publication of the regulations.  The AMA is encouraging physicians to apply for a hardship exemption under the “extreme and uncontrollable circumstances” category, even if they are uncertain whether they will meet the program requirements this year. Doing so will not preclude physicians from receiving an incentive if they do meet meaningful use requirements this year, but applying can serve as a safety net in staving off a penalty. The exemption application will be available early next year.  “In the past, CMS has considered these applications seriously and, in fact, has approved over 85 percent of hardship exemptions,” the agency said in a recent FAQ.

CMS made relatively few changes in the final Stage 3 regulation from what was proposed. Overall, publishing the final Stage 3 rule signals to vendors that these are the requirements for the program, and they may begin developing systems to meet these standards. Under the rule, all physicians will be required to meet Stage 3 requirements beginning in 2018. The finalized rule as currently written would be very burdensome for physicians, to put it mildly. Among the many mandates will be upgrading to EHR products that meet the new certification requirements. Read a summary (log in) of the main requirements for Stage 3 outlined in the new regulations.

From October 21 AMA Wire post

For More Information:

Final Rule: EHR Incentive Program — Stage 3 and Modifications to Meaningful Use in 2015 through 2017

Final Rule: 2015 Edition Health IT Certification Criteria, 2015 Edition Base EHR Definition, and ONC Health IT Certification Program Modifications

Fact Sheet: EHR Incentive Program and Health IT Certification Program Final Rule

Fact Sheet: EHR Incentive Programs in 2015 and Beyond

Fact Sheet: 2015 Edition Health IT Certification Criteria, 2015 Edition Base EHR Definition, and ONC Health IT Certification Program Modifications Final Rule