Proposed modifications to EHR Incentive Programs

by Sheppard Mullin Richter & Hampton LLP
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Last year, HHS revised policies and definitions surrounding what constitutes certified EHR technology—required for meaningful use incentive program payment eligibility—from the 2011 Edition criteria to the 2014 Edition criteria. Now, CMS has issued a proposed rule in response to hardships expressed by vendors, hospitals and healthcare providers regarding updating their systems per the new standards within the given time frame.

The rule would allow the ongoing use of the 2011 Edition criteria or a hybrid of the two through the end of 2014.[1] Hospitals and providers that would otherwise be required to move to Stage 2 of the program—to attest to meeting requirements focusing on clinical processes—would be able to remain at Stage 1 for another year. The focus of Stage 1 is capturing and sharing data.

These delays are strictly for hospitals and providers that were unable to fully implement a 2014 Edition criteria compliant system because of delays in the availability of the technology.

CMS  “strongly recommend[s]” that hospitals and providers new to the Incentive Programs and yet to select EHR technology adopt a 2014 Edition certified system. To encourage this, participants in the Medicaid EHR Incentive Program would not be able to obtain an incentive payment for newly adopting, implementing, or upgrading to 2011 Edition technology.

Applicable to participants who joined the Incentive Programs in 2011 or 2012, the rule would also delay the start of Stage 3 of the program until 2017. Stage 3, the final stage of evolution for meaningful use criteria, focuses on improved outcomes such as quality, safety, and efficiency. Requirements for Stage 3 are planned to be finalized in the first half of 2015.

Will these delays suffice? As health information technology and data management is a rapidly transforming sector, how might this experience inform future Edition certification processes in terms of realistic expectations for the development and implementation of new technology standards? The relevance of this question is magnified by the fact that this delay is the second major health information technology delay of the year. In March, Congress intervened to push back, yet again, the ICD-10 compliance deadline from October 2014 to October 2015.

CMS is accepting comments on the proposed rule until July 21, 2014.

[1] The rule is published in the May 23 issue of the Federal Register, available here.

 

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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