CMS Releases Final Rule for Meaningful Use Stage 2 Flexibility > Michigan State Medical Society

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CMS Releases Final Rule for Meaningful Use Stage 2 Flexibility

The Centers for Medicare and Medicaid Services (CMS) has finalized a rule allowing hospitals and eligible professionals more flexibility in how they meet meaningful use requirements for the electronic health record incentive program.

The agency had first proposed the idea in a May draft rule that outlined what this flexibility would mean to physicians. The final rule released this week has left the May proposal unchanged.

In the final rule, physicians unable to adopt 2014 technology because of availability of certified technology have three options. For physicians intending to demonstrate Stage 1 meaningful use in 2014, they can use 2011 technology to show they met 2013 first-stage standards; or can use a combination of 2011 and 2014 technology to meet 2013-14 first-stage standards; or could use 2014 technology to fulfill 2014 first-stage standards. (See chart)

The situation is similar for providers intending to attest to Stage 2 meaningful use in 2014. They may use 2011 technology to show Stage 1 objectives; a combination of 2011 and 2014 technology to meet 2011 or 2013 Stage 1 objectives or 2014 technology to show 2014 Stage 2 objectives; or 2014 technology to fulfill 2014 Stage 1 or Stage 2 objectives. (See chart)

In December 2013, CMS announced it would add a third year to Stage 2 in 2016 and delay the start of Stage 3 to 2017. The final rule officially pushes back the beginning of the third stage of meaningful use for the first cohort of adopters until Jan. 1, 2017, as opposed to the old standard of Jan. 1, 2016.

Stage 2011 Version 2011/2014 Combined 2014 Version
Stage 1 2013 Definition Stage 1 objectives and 2013 CQMs 2013 Definition Stage 1 objectives and 2013 CQMs;
 
- or -
 
2014 Definition Stage 1 objectives and 2014 CQMs
2014 Definition Stage 1 objectives and 2014 CQMs
Stage 2 2013 Definition Stage 1 objectives and 2013 CQMs 2013 Definition Stage 1 objectives and 2013 CQMs;
 
- or -
 
2014 Definition Stage 1 objectives and 2014 CQMs;
 
- or -
 
2014 Definition Stage 2 objectives and 2014 CQMs
2014 Definition Stage 2 objectives and 2014 CQMs;
 
- or -
 
2014 Definition Stage 1 objectives and 2014 CQMs

Most physicians are still wondering where to go from here and what this new rule means for their practices. Guidance from CMS is that “Only providers who could not fully implement 2014 Edition CEHRT for the EHR reporting period in 2014 due to delays in 2014 Edition CEHRT availability.”

Basically, if you have implemented the 2014 version of your EHR and can attest to Stage 2 meaningful use, you better go ahead and do so. There is no guidance about what type of documentation would be required to prove the need for the flexibility if audited yet, but physicians will have to attest that they could not meet Stage 2 EHR requirements.

For everyone else still working on implementation of the 2014 version, the best recommendation is to continue on with your path to achieving Stage 2 criteria and use the flexibility offered for this year to allow you more time to implement your changes properly. These changes are only effective for the 2014 reporting year and you will need to be able to perform Stage 2 objectives in 2015.

For more information and an interactive tool to assist you in determining your 2014 attestation path, visit http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/CEHRT_NPRM_DecisionTool-.pdf.

The Michigan State Medical Society is here to help with MSMS HIT Consulting Services. MSMS consulting is designed to assist physicians in any specialty or practice size to achieve Meaningful Use, and has staff available to assist you. For more information, contact Dara Barrera at 517-336-5770 or djbarrera@msms.org.

 

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