On October 6, 2015, CMS released the final Stage 3 Meaningful Use Rule that, among other provisions, sets forth the requirements that eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) must satisfy to qualify for Medicare and Medicaid incentive payments and avoid payment cuts under the Medicare Electronic Health Record (EHR) Incentive Program. The Stage 3 criteria are optional for providers beginning in CY 2017 and become mandatory in CY 2018. The same day, the HHS Office of the National Coordinator for Health Information Technology (ONC) released a final rule (ONC Final Rule) that makes changes to the ONC Health IT Certification Program, releases the new 2015 edition of health IT certification criteria (2015 Edition), and finalizes a new Base EHR definition specific to the 2015 Edition. Both final rules are scheduled to be published in the Federal Register on October 16, 2015. The Stage 3 Final Rule is effective 60 days after publication in the Federal Register, and, with the exception of certain provisions that are effective on April 1, 2016, the ONC Final Rule is effective 90 days after Federal Register publication.
The Stage 3 Final Rule finalizes provisions in the proposed rule issued on March 30, 2015 regarding Stage 3 of the of the EHR Incentive Program, as well as a subsequent proposed rule issued on April 9, 2015. CMS states that it intends Stage 3 Final Rule to ease the reporting burdens on providers. To that end, CMS decreases the number of reporting objectives for EPs, eligible hospitals, and CAHs, modifies the objectives and measures of the EHR Incentive Programs in 2015 through 2017 to align with Stage 3, and adopts flexible reporting periods beginning in 2015.
Specifically, CMS will move all providers to a calendar-year EHR reporting period. For CY 2015, EPs may choose any continuous 90-day period from January 1, 2015, through December 31, 2015, and eligible hospitals and CAHs may choose any continuous 90-day period from October 1, 2014, through December 31, 2015. For CY 2016, CMS finalized a 90-day reporting period for all EPs, eligible hospitals and CAHs that have not demonstrated Meaningful Use prior to CY 2016 and the entire CY 2016 for those who already successfully demonstrated meaningful use in a prior year. Finally, for CY 2017 and 2018, with the exception of a 90-day EHR reporting period for a provider’s first payment year based on Meaningful Use for EPs and eligible hospitals in the Medicaid EHR Incentive Program and a few other exceptions, CMS finalized a reporting period of the entire calendar year.
The CMS Final Rule also announces a 60-day comment period requesting comments on the phasing out of the EHR Incentive Programs and the transition to the Merit-Based Incentive Payment System (MIPS) for physicians. CMS expects to issue a proposed rule regarding MIPS in the spring of 2016. The CMS Final Rule is available here.
According to ONC, the ONC Final Rule responds to comments received on the proposed rule by attempting to reduce the burden on providers and health IT developers. The ONC Final Rule modifies several existing 2014 Edition certification criteria and adopts several new certification criteria, such as new Application Access, Common Clinical Data Set Summary Record, Data Segmentation for Privacy, and Care Plan certification criteria. In addition to adopting a new Base EHR definition, and modifies the definition of “Common MU Data Set” and changes the name to “Common Clinical Data Set.” Finally, the ONC Final Rule also makes several changes the ONC HIT Certification Program (renamed the ONC Health IT Certification Program). The ONC Final Rule is available here.