HHS Proposed Rule on Meaningful Use for 2014

In response to provider and vendor concerns about the ability to certify to the 2014 Electronic Health Record (EHR) standards to qualify for incentive payments under the meaningful use program, the Department of Health and Human Services (HHS) issued a  proposed rule on May 20, 2014, revising the requirements for meeting meaningful use in 2014.

The proposed rule, in an effort to “grant more flexibility” to providers, who due to the lack of availability of 2014 Edition Certified Electronic Health Record Technology (CEHRT) products cannot fully implement 2014 Edition CEHRT,  proposed to:

“allow these EPs [eligible professionals], eligible hospitals, and CAHs that could not fully implement 2014 Edition CEHRT for the 2014 reporting year due to delays in  2014 Edition CEHRT availability to continue to use 2011 Edition CEHRT or a combination of 2011 Edition and 2014 Edition CEHRT for the EHR reporting periods in CY 2014 and FY 2014, respectively.”

The proposed rule provided a number of alternatives to providers depending on whether the provider used 2011 Edition CEHRT, 2014 Edition CEHRT or a combination of the two.  For each alternative, the provider will be required to attest that provider was unable to fully implement the 2014 CEHRT because of issues related to delays in the availability of 2014 Edition CEHRT.

For providers who continue to use the 2011 CEHRT, the proposed rule allows those providers to meet the Stage 1 goals and objectives pursuant to 42 C.F.R.  495.6 that were applicable for the 2013 payment year.   Providers using a combination of the 2011 and 2014 CEHRT can choose to meet the 2013 Stage 1 objectives and measures, the 2014 Stage 1 objectives and measures, or the Stage 2 objectives and measures.

Providers scheduled to begin Stage 2 in 2014 who cannot fully implement the functions of the 2014 Edition CEHRT required for 2014 Stage 2 can choose: (1) to use the 2014 Edition CEHRT or a combination of 2014 and 2011 Edition CEHRT to attest to the 2014 Stage 1 objectives and measures; (2) use a combination of the 2011 and 2014 Edition CEHRT to attest to Stage 2;  or (3) attest to 2013 Stage 1 objectives and measures using 2011 Edition CEHRT or a combination of 2011 and 2014 Edition CEHRT.

The rule also proposed changes to reporting on clinical quality measures (CQM) for 2014 because the method for reporting CQUM is dependent on the edition of CEHRT used.  The rule also noted that in 2015, all providers are required to have 2014 Edition CEHRT in order to successfully demonstrate meaningful use.

The rule also proposed an extension to Stage 2, with Stage 3 to begin CY 2017 for EPs and FY 2017 for eligible hospitals and CAHs that first became meaningful users in 2011 or 2012.

 

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